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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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The nurse cares for a patient with a terminal illness. Which way would be the most therapeutic for the nurse to communicate with this patient?
- A. Use an honest, judgmental attitude.
- B. Demonstrate understanding with empathy.
- C. Acknowledge hope by expressions of sympathy.
- D. Consistently evaluate the patient's feelings.
Correct Answer: B
Rationale: The correct answer is B: Demonstrate understanding with empathy. This approach is the most therapeutic as it shows the nurse's genuine care and support for the patient, fostering a sense of trust and emotional connection. By empathizing, the nurse validates the patient's feelings and provides comfort without judgment.
A: Using an honest, judgmental attitude can be harmful and create a barrier in the nurse-patient relationship.
C: Acknowledging hope by expressions of sympathy is important but may not address the patient's immediate emotional needs.
D: Consistently evaluating the patient's feelings is important, but without demonstrating empathy, it may come across as clinical and detached.
In summary, choice B is the best approach as it prioritizes empathy and understanding, essential components in providing effective therapeutic communication.
Which characteristic would the nurse use to define culture? (Select all that apply)
- A. Learned and shared lifeways of a particular group.
- B. Social identity influenced by language and religion.
- C. Belief in superiority of one's own ethnic group.
- D. Values influence both thinking and actions.
Correct Answer: A
Rationale: The correct answer is A because culture is defined as the learned and shared lifeways of a particular group. This includes traditions, customs, beliefs, and practices that are passed down from generation to generation within a community. This definition aligns with the concept of culture being a set of learned behaviors and beliefs that are commonly practiced and shared among individuals in a society.
Choice B is incorrect because while social identity can be influenced by language and religion, it does not fully encompass the complexity of culture. Choice C is incorrect as it refers to ethnocentrism, which is the belief in the superiority of one's own ethnic group and is not a defining characteristic of culture. Choice D is incorrect because while values do influence thinking and actions within a culture, it does not capture the entirety of what culture entails, such as traditions, customs, and shared beliefs.
The nurse cares for a client who is scheduled for a breast biopsy. Which is the main purpose of the client–nurse relationship?
- A. To develop a mutually satisfying experience for the client and nurse.
- B. To assist the client in achieving and maintaining optimal health.
- C. To provide excellent client service and improve quality of care.
- D. To allow the client to receive important health information.
Correct Answer: B
Rationale: The correct answer is B: To assist the client in achieving and maintaining optimal health. The main purpose of the client-nurse relationship is to promote the client's health and well-being. The nurse's role is to support the client in achieving their health goals and maintaining good health. This goes beyond just providing care during a specific procedure like a breast biopsy. Options A, C, and D are incorrect because while they may be components of the client-nurse relationship, they do not encompass the main purpose of promoting optimal health.
The first-semester nursing student tells the team leader that her clinical assignment for the day is to take vital signs and obtain a client history that will take about 1 or 2 hours to complete. Which clients would the leader recommend that she approach to fulfill her assignment? (Select all that apply.)
- A. Mr. N (non-Hodgkin lymphoma)
- B. Mr. L (tracheostomy and partial laryngectomy)
- C. Mr. B (bladder cancer)
- D. Ms. C (bowel resection and colostomy)
Correct Answer: B
Rationale: The correct answer is B because Mr. L, who has a tracheostomy and partial laryngectomy, will likely require vital signs monitoring and a detailed client history due to his complex respiratory and communication needs. This assignment will provide the student with valuable experience in caring for clients with specialized needs.
Incorrect choices:
A: Mr. N (non-Hodgkin lymphoma) - While Mr. N may require vital signs monitoring, his condition does not necessarily involve complex care needs that would warrant a 1-2 hour history-taking session.
C: Mr. B (bladder cancer) - Vital signs monitoring and history-taking for a client with bladder cancer may not require as much time as the scenario suggests, as the care needs may not be as complex as those of a client with a tracheostomy and laryngectomy.
D: Ms. C (bowel resection and colostomy) - While Ms. C may require vital signs monitoring and history-taking
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.