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A nursing student is nervous and concerned about working at a clinical facility. Which action would best decrease anxiety and help ensure successful delivery of patient care?
- A. Determining the established goals of the institution
- B. Ensuring that verbal and nonverbal communication is congruent
- C. Engaging in self-talk to plan the day and decrease fear
- D. Speaking with fellow colleagues about how they feel
Correct Answer: C
Rationale: By engaging in positive self-talk, or intrapersonal communication, the nursing student can plan the day, decrease fear and anxiety, and enhance clinical performance.
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A nursing student is preparing to administer morning care to a patient. What question by the student is most important to ask?
- A. Would you prefer a bath or a shower?
- B. May I help you with a bed bath now or later this morning?
- C. I will be giving you your bath. Do you use soap or shower gel?
- D. I prefer a shower in the evening. When would you like your bath?
Correct Answer: B
Rationale: The nurse should ask permission to assist the patient with a bath. This allows for patient preferences and consent for care that involves entering the patient's personal space.
A nurse enters a patient's room and finds them vomiting bright red blood. After taking vital signs, the nurse communicates the event to the health care provider using the SBAR format. Which information will the nurse include in the 'A' portion of the SBAR communication?
- A. Admitted with peptic ulcer and bleeding disorder
- B. Found vomiting in bathroom
- C. Anti-ulcer medication recommendation
- D. Vital signs, oxygen saturation, bright red emesis
Correct Answer: D
Rationale: The SBAR method is used to improve hand-off communication. SBAR, which stands for Situation, Background, Assessment, and Recommendations, provides a clear, structured, and easy to use framework. Vital signs, oxygen saturation, and the presence of emesis and its color are assessments.
A nurse notices a patient is walking to the bathroom with a stooped gait, facial grimacing, and grunting sounds. Based on these nonverbal cues, what action will the nurse take next?
- A. Assess for pain and the need for analgesia.
- B. Ask the patient if they feel anxious.
- C. Offer to sit with the patient and listen to their feelings.
- D. Suggest the patient increase their fluid intake to prevent constipation.
Correct Answer: A
Rationale: A patient who presents with nonverbal communication of a stooped gait, facial grimacing, and grunting sounds is most likely communicating pain. The nurse should clarify this nonverbal behavior.
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.
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.