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A patient asks the nurse, "What would you do if you had cancer and had to choose between surgery and chemotherapy?" The reply that can best help the patient is:
- A. "If I were you, I would choose surgery and then consider chemo afterward."
- B. "What solutions have you considered?"
- C. "I would talk it over with my friends first."
- D. "I don't know. I'm glad it isn't my decision." Nurses can help by reminding patients of alternatives open to them and should refrain from giving advice but can encourage the patient to consider options. The nurse may be glad not to face a decision a patient must, but it is not helpful to the patient to say this.
Correct Answer: B
Rationale: Step-by-step rationale for why answer B is correct:
1. Answer B encourages patient autonomy by asking what solutions the patient has considered.
2. This response acknowledges the patient's ability to make decisions about their own healthcare.
3. By asking the patient about their considered solutions, the nurse can guide the discussion towards exploring different options.
4. This approach promotes shared decision-making between the patient and healthcare provider.
5. It empowers the patient to actively participate in their treatment planning.
6. Ultimately, answer B respects the patient's autonomy, fosters open communication, and supports informed decision-making.
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The nurse cares for a client with hypertension, and a nurse–client contract is developed outlining the activities and responsibilities of each. Which would be appropriate to include in this contract? (Select all that apply)
- A. The outcomes should be realistic and measurable.
- B. Progress should be reviewed at regular intervals.
- C. The contract should be written and signed.
- D. The nurse should keep the information confidential.
Correct Answer: A
Rationale: The correct answer is A: The outcomes should be realistic and measurable. This is appropriate to include in the nurse-client contract because setting realistic and measurable outcomes helps in monitoring progress and evaluating the effectiveness of interventions in managing hypertension. It allows for clear communication between the nurse and the client regarding the goals of treatment.
Incorrect choices:
B: Progress should be reviewed at regular intervals - While this is important in the management of hypertension, it is a process rather than a specific component of a contract.
C: The contract should be written and signed - This is important for legal purposes but not specifically related to setting goals and outcomes.
D: The nurse should keep the information confidential - This is a standard ethical practice but not a specific component of a contract outlining activities and responsibilities.
It would be most important for the nurse to temporarily withdraw expressions of warmth to which patient?
- A. A 20-year-old patient who is angry and throwing objects.
- B. A 32-year-old patient who is withdrawn and refuses nursing care.
- C. A 48-year-old patient who is extremely anxious about surgery.
- D. A 56-year-old patient who has a history of violent behavior.
Correct Answer: D
Rationale: The correct answer is D because the patient with a history of violent behavior poses a potential risk to the nurse's safety. Temporarily withdrawing expressions of warmth is important to establish boundaries and ensure safety. Choice A involves an angry patient, but the risk of violence is higher with a history of violent behavior. Choices B and C do not indicate immediate safety concerns.
An experienced nurse is supervising a student nurse in an acute care setting. Which statement, if made by the experienced nurse, would be most appropriate to help the student nurse establish credibility with other nurses on the unit?
- A. "It is impossible to be credible when you are a student because you lack experience.=
- B. "Try to hide your feelings of inadequacy and portray a sense of confidence.=
- C. "Be honest with the nurses about your strengths and about areas that need improvement.=
- D. "It would help if you bring special treats for the nurses so that they will like you.=
Correct Answer: C
Rationale: The correct answer is C: "Be honest with the nurses about your strengths and about areas that need improvement." This statement promotes transparency, self-awareness, and humility, which are important traits in gaining credibility. Being honest about strengths shows confidence, while acknowledging areas for improvement demonstrates a willingness to learn and grow. This approach fosters trust and respect among colleagues.
Choice A is incorrect as it undermines the student nurse's potential for credibility based on experience. Choice B suggests masking feelings of inadequacy, which can lead to inauthentic interactions. Choice D is inappropriate as it implies trying to buy favor with treats rather than earning credibility through professional conduct.
While admitting a patient to the medical unit, the nurse should take which action?
- A. Demonstrate human caring by hugging the patient for brief intervals.
- B. Disclose shared intimate details with other healthcare providers.
- C. Maintain a physical distance of at least 3 to 4 feet at all times.
- D. Develop the plan of care and measurable objectives with the patient.
Correct Answer: D
Rationale: The correct answer is D because developing a plan of care and measurable objectives with the patient promotes patient-centered care, encourages collaboration, and ensures the patient's active involvement in their own care. This approach respects the patient's autonomy and preferences, fosters shared decision-making, and enhances treatment adherence.
A: Demonstrating human caring by hugging the patient may not be appropriate as it can violate professional boundaries and personal space.
B: Disclosing shared intimate details with other healthcare providers breaches patient confidentiality and violates privacy rights.
C: Maintaining a physical distance of at least 3 to 4 feet at all times may be necessary for infection control but does not address the core aspect of involving the patient in their care plan.
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: Ask the patient how he prefers to be addressed. This approach respects the patient's autonomy and personal preferences, promoting patient-centered care. By asking the patient directly, the nurse acknowledges the patient's individuality and ensures respectful communication.
A: Using both first and last name with each encounter may come across as too formal or impersonal for some patients, potentially creating a barrier in the nurse-patient relationship.
C: Calling the patient by his first name without consent may be perceived as too familiar or disrespectful by some patients, leading to discomfort or a lack of trust in the nurse.
D: Addressing the patient by his last name may be too formal for some patients and can create a sense of distance or hierarchy in the nurse-patient relationship.