Nokea
In the early postoperative period, what is the priority concern for Mr. L, who has a tracheostomy and partial laryngectomy?
- A. Possible infection related to chemotherapy and surgical procedure
- B. Poor nutritional intake related to dysphagia and malignancy
- C. Difficulty communicating needs because of the tracheostomy tube
- D. High risk for aspiration because of secretions and removal of epiglottis
Correct Answer: D
Rationale: The correct answer is D: High risk for aspiration because of secretions and removal of epiglottis. This is the priority concern for Mr. L due to the risk of food or liquid entering the airway, leading to aspiration pneumonia and respiratory distress. The tracheostomy and partial laryngectomy compromise the airway protection mechanism, increasing the risk of aspiration. Options A and B are not the priority as infection and poor nutrition can be managed after addressing the risk of aspiration. Option C, while important for communication, is not as immediately life-threatening as the risk of aspiration.
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When communicating with an adolescent, the nurse should be very sensitive to avoid:
- A. asking embarrassing questions.
- B. offering advice.
- C. interrupting frequently.
- D. using active listening. An adolescent needs time to talk. The nurse should use active listening, avoid interrupting, and show acceptance. The nurse should try not to give advice.
Correct Answer: B
Rationale: The correct answer is B because offering advice can come off as dismissive to adolescents who value autonomy and independence. Adolescents prefer to feel heard and understood rather than being told what to do. Providing unsolicited advice can hinder trust and communication. Asking embarrassing questions (A) can be inappropriate but can still be necessary for assessment. Interrupting frequently (C) disrupts the flow of communication. Using active listening (D) is important but does not directly relate to avoiding sensitive topics with adolescents.
Ms. G (breast lumpectomy) continues to be anxious and tearful, and she says that she has changed her mind about the surgery, saying, "I'm going to go home. I just can't deal with everything that is going on right now. I need some time to think about things." What is the best response?
- A. "It's okay to change your mind. You have the right to make your own decisions."
- B. "Please reconsider. This surgery is very important, and your health is the priority."
- C. "Would you like me to call your HCP, so you can discuss your concerns?"
- D. "I see you are very concerned. What things are you dealing with and thinking about?"
Correct Answer: A
Rationale: The correct answer is A because it acknowledges Ms. G's autonomy and respects her right to make decisions about her own body. By validating her feelings and choices, it helps build trust and rapport. Choice B is incorrect as it disregards Ms. G's emotional state and can come off as dismissive. Choice C assumes Ms. G needs immediate medical intervention without exploring her concerns further. Choice D, although showing empathy, does not directly address Ms. G's decision to change her mind about the surgery.
A home health patient with a bleeding ulcer informs the nurse that she ate a bowl of chili with jalapenos. An inappropriate communication block with a judgmental tone by the nurse would be:
- A. "Well, you have had this problem long enough to know what will happen—you certainly can't blame me!"
- B. "I don't think that was a smart thing for you to do considering your ulcer."
- C. "Well, you better watch your stool for evidence of blood so you can notify your primary care provider."
- D. "Oh, poo! A bowl of chili every now and then won't make a lot of difference to your ulcer." Judgmental response is a block to effective communication in which the nurse is judging the patient's action. It implies that the patient must take on the nurse's values and is demeaning to the patient.
Correct Answer: B
Rationale: The correct answer is B because it demonstrates a judgmental tone towards the patient's actions. The nurse is passing a negative judgment on the patient by stating that eating chili with jalapenos was not a smart decision considering the ulcer. This response can make the patient feel guilty or ashamed, hindering effective communication.
Choice A shows frustration and blame towards the patient, which can lead to a defensive response. Choice C is directive and lacks empathy, focusing solely on the medical aspect without considering the patient's feelings. Choice D dismisses the patient's concerns and minimizes the impact of the action, which can be perceived as condescending.
In summary, choice B is the correct answer as it highlights the importance of maintaining a non-judgmental and supportive attitude in patient communication.
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.
When an office nurse asks the patient to repeat information that he has just given to the patient over the telephone, the nurse is:
- A. testing the patient's intelligence and memory.
- B. acting in a cautious way to avoid charges of negligence.
- C. verifying that the patient understands the information.
- D. saving the extra time it would take to mail the information. Obtaining feedback from a patient to ascertain that the patient understands instructions is an important part of the communication process, especially over the phone, when the nurse does not have nonverbal cues.
Correct Answer: C
Rationale: The correct answer is C because asking the patient to repeat the information verifies their understanding. This is crucial in healthcare to ensure accurate communication and patient safety. Choice A is incorrect as it focuses on intelligence rather than comprehension. Choice B is incorrect as it assumes the nurse is motivated by avoiding negligence rather than patient care. Choice D is incorrect as saving time should not compromise patient understanding.Verifying patient comprehension fosters effective communication and prevents errors.