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A hospital nurse is concerned about the demands of providing safe care to clients who are seriously ill. The nurse manager should suggest which intervention to effectively help the nurse balance the demanding work in the hospital setting?
- A. Delegate more tasks to the unlicensed nursing personnel on the unit.
- B. Request a transfer to another nursing care unit with patients who are stable.
- C. Write down stories in a journal about how caring makes a difference for patients.
- D. Use an assertive communication style for every patient3nurse interaction.
Correct Answer: B
Rationale: The correct answer is B: Request a transfer to another nursing care unit with patients who are stable.
Rationale:
1. By transferring to a unit with stable patients, the nurse can reduce the demands of caring for seriously ill clients.
2. This intervention helps in balancing the workload and provides a less stressful environment for the nurse.
3. It allows the nurse to focus on providing safe care without being overwhelmed by the demands of seriously ill patients.
Incorrect choices:
A: Delegating more tasks to unlicensed nursing personnel may not address the root cause of the nurse's concern and could potentially compromise patient safety.
C: Writing stories in a journal may be a helpful coping mechanism but does not directly address the nurse's workload concerns.
D: Using an assertive communication style is important but may not be the most effective solution for balancing the demands of caring for seriously ill clients.
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The nurse provides care for a male patient. When the nurse addresses the patient, which would be most appropriate?
- A. Use both first and last name with each encounter.
- B. Ask the patient how he prefers to be addressed.
- C. Call the patient by his first name.
- D. Address the patient by his last name.
Correct Answer: B
Rationale: The correct answer is B: Ask the patient how he prefers to be addressed. This approach respects the patient's autonomy and personal preferences, promoting patient-centered care. By asking the patient directly, the nurse acknowledges the patient's individuality and ensures respectful communication.
A: Using both first and last name with each encounter may come across as too formal or impersonal for some patients, potentially creating a barrier in the nurse-patient relationship.
C: Calling the patient by his first name without consent may be perceived as too familiar or disrespectful by some patients, leading to discomfort or a lack of trust in the nurse.
D: Addressing the patient by his last name may be too formal for some patients and can create a sense of distance or hierarchy in the nurse-patient relationship.
In the early postoperative period, what is the priority concern for Mr. L, who has a tracheostomy and partial laryngectomy?
- A. Possible infection related to chemotherapy and surgical procedure
- B. Poor nutritional intake related to dysphagia and malignancy
- C. Difficulty communicating needs because of the tracheostomy tube
- D. High risk for aspiration because of secretions and removal of epiglottis
Correct Answer: D
Rationale: The correct answer is D: High risk for aspiration because of secretions and removal of epiglottis. This is the priority concern for Mr. L due to the risk of food or liquid entering the airway, leading to aspiration pneumonia and respiratory distress. The tracheostomy and partial laryngectomy compromise the airway protection mechanism, increasing the risk of aspiration. Options A and B are not the priority as infection and poor nutrition can be managed after addressing the risk of aspiration. Option C, while important for communication, is not as immediately life-threatening as the risk of aspiration.
The nurse manager asks the staff nurse to work an extra shift. Which response by the staff nurse is assertive and based on rational beliefs?
- A. "I don't want you upset, so I will work extra."
- B. "Why do I always have to cover extra shifts?"
- C. "I am not able to work an extra shift."
- D. "If you can't find anyone else, I will do it."
Correct Answer: C
Rationale: The correct answer is C because it directly and assertively communicates the staff nurse's inability to work an extra shift. This response sets clear boundaries and respects the nurse's own limitations and well-being. It is based on rational beliefs as it acknowledges personal capacity without guilt or unnecessary explanations.
Explanation of other choices:
A: This choice is not assertive as it prioritizes avoiding upsetting the nurse manager over the nurse's own needs and boundaries.
B: This response is confrontational and does not address the request directly, focusing instead on questioning past occurrences.
D: While this response offers to work the extra shift as a last resort, it does not assert the nurse's own limitations clearly, leaving room for potential guilt or manipulation.
The nurse tells a patient, "For the last 2 days we have talked about whether to notify your daughter of your upcoming surgery in 2 days. You have indicated you do not want to be a burden to her, but you also would like to have her here. You may have to decide rather quickly because of the time constraint." The nurse is using the technique of:
- A. focusing.
- B. reflection.
- C. restatement.
- D. summarizing. Summarizing presents the problem and possible solutions with the attendant difficulties. This technique "unclutters" the problem and presents it back to the patient for his or her choice of a solution.
Correct Answer: D
Rationale: The correct answer is D: summarizing. Summarizing involves presenting the problem and potential solutions to the patient in a clear and concise manner. In this scenario, the nurse is summarizing the patient's thoughts and concerns about notifying their daughter of the upcoming surgery. By doing so, the nurse is helping the patient to make a decision by clarifying the situation and potential options. This technique allows the patient to reflect on the information presented and make an informed choice.
A: Focusing involves directing the conversation to a specific topic or issue.
B: Reflection involves restating the patient's feelings or thoughts to show understanding.
C: Restatement involves repeating the patient's words to confirm understanding.
Therefore, the correct answer is D because summarizing is the technique being used in this scenario to help the patient make a decision regarding notifying their daughter about the upcoming surgery.
The nurse cares for a client with hypertension, and a nurse–client contract is developed outlining the activities and responsibilities of each. Which would be appropriate to include in this contract? (Select all that apply)
- A. The outcomes should be realistic and measurable.
- B. Progress should be reviewed at regular intervals.
- C. The contract should be written and signed.
- D. The nurse should keep the information confidential.
Correct Answer: A
Rationale: The correct answer is A: The outcomes should be realistic and measurable. This is appropriate to include in the nurse-client contract because setting realistic and measurable outcomes helps in monitoring progress and evaluating the effectiveness of interventions in managing hypertension. It allows for clear communication between the nurse and the client regarding the goals of treatment.
Incorrect choices:
B: Progress should be reviewed at regular intervals - While this is important in the management of hypertension, it is a process rather than a specific component of a contract.
C: The contract should be written and signed - This is important for legal purposes but not specifically related to setting goals and outcomes.
D: The nurse should keep the information confidential - This is a standard ethical practice but not a specific component of a contract outlining activities and responsibilities.