Nokea
A patient reports to the nurse, "My doctor is not doing anything about my pain." Which response by the nurse is assertive and expresses warmth?
- A. "If I were you, I would see a different doctor."
- B. "What you really mean is you do not like your doctor."
- C. "It is wrong for you to blame your doctor."
- D. "You seem frustrated with your doctor."
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the patient's feelings without judgment and expresses empathy. The nurse reflects the patient's emotions by stating, "You seem frustrated with your doctor," showing understanding. Option A is dismissive, suggesting the patient change doctors. Option B assumes the patient's feelings and could come off as confrontational. Option C is accusatory and could make the patient defensive. Overall, option D is assertive, warm, and empathetic, making it the best response in this situation.
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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.
A patient who has had a stroke is unable to speak clearly and has right sided hemiplegia. The nurse will design the approach to the assessment interview by:
- A. asking questions and explaining procedures to the patient's daughter.
- B. speaking slowly and giving the patient time to respond.
- C. telling the patient he will get all necessary information from the daughter.
- D. prompting the answers and finishing the sentences for the patient. Speaking slowly recognizes that the patient may process (if able) information more slowly.
Correct Answer: B
Rationale: The correct answer is B because speaking slowly and giving the patient time to respond allows the patient with speech difficulties due to the stroke to process information and formulate a response. Prompting or finishing sentences can hinder the patient's ability to communicate independently. Asking questions to the patient directly, rather than relying on a family member, ensures accurate information is obtained directly from the patient. Telling the patient that all information will come from the daughter undermines the patient's autonomy and may lead to incomplete or inaccurate information.
The first-semester nursing student tells the team leader that her clinical assignment for the day is to take vital signs and obtain a client history that will take about 1 or 2 hours to complete. Which clients would the leader recommend that she approach to fulfill her assignment? (Select all that apply.)
- A. Mr. N (non-Hodgkin lymphoma)
- B. Mr. L (tracheostomy and partial laryngectomy)
- C. Mr. B (bladder cancer)
- D. Ms. C (bowel resection and colostomy)
Correct Answer: B
Rationale: The correct answer is B because Mr. L, who has a tracheostomy and partial laryngectomy, will likely require vital signs monitoring and a detailed client history due to his complex respiratory and communication needs. This assignment will provide the student with valuable experience in caring for clients with specialized needs.
Incorrect choices:
A: Mr. N (non-Hodgkin lymphoma) - While Mr. N may require vital signs monitoring, his condition does not necessarily involve complex care needs that would warrant a 1-2 hour history-taking session.
C: Mr. B (bladder cancer) - Vital signs monitoring and history-taking for a client with bladder cancer may not require as much time as the scenario suggests, as the care needs may not be as complex as those of a client with a tracheostomy and laryngectomy.
D: Ms. C (bowel resection and colostomy) - While Ms. C may require vital signs monitoring and history-taking
Which characteristic would the nurse use to define culture? (Select all that apply)
- A. Learned and shared lifeways of a particular group.
- B. Social identity influenced by language and religion.
- C. Belief in superiority of one's own ethnic group.
- D. Values influence both thinking and actions.
Correct Answer: A
Rationale: The correct answer is A because culture is defined as the learned and shared lifeways of a particular group. This includes traditions, customs, beliefs, and practices that are passed down from generation to generation within a community. This definition aligns with the concept of culture being a set of learned behaviors and beliefs that are commonly practiced and shared among individuals in a society.
Choice B is incorrect because while social identity can be influenced by language and religion, it does not fully encompass the complexity of culture. Choice C is incorrect as it refers to ethnocentrism, which is the belief in the superiority of one's own ethnic group and is not a defining characteristic of culture. Choice D is incorrect because while values do influence thinking and actions within a culture, it does not capture the entirety of what culture entails, such as traditions, customs, and shared beliefs.
A Hispanic patient approaches the Asian nurse and, standing very close, touches the nurse's shoulder during their conversation. The nurse begins to step back to 18 to 24 inches, while smiling and nodding to the patient. This situation is most likely an example of:
- A. the nurse's need to maintain a professional role rather than a social role.
- B. a patient's attempt to keep the nurse's attention.
- C. a nurse's need to establish a more appropriate location for conversation.
- D. a difference in culturally learned personal space of the nurse and the patient.
Correct Answer: D
Rationale: The correct answer is D: a difference in culturally learned personal space of the nurse and the patient. This is because different cultures have varying norms regarding personal space. In this scenario, the Hispanic patient touching the Asian nurse's shoulder and standing very close suggests a cultural difference in personal space expectations. The nurse stepping back to establish a distance of 18 to 24 inches is a respectful response to accommodate the patient's cultural norm. It demonstrates cultural competence and understanding.
Explanation for why the other choices are incorrect:
A: the nurse's need to maintain a professional role rather than a social role - This choice does not address the cultural aspect of personal space and assumes the nurse's response is solely professional.
B: a patient's attempt to keep the nurse's attention - This choice does not consider the cultural factor influencing the patient's behavior.
C: a nurse's need to establish a more appropriate location for conversation - This choice does not acknowledge the cultural difference in personal space as the primary reason for the nurse