Nokea
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.
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When a patient begins crying during a conversation with the nurse about the patient's upcoming surgery for possible malignancy, the nurse's most therapeutic response would be:
- A. "Your surgeon is excellent, and I know he'll do a great job."
- B. "Oh, dear, your gown is way too big, let me get you another one."
- C. "Don't cry; think about something else and you'll feel better."
- D. "Here is a tissue. I'd like to sit here for a while if you want to talk."
Correct Answer: D
Rationale: The correct answer is D. This response acknowledges the patient's emotions, offers support, and provides an opportunity for the patient to express their feelings. Offering a tissue shows empathy and readiness to listen. Sitting with the patient shows availability and willingness to engage further. This response validates the patient's emotions and fosters a therapeutic nurse-patient relationship.
Choice A is incorrect because it dismisses the patient's emotions and focuses on the surgeon rather than the patient. Choice B is incorrect as it ignores the patient's emotional distress and focuses on a non-essential issue. Choice C is incorrect as it invalidates the patient's feelings and suggests avoidance rather than addressing the emotions directly.
The nurse cares for a patient with a terminal illness. Which way would be the most therapeutic for the nurse to communicate with this patient?
- A. Use an honest, judgmental attitude.
- B. Demonstrate understanding with empathy.
- C. Acknowledge hope by expressions of sympathy.
- D. Consistently evaluate the patient's feelings.
Correct Answer: B
Rationale: The correct answer is B: Demonstrate understanding with empathy. This approach is the most therapeutic as it shows the nurse's genuine care and support for the patient, fostering a sense of trust and emotional connection. By empathizing, the nurse validates the patient's feelings and provides comfort without judgment.
A: Using an honest, judgmental attitude can be harmful and create a barrier in the nurse-patient relationship.
C: Acknowledging hope by expressions of sympathy is important but may not address the patient's immediate emotional needs.
D: Consistently evaluating the patient's feelings is important, but without demonstrating empathy, it may come across as clinical and detached.
In summary, choice B is the best approach as it prioritizes empathy and understanding, essential components in providing effective therapeutic communication.
A patient asks the nurse to make a decision for her about whether or not to continue taking hormone replacement therapy (estrogen). Which response by the nurse is most appropriate?
- A. "You should check with a doctor; I cannot give you advice about drugs."
- B. "My friend has taken estrogen for more than 5 years without any problems."
- C. "I can answer any questions you have but it is up to you to make this decision."
- D. "Herbal supplements were much better for me than prescription-strength estrogen."
Correct Answer: C
Rationale: The correct answer is C because it emphasizes patient autonomy and informed decision-making, aligning with ethical principles. The nurse should not make decisions for the patient but should provide information and support. Choice A deflects responsibility and does not empower the patient. Choice B is anecdotal and not a reliable source of information. Choice D is not relevant to the patient's question and could potentially lead to misinformation. Ultimately, choice C encourages the patient to take an active role in their healthcare decisions, which promotes patient-centered care.
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.
A teacher at a local elementary school asks a nurse to talk to the students about nutrition. Which response by the nurse is most appropriate?
- A. "I will teach the students how to read nutrition labels.=
- B. "What would you like the students to learn about nutrition?=
- C. "The students need to know about the consequences of obesity.=
- D. "I will enjoy teaching the students everything I know about nutrition.=
Correct Answer: B
Rationale: The correct answer is B because it shows the nurse's willingness to understand the teacher's specific objectives and tailor the nutrition talk accordingly. This approach ensures that the nurse addresses the teacher's concerns and meets the students' needs effectively.
Explanation for why the other choices are incorrect:
A: Teaching students how to read nutrition labels may be important, but it assumes that this is the teacher's primary goal without confirming it first.
C: Focusing on the consequences of obesity may not align with the teacher's desired focus on general nutrition education.
D: While enthusiasm for teaching is positive, this response does not address the teacher's specific request for the nutrition talk.