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An experienced nurse is supervising a student nurse in an acute care setting. Which statement, if made by the experienced nurse, would be most appropriate to help the student nurse establish credibility with other nurses on the unit?
- A. "It is impossible to be credible when you are a student because you lack experience.=
- B. "Try to hide your feelings of inadequacy and portray a sense of confidence.=
- C. "Be honest with the nurses about your strengths and about areas that need improvement.=
- D. "It would help if you bring special treats for the nurses so that they will like you.=
Correct Answer: C
Rationale: The correct answer is C: "Be honest with the nurses about your strengths and about areas that need improvement." This statement promotes transparency, self-awareness, and humility, which are important traits in gaining credibility. Being honest about strengths shows confidence, while acknowledging areas for improvement demonstrates a willingness to learn and grow. This approach fosters trust and respect among colleagues.
Choice A is incorrect as it undermines the student nurse's potential for credibility based on experience. Choice B suggests masking feelings of inadequacy, which can lead to inauthentic interactions. Choice D is inappropriate as it implies trying to buy favor with treats rather than earning credibility through professional conduct.
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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.
Ms. C (bowel resection) repeatedly refuses to perform a return demonstration of any aspect of colostomy care. Despite steady improvement and independent resumption of other ADLs, she protests, "I'm too weak. You'll have to do it for me." At this point, what is the priority nursing concept to consider in planning interventions for Ms. C?
- A. Mobility
- B. Tissue integrity
- C. Functional ability
- D. Coping
Correct Answer: C
Rationale: The correct answer is C: Functional ability. This is because the priority nursing concept to consider in planning interventions for Ms. C is her ability to independently perform colostomy care. By refusing to demonstrate, she may be indicating a lack of functional ability to manage this aspect of self-care. This is essential for her long-term independence and quality of life. Mobility (choice A) is important but not the priority in this case. Tissue integrity (choice B) is also crucial but not as immediate as ensuring functional ability. Coping (choice D) is important for emotional well-being but does not address the primary issue of functional ability for self-care.
It would be most important for the nurse to temporarily withdraw expressions of warmth to which patient?
- A. A 20-year-old patient who is angry and throwing objects.
- B. A 32-year-old patient who is withdrawn and refuses nursing care.
- C. A 48-year-old patient who is extremely anxious about surgery.
- D. A 56-year-old patient who has a history of violent behavior.
Correct Answer: D
Rationale: The correct answer is D because the patient with a history of violent behavior poses a potential risk to the nurse's safety. Temporarily withdrawing expressions of warmth is important to establish boundaries and ensure safety. Choice A involves an angry patient, but the risk of violence is higher with a history of violent behavior. Choices B and C do not indicate immediate safety concerns.
When interacting with an older adult patient, the nurse would enhance communication by:
- A. speaking slowly in order to allow the patient to process the message.
- B. addressing him by his first name to encourage a therapeutic relationship.
- C. standing in the doorway rather than entering the room to give the older adult patient more privacy.
- D. speaking in simple sentences, as if to a child. When interacting with an older adult, the nurse should try not to speak too quickly or expect an immediate answer because the older adult may take more time to process the message. Do not use baby talk or speak to them as if they were children.
Correct Answer: A
Rationale: The correct answer is A because speaking slowly allows the older adult patient to process the message at their own pace, considering potential hearing or cognitive impairments. Speaking slowly also shows respect and patience.
Option B is incorrect because using the first name may not be culturally appropriate or may not align with the patient's preference for formality.
Option C is incorrect because standing in the doorway may be seen as disrespectful and inhibit effective communication by creating physical barriers.
Option D is incorrect because speaking in simple sentences is important, but speaking as if to a child may be patronizing and disrespectful to the older adult patient.
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.