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A patient discloses several concerns and associated feelings. If the nurse wants to seek clarification, which comment would be appropriate?
- A. What are the common elements here?
- B. Tell me again about your experiences.
- C. Am I correct in understanding that...?
- D. Tell me everything from the beginning.
Correct Answer: C
Rationale: Asking, 'Am I correct in understanding that...?' permits clarification to ensure that both the nurse and patient share mutual understanding of the communication. Asking about common elements encourages comparison rather than clarification. The remaining responses are implied questions that suggest the nurse was not listening.
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The patient says, 'My marriage is just great. My spouse and I usually agree on everything.' The nurse observes the patient's foot moving continuously as the patient twirls a shirt button. What type of communication is the patient presenting?
- A. Clear
- B. Mixed
- C. Precise
- D. Inadequate
Correct Answer: B
Rationale: Mixed messages involve the transmission of conflicting or incongruent messages by the speaker. The patient's verbal message that all is well in the relationship is modified by the nonverbal behaviors denoting anxiety. Data are not present to support the choice of the verbal message being clear, explicit, or inadequate.
During the first interview with a parent whose child died in a car accident, the nurse feels empathic and reaches out to take the patient's hand. Select the correct analysis of the nurse's behavior.
- A. It shows empathy and compassion. It will encourage the patient to continue to express feelings.
- B. The gesture is premature. The patient's cultural and individual interpretation of touch is unknown.
- C. The patient will perceive the gesture as intrusive and overstepping boundaries.
- D. The action is inappropriate. Patients in a psychiatric setting should not be touched.
Correct Answer: B
Rationale: Touch has various cultural and individual interpretations. Nurses should refrain from using touch until an assessment can be made regarding the way in which the patient will perceive touch. The other options present prematurely drawn conclusions.
A patient tells the nurse, 'I don't think I will ever get out of here.' Select the nurse's most therapeutic response.
- A. Don't talk that way. Of course, you will leave here.
- B. Keep up the good work and you certainly will.
- C. You don't think you're making progress?
- D. Everyone feels that way sometimes.
Correct Answer: C
Rationale: By asking if the patient does not believe that progress has been made, the nurse is reflecting by putting into words what the patient is hinting. By making communication more explicit, issues are easier to identify and resolve. The remaining options are nontherapeutic techniques. Telling the patient not to 'talk that way' is disapproving. Saying that everyone feels that way at times minimizes feelings. Telling the patient that good work will always result in success is falsely reassuring.
Which benefits are most associated with the use of telehealth? (Select all that apply.)
- A. Cost savings for patients
- B. Maximization of care management
- C. Access to services for patients in rural areas
- D. Prompt reimbursement by third-party payers
- E. Rapid development of trusting relationships with patients
Correct Answer: A,B,C
Rationale: Use of telehealth technologies has shown that they can maximize health and improve disease management skills and confidence with the disease process. Many rural patients have felt disconnected from services; telehealth technologies can solve these problems. Although telehealth's improved health outcomes regularly show cost savings for payers, one significant barrier is the current lack of reimbursement for remote patient monitoring by third-party payers. Telehealth is not associated with rapid development of trusting relationships.
A school-age child tells the school nurse, 'Other kids call me mean names and will not sit with me at lunch. Nobody likes me.' Select the nurse's most therapeutic response.
- A. Just ignore them and they will leave you alone.
- B. You should make friends with other children.
- C. Call them names if they do that to you.
- D. Tell me more about how you feel.
Correct Answer: D
Rationale: The correct response uses exploring, a therapeutic technique. The distracters give advice, a nontherapeutic technique.