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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.
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The nurse is performing a well-child assessment on a 15-month-old child. The child's mother and father are present. Which action by the nurse will best determine the health beliefs and values of the parents?
- A. Have the parents independently complete the Myers-Briggs Type Indicator survey.
- B. Read the documented health histories of the child's parents and grandparents.
- C. Actively listen to the parents talk about their lives and health concerns.
- D. Review the traditional health practices of the ethnic group identified by the parents.
Correct Answer: C
Rationale: The correct answer is C: Actively listen to the parents talk about their lives and health concerns. This action allows the nurse to directly learn about the parents' health beliefs and values. By listening attentively, the nurse can understand the parents' perspectives, concerns, and priorities regarding their child's health. This approach promotes trust and open communication, enabling the nurse to provide individualized and culturally sensitive care.
Explanation for why the other choices are incorrect:
A: Having the parents complete the Myers-Briggs Type Indicator survey is not relevant to determining their health beliefs and values.
B: Reading the health histories of the child's parents and grandparents may provide some background information but may not reflect their current health beliefs and values.
D: Reviewing traditional health practices of the ethnic group identified by the parents assumes that all individuals within that group hold the same beliefs, which may not be accurate.
According to Swanson's theory, there are five caring processes, one of which is "knowing." What are the other four?
- A. Communication, assertiveness, responsibility, and caring
- B. Maintaining belief, being with, doing for, and enabling
- C. Understanding, action, information, and comfort
- D. Maintaining belief, being with, enabling, and supporting
Correct Answer: B
Rationale: The correct answer is B: Maintaining belief, being with, doing for, and enabling.
- Maintaining belief: Involves believing in the patient's capacity for self-care.
- Being with: Being present and connecting emotionally with the patient.
- Doing for: Providing assistance and meeting the patient's needs.
- Enabling: Encouraging and supporting the patient to reach their full potential.
Other choices are incorrect:
- A: Communication, assertiveness, responsibility, and caring do not align with Swanson's caring processes.
- C: Understanding, action, information, and comfort are not the caring processes in Swanson's theory.
- D: Maintaining belief, being with, enabling, and supporting is partly correct but lacks the "doing for" process.
According to a study by Robinson (2014), three parts of our true presence (how we connect with patients) are found in being:
- A. Friendly, kind, and sweet
- B. Genuine, gifted, and creative
- C. Humorous, partial, and grateful
- D. Genuine, attentive, and immersed
Correct Answer: D
Rationale: The correct answer is D: Genuine, attentive, and immersed. This is because being genuine helps establish trust and rapport with patients, being attentive shows active listening and care, and being immersed means being fully engaged in the interaction. These qualities enhance the connection with patients and create a conducive environment for effective communication and care.
Explanation of other choices:
A: Friendly, kind, and sweet - While these qualities are positive, they do not fully capture the depth of true presence required for effective patient connection.
B: Genuine, gifted, and creative - Being genuine is essential, but being gifted and creative are not directly related to establishing a strong connection with patients.
C: Humorous, partial, and grateful - Humor can be beneficial, but being partial and grateful may not always align with maintaining professionalism and unbiased care for all patients.
The nurse prepares to obtain a health history from a hospitalized patient. Which action by the nurse is appropriate?
- A. Set time limits for the interview to reduce cost.
- B. Avoid asking questions that may upset the patient.
- C. Respect the patient's privacy by closing the door.
- D. Stand at the foot of the bed to maintain eye contact.
Correct Answer: C
Rationale: The correct answer is C: Respect the patient's privacy by closing the door. Closing the door ensures confidentiality and privacy during the health history interview. This step is crucial to maintain the patient's dignity and foster trust. Setting time limits (choice A) may compromise the quality of the assessment. Avoiding upsetting questions (choice B) may hinder the gathering of important information. Standing at the foot of the bed for eye contact (choice D) is not appropriate as it may seem confrontational and uncomfortable for the patient.
The nurse manager asks the staff nurse to work an extra shift. Which response by the staff nurse is assertive and based on rational beliefs?
- A. "I don't want you upset, so I will work extra."
- B. "Why do I always have to cover extra shifts?"
- C. "I am not able to work an extra shift."
- D. "If you can't find anyone else, I will do it."
Correct Answer: C
Rationale: The correct answer is C because it directly and assertively communicates the staff nurse's inability to work an extra shift. This response sets clear boundaries and respects the nurse's own limitations and well-being. It is based on rational beliefs as it acknowledges personal capacity without guilt or unnecessary explanations.
Explanation of other choices:
A: This choice is not assertive as it prioritizes avoiding upsetting the nurse manager over the nurse's own needs and boundaries.
B: This response is confrontational and does not address the request directly, focusing instead on questioning past occurrences.
D: While this response offers to work the extra shift as a last resort, it does not assert the nurse's own limitations clearly, leaving room for potential guilt or manipulation.