Nokea
A Puerto Rican-American patient uses dramatic body language when describing emotional discomfort. Which analysis most likely explains the patient's behavior?
- A. A histrionic personality disorder is likely.
- B. A belief that dramatic body language is sexually appealing.
- C. Wishes to impress staff with the degree of emotional pain.
- D. Belongs to a culture in which dramatic body language is the norm.
Correct Answer: D
Rationale: Members of Hispanic-American subcultures tend to use high affect and dramatic body language as they communicate. The other options are more remote possibilities.
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A patient tells the nurse, 'I don't think I will ever get out of here.' Select the nurse's most therapeutic response.
- A. Don't talk that way. Of course, you will leave here.
- B. Keep up the good work and you certainly will.
- C. You don't think you're making progress?
- D. Everyone feels that way sometimes.
Correct Answer: C
Rationale: By asking if the patient does not believe that progress has been made, the nurse is reflecting by putting into words what the patient is hinting. By making communication more explicit, issues are easier to identify and resolve. The remaining options are nontherapeutic techniques. Telling the patient not to 'talk that way' is disapproving. Saying that everyone feels that way at times minimizes feelings. Telling the patient that good work will always result in success is falsely reassuring.
Which benefits are most associated with the use of telehealth? (Select all that apply.)
- A. Cost savings for patients
- B. Maximization of care management
- C. Access to services for patients in rural areas
- D. Prompt reimbursement by third-party payers
- E. Rapid development of trusting relationships with patients
Correct Answer: A,B,C
Rationale: Use of telehealth technologies has shown that they can maximize health and improve disease management skills and confidence with the disease process. Many rural patients have felt disconnected from services; telehealth technologies can solve these problems. Although telehealth's improved health outcomes regularly show cost savings for payers, one significant barrier is the current lack of reimbursement for remote patient monitoring by third-party payers. Telehealth is not associated with rapid development of trusting relationships.
A Filipino-American patient avoided eye contact when interacting with the nurse. The nurse concluded that the patient had low self-esteem. Interventions were used to raise the patient's self-esteem; however, after 3 weeks, the patient's eye contact did not improve. What is the most accurate analysis of this scenario?
- A. The patient's eye contact should have been directly addressed by role-playing to increase comfort with eye contact.
- B. The nurse should not have independently embarked on treatment planning for this patient.
- C. The patient's poor eye contact is indicative of anger and hostility that remain unaddressed.
- D. The nurse should have assessed the patient's culture before concluding the patient had low self-esteem.
Correct Answer: D
Rationale: The amount of eye contact in which a person engages is often culturally determined. In some cultures, eye contact is considered insolent, whereas in other cultures, eye contact is expected. Asian Americans, including persons from the Philippines, often prefer not to engage in direct eye contact.
A patient is having difficulty making a decision. The nurse has mixed feelings about whether to provide advice. Which principle usually applies about giving advice?
- A. It is rarely helpful.
- B. It fosters independence.
- C. It lifts the burden of personal decision making.
- D. It helps the patient develop feelings of personal adequacy.
Correct Answer: A
Rationale: Giving advice fosters dependence on the nurse and interferes with the patient's right to make personal decisions. Giving advice also robs patients of the opportunity to weigh alternatives and to develop problem-solving skills. Furthermore, it contributes to patient feelings of personal inadequacy. It also keeps the nurse in control and feeling powerful.
An African-American patient says to a Caucasian nurse, 'There's no sense talking. You wouldn't understand because you live in a white world.' What would be the nurse's best action?
- A. Explain, 'Yes, I do understand. Everyone goes through the same experiences.'
- B. Say, 'Please give an example of something you think I wouldn't understand.'
- C. Reassure the patient that nurses interact with people from all cultures.
- D. Change the subject to one that is less emotionally disturbing.
Correct Answer: B
Rationale: Having the patient speak in specifics rather than globally helps the nurse understand the patient's perspective. This approach helps the nurse engage the patient.