Nokea
A patient states, 'I have been experiencing complications of diabetes.' What question will the nurse use to elicit additional information?
- A. Do you take two injections of insulin to prevent complications?
- B. Are you using diet and exercise to help regulate your blood sugar?
- C. Have you been experiencing the complications of neuropathy?
- D. Can you tell me about the complications you've experienced?
Correct Answer: D
Rationale: Requesting information regarding the patient's specific complications of diabetes will guide the nurse to further questioning and related assessments.
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A primary nurse is preparing a discharge plan for a patient who has been hospitalized following a double mastectomy. Which statement is most appropriate for the nurse to use in the termination phase of the therapeutic relationship?
- A. Let's review the progress you've made in meeting your goals.
- B. I'd like to review your medication schedule with you.
- C. I need to document today's teaching session in the electronic health record.
- D. Should we include your family in today's session?
Correct Answer: A
Rationale: The termination phase occurs when the conclusion of the initial agreement is acknowledged. Discharge planning correlates with the termination phase of a therapeutic relationship and the progress toward the patient's goals are reviewed.
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 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.
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.
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.