Nokea
According to the NCSBN, appropriate self-disclosure is a part of maintaining professional boundaries. Appropriate self-disclosure includes the following:
- A. Discussing intimate or personal values with patients
- B. Keeping secrets with a patient or for a patient
- C. Expressing you are the only one who truly understands patient
- D. Brief, focused, and only used if experience is similar
Correct Answer: D
Rationale: The correct answer is D because appropriate self-disclosure in a therapeutic setting should be brief, focused, and only shared if it enhances the therapeutic relationship. This helps maintain professional boundaries and keeps the focus on the patient's needs. Choice A is incorrect because discussing intimate or personal values with patients can blur boundaries and shift the focus away from the patient. Choice B is incorrect because keeping secrets with or for a patient can lead to ethical dilemmas and compromise trust. Choice C is incorrect because expressing that you are the only one who truly understands the patient can create a power imbalance and hinder the therapeutic process.
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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.
The nurse discusses smoking cessation with a client. Which action, if taken by the nurse, would most likely result in a behavior change?
- A. The nurse should advise the client to contact the national telephone quitline.
- B. The nurse should recommend nicotine replacement and behavioral interventions.
- C. The nurse should collaborate with the client to develop an individualized plan of action.
- D. The nurse should implement a strategy that has been validated by research.
Correct Answer: C
Rationale: The correct answer is C: The nurse should collaborate with the client to develop an individualized plan of action. This is the most likely action to result in a behavior change because it involves actively involving the client in the process, taking into account their unique needs, preferences, and circumstances. By collaborating with the client, the nurse can tailor the smoking cessation plan to be more personalized and therefore more effective.
Choice A (contact the national telephone quitline) may be helpful but lacks individualization. Choice B (recommend nicotine replacement and behavioral interventions) is a good approach but may not address the client's specific needs. Choice D (implement a strategy validated by research) is important but may not be as effective if it does not consider the client's individual factors. Overall, choice C is the best option as it promotes client engagement and customization for a higher chance of successful behavior change.
The nurse provides care to a client from Nigeria who is visiting the United States. Which should the nurse use to communicate with this client?
- A. Review the predominant health beliefs of the Nigerian population.
- B. Appraise the client's health beliefs and behaviors with a cultural assessment.
- C. Consult with other nurses who have taken care of clients from other countries.
- D. Use standard communication techniques to establish a helping relationship.
Correct Answer: B
Rationale: The correct answer is B because conducting a cultural assessment allows the nurse to understand the client's individual health beliefs and behaviors. This approach promotes culturally competent care by tailoring interventions to the client's specific needs. Option A is incorrect as it assumes all Nigerians have the same health beliefs. Option C is not necessary as the nurse can directly assess the client. Option D does not consider the importance of cultural competence in communication. Conducting a cultural assessment ensures effective communication and respectful care.
The nurse cares for elderly clients in an assisted living center. Which action by the nurse would best show respect for these clients?
- A. Patronize clients who share ideas or voice concerns.
- B. Identify healthcare needs by listening to the clients.
- C. Address the clients formally by their last names.
- D. Limit the clients' opportunities to express opinions.
Correct Answer: B
Rationale: The correct answer is B because listening to the elderly clients to identify their healthcare needs demonstrates respect by valuing their input and autonomy. This approach fosters a collaborative and client-centered care environment. Choice A is incorrect as patronizing clients undermines their dignity. Choice C may be seen as impersonal and distant. Choice D is disrespectful as it restricts clients' autonomy and diminishes their voice. Listening and considering clients' needs is crucial in providing respectful care to the elderly population.
The nurse plans to delegate a client's personal hygiene to a nursing assistant. Which statement if made by the nurse to the nursing assistant is assertive?
- A. "Would you mind helping the client with a bath when you have time? If not, I will skip my lunch and do it myself."
- B. "You never get your work done and are always on the phone. You need to help the client right now with a bath, or I will write you up."
- C. "The client needs help with bathing. I want you to assist the client now, and you can go to lunch when you are finished."
- D. "I have important work to complete this morning. You will assist the client with a bath. Do not take a break until you have finished."
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. The statement in choice C is assertive because it clearly states the task, timeline, and expectation without being aggressive or demeaning.
2. It communicates the need for assistance with the client's bath and sets a clear priority.
3. It provides a specific instruction for the nursing assistant to assist the client immediately and then take a break.
4. This approach demonstrates effective delegation and ensures the client's needs are met promptly and respectfully.
Summary:
A: This choice is not assertive as it presents a conditional statement and implies a personal sacrifice by the nurse if the task is not completed.
B: This choice is aggressive and threatening, which is not appropriate in a professional setting.
D: This choice is directive but lacks consideration for the nursing assistant's well-being and does not communicate the urgency of the task for the client.