Nokea
A nurse interacts with a newly hospitalized patient. Which nursing statement reflects the communication technique of 'offering self'?
- A. I've also had traumatic life experiences. Maybe it would help if I told you about them.
- B. Why do you think you had so much difficulty adjusting to this change in your life?
- C. I hope you will feel better after getting accustomed to how this unit operates.
- D. I'd like to sit with you for a while to help you get comfortable talking to me.
Correct Answer: D
Rationale: Offering self' is a technique that should be used in the orientation phase of the nurse-patient relationship. Sitting with the patient, an example of 'offering self,' helps build trust and conveys that the nurse cares about the patient. Two incorrect responses are ineffective and nontherapeutic. The other incorrect response is therapeutic but an example of 'offering hope.'
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While talking with a patient diagnosed with major depressive disorder, a nurse notices the patient is unable to maintain eye contact. The patient's chin lowers to the chest while the patient looks at the floor. Which aspect of communication has the nurse assessed?
- A. Nonverbal communication
- B. A message filter
- C. A cultural barrier
- D. Social skills
Correct Answer: A
Rationale: Eye contact and body movements are considered nonverbal communication. Insufficient data are available to determine the level of the patient's social skills or whether a cultural barrier exists.
When a female Mexican-American patient and a female nurse sit together, the patient often holds the nurse's hand. The patient also links arms with the nurse when they walk. The nurse is uncomfortable with this behavior and thinks the patient is misunderstanding the nurse-patient relationship. Which alternative is a more accurate assessment?
- A. The patient is accustomed to touch during conversations, as are members of many Hispanic subcultures.
- B. The patient understands that touch makes the nurse uncomfortable and controls the relationship based on that factor.
- C. The patient is afraid of being alone. When touching the nurse, the patient is reassured and comforted.
- D. The nurse is quick to make assumptions.
Correct Answer: A
Rationale: The most likely answer is that the patient's behavior is culturally influenced. Hispanic women frequently touch women they consider to be their friends. Although the other options are possible, they are less likely.
A Filipino-American patient avoided eye contact when interacting with the nurse. The nurse concluded that the patient had low self-esteem. Interventions were used to raise the patient's self-esteem; however, after 3 weeks, the patient's eye contact did not improve. What is the most accurate analysis of this scenario?
- A. The patient's eye contact should have been directly addressed by role-playing to increase comfort with eye contact.
- B. The nurse should not have independently embarked on treatment planning for this patient.
- C. The patient's poor eye contact is indicative of anger and hostility that remain unaddressed.
- D. The nurse should have assessed the patient's culture before concluding the patient had low self-esteem.
Correct Answer: D
Rationale: The amount of eye contact in which a person engages is often culturally determined. In some cultures, eye contact is considered insolent, whereas in other cultures, eye contact is expected. Asian Americans, including persons from the Philippines, often prefer not to engage in direct eye contact.
A Puerto Rican-American patient uses dramatic body language when describing emotional discomfort. Which analysis most likely explains the patient's behavior?
- A. A histrionic personality disorder is likely.
- B. A belief that dramatic body language is sexually appealing.
- C. Wishes to impress staff with the degree of emotional pain.
- D. Belongs to a culture in which dramatic body language is the norm.
Correct Answer: D
Rationale: Members of Hispanic-American subcultures tend to use high affect and dramatic body language as they communicate. The other options are more remote possibilities.
An African-American patient says to a Caucasian nurse, 'There's no sense talking. You wouldn't understand because you live in a white world.' What would be the nurse's best action?
- A. Explain, 'Yes, I do understand. Everyone goes through the same experiences.'
- B. Say, 'Please give an example of something you think I wouldn't understand.'
- C. Reassure the patient that nurses interact with people from all cultures.
- D. Change the subject to one that is less emotionally disturbing.
Correct Answer: B
Rationale: Having the patient speak in specifics rather than globally helps the nurse understand the patient's perspective. This approach helps the nurse engage the patient.