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A nurse says to their nurse manager, 'I need the day off, and you didn't give it to me!' The manager replies, 'I wasn't aware you needed the day off, and it isn't possible since staffing is inadequate.' How could the nurse best modify the communication for a more positive interaction?
- A. I placed a request to have 8th of August off for a doctor's appointment, but I'm scheduled to work.
- B. Could I make an appointment to discuss my schedule with you? I requested the 8th of August off for a doctor's appointment.
- C. I will need to call in on the 8th of August because I have a doctor's appointment.
- D. Since you didn't give me the 8th of August off, will I need to find someone to work for me?
Correct Answer: B
Rationale: Effective communication involves sending clear, nonthreatening, and respectful information to the receiver. The nurse identifies the subject of the meeting and determines a mutually agreed upon time.
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The charge nurse overhears an AP yelling loudly to a patient who is hard of hearing, while transferring them from the bed to a chair. Upon entering the room, which response by the charge nurse is most appropriate?
- A. Please speak more quietly so you don't disturb the other patients.
- B. Let me help you with your transfer technique.
- C. When you are finished, be sure to apologize for shouting.
- D. When your patient is safe and comfortable, meet me at the desk.
Correct Answer: D
Rationale: The charge nurse should direct the AP to see to the patient's safety, then address any concerns privately. The nurse then can discuss appropriate use of therapeutic communication.
The nurse preceptor and a new graduate nurse on the surgical unit are performing preoperative assessments on a group of patients. What statement by the graduate nurse requires the preceptor to intervene?
- A. I am sure everything will be fine; you have nothing to worry about.
- B. When you return from surgery, you'll need to cough and deep breathe.
- C. Many people on this unit have had that procedure with good success.
- D. You seem fearful, can I answer any questions about the procedure?
Correct Answer: A
Rationale: Telling a patient that everything will be fine is a clich?©. This statement gives false assurance and may give the patient the impression that the nurse is dismissive of a patient's concerns or condition.
During an interaction with a patient diagnosed with epilepsy, a nurse notes that the patient is silent after hearing the plan of care. How does the nurse best respond? Select all that apply.
- A. Fill the silence with lighter conversation directed at the patient.
- B. Use the time to perform the care that is needed uninterrupted.
- C. Discuss the silence with the patient to ascertain its meaning.
- D. Allow the patient time to think and explore inner thoughts.
- E. Determine if the patient's culture requires pauses between conversation.
- F. Arrange for a counselor to help the patient cope with emotional issues.
Correct Answer: C,D,E
Rationale: Appropriate use of silence allows the patient to initiate or to continue speaking; the nurse can reflect on what has been shared while observing the patient without having to concentrate simultaneously on conversation. In due time, the nurse might discuss the meaning of silence with the patient. The nurse considers whether the patient's culture may require longer pauses between verbal communication.
A public health nurse is leaving the home of a young mother who has an infant with special needs. The neighbor states, 'How is she doing, since the baby's father is no help?' What is the nurse's best response?
- A. New mothers need support.
- B. The lack of a father is difficult.
- C. How are you today?
- D. It is a very sad situation.
Correct Answer: A
Rationale: The nurse must maintain confidentiality when providing care. The statement 'New mothers need support' is a general statement that all new parents need help. The statement is not judgmental of the family's roles. 'How are you today?' is dismissive of the neighbor's question.
A nurse enters the room of a patient with cancer. The patient is crying and states, 'I feel so alone.' How will the nurse best communicate a therapeutic response?
- A. The nurse stands at the patient's bedside and states, 'I understand how you feel. My mother said the same thing when she was ill.'
- B. The nurse places a hand on the patient's arm and states, 'You feel so alone.'
- C. The nurse stands in the patient's room and asks, 'Why do you feel so alone? Your wife has been here every day.'
- D. The nurse holds the patient's hand and asks, 'Tell me what feeling so alone is like for you?'
Correct Answer: D
Rationale: The use of touch conveys acceptance, and the implementation of an open-ended question allows the patient time to verbalize freely.