Nokea
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.
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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.
A nurse enters a patient's room and examines the patient's intravenous (IV) fluids and cardiac monitor. When asked, 'who are you?', which response by the nurse is most appropriate?
- A. I'm just the IV therapist checking your IV.
- B. I've been transferred to this division and will be caring for you.
- C. I'm sorry, my name is John Smith and I am your nurse.
- D. I am John Smith, your nurse, and I'll be caring for you until 11 PM.
Correct Answer: D
Rationale: The nurse should identify themselves, ensure the patient knows what will be happening, and the duration of their relationship.
A nurse enters a patient's room and finds them vomiting bright red blood. After taking vital signs, the nurse communicates the event to the health care provider using the SBAR format. Which information will the nurse include in the 'A' portion of the SBAR communication?
- A. Admitted with peptic ulcer and bleeding disorder
- B. Found vomiting in bathroom
- C. Anti-ulcer medication recommendation
- D. Vital signs, oxygen saturation, bright red emesis
Correct Answer: D
Rationale: The SBAR method is used to improve hand-off communication. SBAR, which stands for Situation, Background, Assessment, and Recommendations, provides a clear, structured, and easy to use framework. Vital signs, oxygen saturation, and the presence of emesis and its color are assessments.
A public health nurse is leaving the home of a young mother who has an infant with special needs. The neighbor states, 'How is she doing, since the baby's father is no help?' What is the nurse's best response?
- A. New mothers need support.
- B. The lack of a father is difficult.
- C. How are you today?
- D. It is a very sad situation.
Correct Answer: A
Rationale: The nurse must maintain confidentiality when providing care. The statement 'New mothers need support' is a general statement that all new parents need help. The statement is not judgmental of the family's roles. 'How are you today?' is dismissive of the neighbor's question.
A nursing student is preparing to administer morning care to a patient. What question by the student is most important to ask?
- A. Would you prefer a bath or a shower?
- B. May I help you with a bed bath now or later this morning?
- C. I will be giving you your bath. Do you use soap or shower gel?
- D. I prefer a shower in the evening. When would you like your bath?
Correct Answer: B
Rationale: The nurse should ask permission to assist the patient with a bath. This allows for patient preferences and consent for care that involves entering the patient's personal space.