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A nurse manager offers a staff nurse a choice between working 8- or 12-hour shifts. Which statement, if made by the staff nurse, is nonassertive and may result in a frustrated response from the nurse manager?
- A. "I want to decide the shifts for all of the other staff nurses."
- B. "Do whatever you want. It doesn't really matter to me."
- C. "Thank you for offering me a choice. I prefer 12-hour shifts."
- D. "You will never be able to give me what I really want to work."
Correct Answer: A
Rationale: The correct answer is A because it shows an attempt to control others' decisions, which is nonassertive and inappropriate in a professional setting. Assertiveness involves expressing one's own needs and preferences while respecting others' choices. Option A implies a desire for power over others' schedules, leading to potential conflict and frustration. In contrast, options B and D show indifference and negativity, respectively, without clearly stating preferences. Option C is assertive and appreciative of the choice offered, clearly stating a preference for 12-hour shifts without imposing on others.
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The primary care provider informs the student nurse that he would like to give a telephone order. The best response by the student is:
- A. document the telephone order on the primary care provider's orders.
- B. ask another student to listen as a witness to the telephone order.
- C. tape record the primary care provider giving the order to the student nurse.
- D. ask the registered nurse to take the telephone order.
Correct Answer: D
Rationale: The correct answer is D because asking the registered nurse to take the telephone order ensures accuracy and accountability. The registered nurse is trained to accurately transcribe orders and can verify the details with the primary care provider if needed. This also follows the chain of command and delegation principles in healthcare.
Choice A is incorrect because the student nurse should not document the order directly without proper verification. Choice B is incorrect as having another student as a witness does not guarantee accuracy or proper documentation. Choice C is incorrect as recording the order could violate patient privacy laws and does not involve a healthcare professional in the transcription process.
The nurse chooses to use touch in the nurse-patient relationship because touch:
- A. can convey caring and support when words are difficult.
- B. should be avoided because of problems of cultural misinterpretation.
- C. is appropriate only in special circumstances, such as with young children.
- D. is a nursing intervention of choice in almost all situations.
Correct Answer: A
Rationale: The correct answer is A because touch can convey caring and support when words are difficult, enhancing the nurse-patient relationship. This is supported by research showing the positive impact of touch in providing comfort and building trust. Choice B is incorrect as cultural differences can be addressed through communication and understanding. Choice C is incorrect because touch can be appropriate in various situations beyond just young children. Choice D is incorrect as touch should be used judiciously based on individual preferences and boundaries.
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: "I am not able to work an extra shift." This response is assertive because it clearly communicates the staff nurse's inability to work the extra shift without making excuses or apologizing. It sets a boundary based on the staff nurse's current capacity and respects their own needs.
Choice A is incorrect because it prioritizes the nurse manager's feelings over the staff nurse's own needs. Choice B is incorrect as it is confrontational and does not provide a clear reason for not being able to work the extra shift. Choice D is incorrect because it implies a willingness to work based on the unavailability of others, rather than the staff nurse's own limitations.
The nurse is caring for a patient who states, "I tossed and turned last night." The nurse responds to the patient, "You feel like you were awake all night?" This is an example of:
- A. open-ended question.
- B. restatement.
- C. reflection.
- D. offering self. Restatement is a
Correct Answer: B
Rationale: The correct answer is B: restatement. Restatement involves repeating the patient's words to confirm understanding. In this scenario, the nurse echoed the patient's statement to show empathy and acknowledge the patient's feelings. This technique helps build rapport and fosters therapeutic communication.
Explanation of why other choices are incorrect:
A: Open-ended question: This involves encouraging the patient to elaborate on their feelings or experiences, not just repeating what the patient said.
C: Reflection: This involves restating the patient's feelings to show understanding, not simply repeating their words.
D: Offering self: This involves offering oneself to the patient for support, which was not demonstrated in the scenario.
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 because it respects the patient's autonomy and preferences. By asking how the patient prefers to be addressed, the nurse demonstrates respect for the patient's individuality and dignity. This approach promotes a patient-centered care environment.
A: Using both first and last names with each encounter may come off as overly formal and impersonal.
C: Calling the patient by his first name without consent may be perceived as disrespectful and too informal.
D: Addressing the patient by his last name may be too formal and distant, not fostering a therapeutic nurse-patient relationship.