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A nurse preceptor is assigned to help several graduate nurses assess their ability to convey warmth to patients. Which activity, if selected by the nurse preceptor, is best?
- A. Set up sessions for the graduate nurses to practice various nonverbal gestures.
- B. Ask the graduate nurses to record the behaviors of experienced nurses on the unit.
- C. Provide the graduate nurses with a list of nonverbal behaviors that convey warmth.
- D. Have the graduate nurses evaluate each other during simulated patient interviews.
Correct Answer: A
Rationale: The correct answer is A because setting up sessions for the graduate nurses to practice various nonverbal gestures allows for active skill development. By practicing these gestures, they can receive immediate feedback from the preceptor and improve their ability to convey warmth effectively.
Choice B is incorrect because simply observing behaviors of experienced nurses may not actively engage the graduate nurses in practicing and developing their own skills.
Choice C is incorrect because providing a list of nonverbal behaviors may not be as effective as hands-on practice in improving the graduate nurses' ability to convey warmth.
Choice D is incorrect because having the graduate nurses evaluate each other during simulated interviews may not provide structured guidance and feedback from the preceptor to help them improve their nonverbal communication skills effectively.
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The nurse observes a nursing assistant interacting with an elderly patient. Which statement by the nursing assistant requires an immediate intervention by the nurse?
- A. "I will help you remember where your room is located."
- B. "Would you like me to read from your Bible today?"
- C. "Tell me a story about when you were young."
- D. "Sweetie, I will bring your coffee in a few minutes."
Correct Answer: D
Rationale: The correct answer is D because addressing an elderly patient as "Sweetie" is inappropriate and unprofessional. It can be perceived as demeaning and disrespectful. The nurse should intervene immediately to address this issue. Choices A, B, and C are all appropriate ways to interact with an elderly patient and promote their well-being. Choice A shows willingness to assist with orientation, choice B offers emotional support through spiritual means, and choice C encourages reminiscence therapy, which can be beneficial for cognitive function.
The nurse discusses smoking cessation with a client. Which action, if taken by the nurse, would most likely result in a behavior change?
- A. The nurse should advise the client to contact the national telephone quitline.
- B. The nurse should recommend nicotine replacement and behavioral interventions.
- C. The nurse should collaborate with the client to develop an individualized plan of action.
- D. The nurse should implement a strategy that has been validated by research.
Correct Answer: C
Rationale: The correct answer is C: The nurse should collaborate with the client to develop an individualized plan of action. This is the most likely action to result in a behavior change because it involves actively involving the client in the process, taking into account their unique needs, preferences, and circumstances. By collaborating with the client, the nurse can tailor the smoking cessation plan to be more personalized and therefore more effective.
Choice A (contact the national telephone quitline) may be helpful but lacks individualization. Choice B (recommend nicotine replacement and behavioral interventions) is a good approach but may not address the client's specific needs. Choice D (implement a strategy validated by research) is important but may not be as effective if it does not consider the client's individual factors. Overall, choice C is the best option as it promotes client engagement and customization for a higher chance of successful behavior change.
An aspect of computer use in patient care in which the LPN may need to be proficient includes:
- A. input of data such as requests for radiographs or laboratory services.
- B. programming the computer to record data from primary care provider and other health care workers.
- C. educating patients how to use hospital computers to access information such as discharge instructions or information relative to specific medications.
- D. scheduling admissions, discharges, and nurse staffing to keep the unit at the best occupancy and utilization.
Correct Answer: A
Rationale: The correct answer is A because LPNs are often responsible for inputting patient data such as requests for radiographs or lab services into the computer system. This task requires proficiency in navigating electronic health records to accurately document patient information. Option B is incorrect as LPNs typically do not program computers but rather use pre-existing systems. Option C is incorrect because educating patients on computer use is usually the responsibility of other healthcare professionals. Option D is also incorrect as scheduling admissions and nurse staffing is typically managed by unit coordinators or nurse managers, not LPNs. In summary, the LPN's role in computer use for patient care primarily involves inputting data accurately and efficiently.
The nurse plans to delegate a client's personal hygiene to a nursing assistant. Which statement if made by the nurse to the nursing assistant is assertive?
- A. "Would you mind helping the client with a bath when you have time? If not, I will skip my lunch and do it myself."
- B. "You never get your work done and are always on the phone. You need to help the client right now with a bath, or I will write you up."
- C. "The client needs help with bathing. I want you to assist the client now, and you can go to lunch when you are finished."
- D. "I have important work to complete this morning. You will assist the client with a bath. Do not take a break until you have finished."
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. The statement in choice C is assertive because it clearly states the task, timeline, and expectation without being aggressive or demeaning.
2. It communicates the need for assistance with the client's bath and sets a clear priority.
3. It provides a specific instruction for the nursing assistant to assist the client immediately and then take a break.
4. This approach demonstrates effective delegation and ensures the client's needs are met promptly and respectfully.
Summary:
A: This choice is not assertive as it presents a conditional statement and implies a personal sacrifice by the nurse if the task is not completed.
B: This choice is aggressive and threatening, which is not appropriate in a professional setting.
D: This choice is directive but lacks consideration for the nursing assistant's well-being and does not communicate the urgency of the task for the client.
Which assessment finding is the most critical and needs to be addressed first?
- A. Mr. U has tracheal deviation after a pulmonary resection.
- B. Mr. B, with bladder cancer, has decreased urinary output.
- C. Mr. N, with non-Hodgkin lymphoma, is having dysrhythmias.
- D. Ms. C has severe abdominal pain after a bowel resection.
Correct Answer: A
Rationale: The correct answer is A because tracheal deviation after a pulmonary resection indicates a life-threatening condition like tension pneumothorax. This condition requires immediate intervention to prevent respiratory distress and potential cardiovascular collapse. Tracheal deviation is a red flag sign that signals a medical emergency. Options B, C, and D are important but not as urgent as tracheal deviation. Decreased urinary output in a bladder cancer patient could indicate renal dysfunction, dysrhythmias in a patient with non-Hodgkin lymphoma may need further evaluation, and severe abdominal pain post-bowel resection could signal complications but are not as immediately life-threatening as tracheal deviation.