A patient states, "I'm so worried that I might have cancer." The nurse responds, "It is time for you to eat breakfast." The nurse's response is an example of:
- A. using clichés.
- B. judgmental response.
- C. changing the subject.
- D. giving false reassurance. Changing the subject is a block to effective communication in which the patient is deprived of the chance to verbalize concerns.
Correct Answer: C
Rationale: The correct answer is C: changing the subject. The nurse's response shifts the conversation away from the patient's expression of worry about having cancer to a completely unrelated topic - eating breakfast. This technique blocks effective communication as it disregards the patient's concerns and prevents further exploration of the underlying issue. By redirecting the conversation, the nurse fails to address the patient's emotional needs and misses an opportunity to provide support and reassurance. Choices A, B, and D are incorrect as they do not accurately reflect the nurse's response in this scenario.
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Which are examples of a nurse who is communicating responsibly? (Select all that apply)
- A. The nurse uses profanity to respond to a client who is intoxicated and verbally abusive.
- B. The nurse helps a client talk to family members about discontinuing chemotherapy.
- C. The nurse uses interpersonal strategies to help a client develop methods of coping.
- D. The nurse provides a client's health information to a close relative who is visiting.
Correct Answer: B
Rationale: The correct answer is B because helping a client communicate about discontinuing chemotherapy shows responsible communication. This action respects the client's autonomy and involves them in decision-making. This choice prioritizes the client's well-being and supports open and honest communication.
Incorrect choices:
A: Using profanity is unprofessional and disrespectful, violating ethical standards.
C: While using interpersonal strategies to help a client cope is important, it doesn't specifically address responsible communication.
D: Sharing a client's health information without consent breaches confidentiality and violates privacy rights.
The nurse is providing care to a patient who was admitted with heart failure. The patient has not been following the prescribed diet or taking the prescribed medications. Which type of communication approach is most important for the nurse to use with this patient to facilitate a change in self-care behavior?
- A. Authoritative, honest, and outright communication
- B. Assertive, responsible, and caring communication
- C. Aggressive, sympathetic, and realistic communication
- D. Positive, expert, and focused communication
Correct Answer: B
Rationale: The correct answer is B: Assertive, responsible, and caring communication.
Rationale:
1. Assertive communication is important to clearly express expectations and boundaries.
2. Being responsible conveys accountability and encourages the patient to take ownership of their care.
3. Caring communication fosters trust and empathy, crucial for building a therapeutic relationship.
Summary:
A: Authoritative communication may come across as controlling and may not promote patient cooperation.
C: Aggressive communication can be intimidating and may lead to resistance rather than cooperation.
D: Positive communication is beneficial, but being an expert alone may not address the patient's underlying issues or barriers to self-care.
When communicating with a hearing impaired patient, the nurse appropriately:
- A. shouts repeatedly at the patient.
- B. speaks directly into the patient's ear.
- C. uses long, complex sentences.
- D. uses short, simple sentences.
Correct Answer: D
Rationale: The correct answer is D: uses short, simple sentences. This is the most appropriate approach because hearing-impaired patients may have difficulty processing complex information. Using short, simple sentences helps improve comprehension. Shouting repeatedly (choice A) can be distressing and ineffective. Speaking directly into the patient's ear (choice B) may be invasive and uncomfortable. Using long, complex sentences (choice C) can overwhelm the patient and lead to confusion. Therefore, option D is the best choice for effective communication with a hearing-impaired patient.
The nurse plans to delegate a client's personal hygiene to a nursing assistant. Which statement if made by the nurse to the nursing assistant is assertive?
- A. "Would you mind helping the client with a bath when you have time? If not, I will skip my lunch and do it myself."
- B. "You never get your work done and are always on the phone. You need to help the client right now with a bath, or I will write you up."
- C. "The client needs help with bathing. I want you to assist the client now, and you can go to lunch when you are finished."
- D. "I have important work to complete this morning. You will assist the client with a bath. Do not take a break until you have finished."
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. The statement in choice C is assertive because it clearly states the task, timeline, and expectation without being aggressive or demeaning.
2. It communicates the need for assistance with the client's bath and sets a clear priority.
3. It provides a specific instruction for the nursing assistant to assist the client immediately and then take a break.
4. This approach demonstrates effective delegation and ensures the client's needs are met promptly and respectfully.
Summary:
A: This choice is not assertive as it presents a conditional statement and implies a personal sacrifice by the nurse if the task is not completed.
B: This choice is aggressive and threatening, which is not appropriate in a professional setting.
D: This choice is directive but lacks consideration for the nursing assistant's well-being and does not communicate the urgency of the task for the client.
To convey the intervention of active listening, the nurse would:
- A. maintain eye contact by staring at the patient.
- B. prompt the patient when the patient stops talking for a moment.
- C. make a conscious effort to block out other sounds in the immediate environment.
- D. write down remarks on a clipboard to facilitate later topics of conversation. An active listener maintains eye contact without staring, gives the patient full attention, and makes a conscious effort to block out other sounds and distractions.
Correct Answer: C
Rationale: The correct answer is C because active listening involves making a conscious effort to block out other sounds in the immediate environment, demonstrating full focus on the speaker. This allows the nurse to truly understand the patient's perspective and feelings. Maintaining eye contact (A) is important but staring can be intimidating. Prompting the patient (B) may disrupt their train of thought. Writing down remarks (D) can be perceived as disengagement. In summary, active listening requires focused attention and empathy, which choice C exemplifies.
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