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A toddler with vomiting, diarrhea, and dehydration is being seen at an acute care center. During the admission interview, what question will the nurse ask the parents to elicit the most useful information?
- A. Watching your child vomiting and in discomfort must have been scary.
- B. This started yesterday, correct?
- C. Has this child had anything to drink?
- D. Could you tell me the color and approximate amount of the vomiting?
Correct Answer: D
Rationale: Using a clarifying question or comment allows the nurse to gain an understanding of the parents' observations, avoiding misunderstandings that could lead to an inappropriate nursing diagnosis. A reflective question technique involves repeating what the person has said or describes the person's feelings. Assertive questions are direct, demonstrating the ability to stand up for self or others, using open and honest communication. Open-ended questions encourage free verbalization and expression of what the parents believe to be true.
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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.
The nurse preceptor and a new graduate nurse on the surgical unit are performing preoperative assessments on a group of patients. What statement by the graduate nurse requires the preceptor to intervene?
- A. I am sure everything will be fine; you have nothing to worry about.
- B. When you return from surgery, you'll need to cough and deep breathe.
- C. Many people on this unit have had that procedure with good success.
- D. You seem fearful, can I answer any questions about the procedure?
Correct Answer: A
Rationale: Telling a patient that everything will be fine is a clich?©. This statement gives false assurance and may give the patient the impression that the nurse is dismissive of a patient's concerns or condition.
During a nursing staff meeting to discuss delayed documentation, the nurses unanimously agree that they will ensure all vital signs are reported and charted within 15 minutes following assessments. This decision is consistent with which characteristics of effective communication? Select all that apply.
- A. Group decision making
- B. Group leadership
- C. Group power
- D. Group identity
- E. Group patterns of interaction
- F. Group cohesiveness
Correct Answer: A,D,E,F
Rationale: Solving problems involves group decision making; ascertaining the task is important and agreeing to complete the task on time is characteristic of group identity. Group patterns of interaction involve honest communication and member support; cohesiveness occurs when members generally trust each other, have a high commitment to the group, and a high degree of cooperation.
During an interaction with a patient diagnosed with epilepsy, a nurse notes that the patient is silent after hearing the plan of care. How does the nurse best respond? Select all that apply.
- A. Fill the silence with lighter conversation directed at the patient.
- B. Use the time to perform the care that is needed uninterrupted.
- C. Discuss the silence with the patient to ascertain its meaning.
- D. Allow the patient time to think and explore inner thoughts.
- E. Determine if the patient's culture requires pauses between conversation.
- F. Arrange for a counselor to help the patient cope with emotional issues.
Correct Answer: C,D,E
Rationale: Appropriate use of silence allows the patient to initiate or to continue speaking; the nurse can reflect on what has been shared while observing the patient without having to concentrate simultaneously on conversation. In due time, the nurse might discuss the meaning of silence with the patient. The nurse considers whether the patient's culture may require longer pauses between verbal communication.
A nursing student is nervous and concerned about working at a clinical facility. Which action would best decrease anxiety and help ensure successful delivery of patient care?
- A. Determining the established goals of the institution
- B. Ensuring that verbal and nonverbal communication is congruent
- C. Engaging in self-talk to plan the day and decrease fear
- D. Speaking with fellow colleagues about how they feel
Correct Answer: C
Rationale: By engaging in positive self-talk, or intrapersonal communication, the nursing student can plan the day, decrease fear and anxiety, and enhance clinical performance.