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According to Kimble and Bamford-Wade, what distinguishes the behavior of one caring and competent nurse from another nurse who is simply competent but not engaged with the patient?
- A. Immediacy, the availability of the nurse
- B. Warmth, the hallmark of compassion
- C. Attention, the focus of the nurse
- D. Communication, the instructional side of the nurse
Correct Answer: B
Rationale: The correct answer is B: Warmth, the hallmark of compassion. Kimble and Bamford-Wade emphasize that warmth, which signifies compassion, is the key factor that distinguishes a caring and competent nurse from one who is solely competent but lacks engagement with the patient. This is because warmth builds trust, fosters connection, and shows genuine concern for the patient's well-being. Immediacy (A) may be important for timely care, attention (C) is vital but doesn't capture the emotional aspect, and communication (D) is essential but focuses more on the delivery of information rather than the emotional connection that warmth provides.
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According to Swanson's theory, there are five caring processes, one of which is "being with.= Which of the responses by the nurse portrays an understanding of the concept of "being with= a client?
- A. The nurse charting in the room to spend more time with the client
- B. The nurse wearing locator badge so you can quickly respond any time patient would call front desk and ask to page you
- C. The nurse requesting one-on-one nurse staffing
- D. The nurse being emotionally present to the client
Correct Answer: D
Rationale: Step 1: Swanson's theory emphasizes the importance of "being with" a client, which involves being emotionally present and fully engaged.
Step 2: Choice D reflects the concept of "being with" as it highlights the nurse's emotional presence and connection with the client.
Step 3: The nurse actively engages with the client on an emotional level, demonstrating empathy and understanding.
Step 4: Choices A, B, and C do not capture the essence of "being with" as they focus more on physical presence or logistical aspects rather than emotional connection.
Summary: Choice D is correct because it aligns with the core principle of "being with" by emphasizing emotional presence, while the other choices lack this critical component.
A patient is attracted to the nurse and attempts to initiate a social relationship. It is most appropriate for the nurse to take which action?
- A. Encourage the client's behavior to develop a trusting nurse–client relationship.
- B. Inform the charge nurse of the situation and ask for a different patient assignment.
- C. Tell the patient that the relationship must remain professional at all times.
- D. Determine if the patient can be transferred to another nursing care unit.
Correct Answer: C
Rationale: The correct answer is C. It is crucial for healthcare professionals to maintain professional boundaries with patients to ensure ethical practice and prevent potential harm. By telling the patient that the relationship must remain professional, the nurse sets clear boundaries and maintains the integrity of the therapeutic relationship. This approach protects both the patient and the nurse from potential ethical violations.
Choice A is incorrect because encouraging the behavior could lead to boundary violations and harm the therapeutic relationship. Choice B is not the most appropriate immediate action as it does not address the situation directly with the patient. Choice D is also not the best course of action as transferring the patient does not address the underlying issue of maintaining professional boundaries.
The community health nurse is listening to a client talk about a personal problem. Which of these actions by the nurse is most appropriate?
- A. The nurse should increase the physical distance from the client.
- B. The nurse should lean toward the client and make eye contact.
- C. The nurse should periodically interrupt the client to ask questions.
- D. The nurse should initiate the physical assessment to distract the client.
Correct Answer: B
Rationale: The correct answer is B because leaning towards the client and making eye contact demonstrates active listening and empathy, helping to build rapport and trust. This non-verbal communication shows the client that the nurse is engaged and attentive, creating a safe space for them to share their personal problem. Increasing physical distance (A) may convey disinterest or lack of connection. Periodically interrupting the client (C) can disrupt the flow of conversation and hinder the client's ability to express themselves. Initiating a physical assessment (D) would be inappropriate as it could feel intrusive and insensitive given the context of the client discussing a personal problem. Overall, choice B fosters a supportive environment for effective communication and client-centered care.
Which statement describes the affective aspect of learning effective communication strategies?
- A. "The nurse should use clear, direct statements using objective words.=
- B. "The nurse uses body language that is congruent with the verbal message.=
- C. "The nurse believes that positive communication strategies build confidence.=
- D. "The nurse practices assertive and responsible communication strategies.=
Correct Answer: C
Rationale: The correct answer is C because it addresses the emotional or attitudinal aspect of learning effective communication strategies. Believing that positive communication strategies build confidence reflects the affective domain of learning, which involves feelings, attitudes, and beliefs. This statement emphasizes the importance of mindset and attitude in communication effectiveness.
Explanation of why other choices are incorrect:
A: Choice A focuses on the behavioral aspect of communication strategies, not the affective aspect.
B: Choice B emphasizes the non-verbal communication aspect, which is related to the behavioral domain, not the affective domain.
D: Choice D highlights the behavioral aspect of using assertive and responsible communication strategies, not the affective aspect.
While interviewing a Native American man for the admission history, the nurse should expect to:
- A. wait patiently through long pauses in the conversation.
- B. maintain eye contact with the patient.
- C. give the patient permission to speak.
- D. have another family member speak for the patient. Native Americans use long pauses in their conversation to better consider their answer and consider the question. The culturally sensitive nurse would wait quietly through the pauses.
Correct Answer: A
Rationale: The correct answer is A because it acknowledges the cultural communication norms of Native American individuals, who may take longer pauses during conversations to reflect and respond thoughtfully. By waiting patiently through these pauses, the nurse shows respect for the individual's communication style and allows for effective dialogue.
Option B is incorrect because maintaining constant eye contact may be perceived as confrontational or disrespectful in some Native American cultures. Option C is incorrect as it assumes the patient needs permission to speak, which may not align with their cultural norms. Option D is incorrect as it undermines the individual's autonomy and may not accurately represent their perspective.