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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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According to the Workplace Bullying Institute, nurses are also exposed to this type of behavior within their professional environment. In teaching the possibility to an incoming graduate nurse, you know that the nurse understands when he or she includes which of the following as abusive conduct? (Select all that apply)
- A. Threats
- B. Humiliation
- C. Intimidation
- D. Physical abuse
Correct Answer: A
Rationale: The correct answer is A: Threats. Threats are considered abusive conduct in the context of workplace bullying. Nurses may be subjected to threats that create a hostile work environment. Threats can instill fear and distress in the victim, affecting their well-being and performance.
Summary of why other choices are incorrect:
B: Humiliation - While humiliation is a form of abuse, the question specifically asks about abusive conduct in the context of workplace bullying for nurses.
C: Intimidation - Intimidation is another form of abusive behavior, but the question focuses on identifying abusive conduct in the workplace environment for nurses.
D: Physical abuse - While physical abuse is a serious issue, the question pertains to identifying abusive conduct within the professional environment for nurses, where physical abuse may not be as common as other forms of bullying behavior.
A patient is irritable and complains to the nurse about difficulty sleeping last night. Which response by the nurse is most appropriate?
- A. "I know you will sleep better tonight.=
- B. "Tell me more about what happened last night.=
- C. "Did you drink too much caffeine yesterday?=
- D. "No one sleeps well in the hospital.=
Correct Answer: B
Rationale: The correct response is B. Asking the patient to elaborate on what happened last night allows the nurse to gather more information about the situation, which is crucial for assessing the patient's sleep difficulties accurately. It shows active listening and empathy, building rapport and trust with the patient. Options A, C, and D are incorrect because they do not address the patient's concerns effectively or gather relevant information to provide appropriate care. Option A makes an assumption without understanding the root cause of the sleep issue. Option C assumes the cause of sleep difficulty without exploring further. Option D dismisses the patient's concerns without providing support or understanding.
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.
When a patient states, "My son hasn't been to see me in months," the nurse's best verbal response is:
- A. "Don't worry; I'm sure your son will visit."
- B. "Your son hasn't been around much lately?"
- C. "My son doesn't come to visit me either."
- D. "How terrible that he doesn't visit you." Restating in different words what the patient said encourages further communication on that topic.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Reflective listening: Restating the patient's statement shows empathy and understanding.
2. Open-ended question: Encourages patient to share more without assumptions.
3. Non-judgmental: Neutral tone promotes trust and openness.
4. Validates patient's feelings: Acknowledges patient's concerns without dismissing them.
Summary:
A: Provides false reassurance, does not address the patient's feelings.
C: Shifts focus to the nurse, not patient-centered.
D: Implies judgment, may shut down communication.
The nurse greets a patient who is admitted to the hospital. Which action by the nurse displays warmth and concern?
- A. Use a soft and relaxed tone of voice when speaking.
- B. Maintain a distance of 6 to 8 feet from the patient.
- C. Avoid attentive behaviors when interacting with the patient.
- D. Engage in a verbal exchange without physical contact.
Correct Answer: A
Rationale: The correct answer is A because using a soft and relaxed tone of voice conveys warmth and concern, making the patient feel welcomed and cared for. It helps build rapport and comfort. Maintaining a distance of 6 to 8 feet (B) may create a sense of coldness and detachment. Avoiding attentive behaviors (C) will make the patient feel neglected and uncared for. Engaging in verbal exchange without physical contact (D) lacks the personal touch needed to show warmth and concern.