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An experienced nurse is evaluating a new nurse to the unit who is providing discharge instructions to an adult client. The experienced nurse views the following: The new nurse approaches and decreases the volume on the television and then sits beside the client, presenting the information to the client and spouse. The new nurse states, 'You are to take ciprofloxacin 250 mg, two tablets b.i.d. A regular diet is ordered, and you are to follow up with your physician in 2 weeks. Here is printed information on the medication ordered.' The new nurse obtains appropriate signatures and leaves. Which point would the experienced nurse address?
- A. The nurse should use shorter sentences when teaching.
- B. The nurse should improve professionalism and stand.
- C. The nurse should minimize medical terms when teaching.
- D. The nurse should continue with the same method without changes.
Correct Answer: C
Rationale: When teaching adult clients, it is best to minimize technical terms and medical jargon ('b.i.d.' for example) whenever able. The nurse used appropriate sentence length. Sitting beside the client is appropriate, and it is best to reduce noise and distraction by decreasing the volume of the television. With minimal change, the new nurse can improve with teaching skills.
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The nurse is caring for a client who is newly diagnosed with atrial fibrillation. The client expresses having many questions. At what point in the client contact experience should the nurse begin client education?
- A. During a morning assessment
- B. When presenting the client with a brochure
- C. Once the health care provider confirms the diagnosis
- D. As soon as possible after admission to the hospital
Correct Answer: D
Rationale: Client teaching should begin as soon as possible after admission to the hospital. Even when the client is in the emergency department, health care providers and staff are explaining testing and procedures. The nurse will continue client education whenever there is an opportunity for teaching, such as during a morning assessment, when presenting the client with new information, or when the health care provider confirms a diagnosis.
The nurse is caring for a client who has been diagnosed with a cerebral vascular accident and displays expressive aphasia. In which manner does the nurse best promote communication?
- A. Ask the client open-ended questions and allow time for a response.
- B. Give the client a tablet and pencil to use.
- C. Provide the client with a speaking valve.
- D. Use a picture board with common responses.
Correct Answer: D
Rationale: For clients with aphasia, it is most helpful to have a picture board with responses to convey meaning. This decreases some frustration and allows the client to have some control over care. Asking a client with expressive aphasia open-ended questions is not the best option because the client is unable to give lengthy responses. Depending on the client's degree of aphasia, closed-ended questions may be appropriate. A speaking valve is useful for a client who has a tracheostomy or one who has had laryngectomy.
Which of the following is a purpose of affective touch in the context of nursing?
- A. Demonstrating concern
- B. Providing contact for performing procedures
- C. Encouraging verbal communication
- D. Providing brief periods for response
Correct Answer: A
Rationale: Affective touch is touch used to demonstrate concern or affection. Task-oriented touch involves the personal contact that is needed for performing nursing procedures. Silence is the art of remaining quiet. Encouraging verbal communication and providing a brief period during which clients can respond to a question are therapeutic uses of silence.
The nurse is caring for a client and family who are awaiting the results of a diagnostic test. Which nursing action best demonstrates therapeutic nonverbal communication?
- A. The nurse listens to the client's frustration of waiting for test results.
- B. The nurse smiles and rubs the client's shoulder as the client expresses frustration at waiting for the test results.
- C. The nurse is silent while carrying out nursing duties.
- D. The nurse shrugs the shoulders when asked when testing results will return.
Correct Answer: B
Rationale: A smile and rub of the client's shoulder is a nonverbal gesture that the nurse understands the client's situation. Listening to client frustration is an activity that reflects verbal communication because, therapeutically, there is a response. Silence can be therapeutic when the attention is with the client, not the nursing duties. Shrugging the shoulders can be perceived as indifferent and not caring.
Which of the following nursing statements, made to the client, provides an example of a broad opening?
- A. Wow, the weather is looking nice outside.
- B. Would you like your pills whole or cut in half?
- C. So you live in a ranch-style home with a bathroom off your bedroom.
- D. Oh, your daughter lives within walking distance of your home.
Correct Answer: A
Rationale: A broad opening is intended to open communication on a common topic and relieve tension. Focusing on the weather provides that common topic to initiate communication. Further communication and specific topics flow from this point. Inquiring about medication administration is on a specific topic and in need of a specific response. The other options deal with specific topic points presented during a discussion.