Nokea
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- B. A 32-year-old patient who is withdrawn and refuses nursing care.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.
You may also like to solve these questions
The nurse cares for a young adult patient in the emergency room after a sexual assault. Which action by the nurse is appropriate?
- A. Avoid situations in which the patient will be involved with decision making.
- B. Tell the patient to join a local support group for sexual assault victims.
- C. Actively listen to the patient express feelings related to the sexual assault.
- D. Provide detailed information about evidence collection and invasive procedures.
Correct Answer: C
Rationale: The correct answer is C because actively listening to the patient express feelings related to the sexual assault is crucial for providing emotional support and establishing trust. This action demonstrates empathy and validates the patient's experience. It allows the patient to process their emotions and facilitates a therapeutic relationship.
Avoiding decision-making situations (A) is inappropriate as it disregards the patient's autonomy. Suggesting joining a support group (B) may be helpful but should not be the immediate priority over addressing the patient's current emotional needs. Providing detailed information about evidence collection and procedures (D) is important but should come after addressing the patient's emotional well-being.
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.
While admitting a patient to the medical unit, the nurse should take which action?
- A. Demonstrate human caring by hugging the patient for brief intervals.
- B. Disclose shared intimate details with other healthcare providers.
- C. Maintain a physical distance of at least 3 to 4 feet at all times.
- D. Develop the plan of care and measurable objectives with the patient.
Correct Answer: D
Rationale: The correct answer is D because developing a plan of care and measurable objectives with the patient promotes patient-centered care, encourages collaboration, and ensures the patient's active involvement in their own care. This approach respects the patient's autonomy and preferences, fosters shared decision-making, and enhances treatment adherence.
A: Demonstrating human caring by hugging the patient may not be appropriate as it can violate professional boundaries and personal space.
B: Disclosing shared intimate details with other healthcare providers breaches patient confidentiality and violates privacy rights.
C: Maintaining a physical distance of at least 3 to 4 feet at all times may be necessary for infection control but does not address the core aspect of involving the patient in their care plan.
During the initial interview of a patient, the nurse should: (Select all that apply.)
- A. assess the language capabilities of the patient.
- B. use open-ended questions.
- C. limit the interview to approximately 30 minutes.
- D. assess comprehension abilities of the patient.
Correct Answer: A
Rationale: The correct answer is A: assess the language capabilities of the patient. This is crucial to ensure effective communication and understanding. By assessing language capabilities, the nurse can tailor communication strategies appropriately. Option B is helpful but not as essential as language assessment. Option C is incorrect as the interview duration should be based on patient needs, not a set time limit. Option D is relevant, but assessing comprehension abilities alone may not be sufficient if language barriers exist.
According to Swanson's theory, there are five caring processes, one of which is "being with.= Which of the responses by the nurse portrays an understanding of the concept of "being with= a client?
- A. The nurse charting in the room to spend more time with the client
- B. The nurse wearing locator badge so you can quickly respond any time patient would call front desk and ask to page you
- C. The nurse requesting one-on-one nurse staffing
- D. The nurse being emotionally present to the client
Correct Answer: D
Rationale: Step 1: Swanson's theory emphasizes the importance of "being with" a client, which involves being emotionally present and fully engaged.
Step 2: Choice D reflects the concept of "being with" as it highlights the nurse's emotional presence and connection with the client.
Step 3: The nurse actively engages with the client on an emotional level, demonstrating empathy and understanding.
Step 4: Choices A, B, and C do not capture the essence of "being with" as they focus more on physical presence or logistical aspects rather than emotional connection.
Summary: Choice D is correct because it aligns with the core principle of "being with" by emphasizing emotional presence, while the other choices lack this critical component.