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The C step of the DESC method is optional, depending on the circumstances. Explain what the C step is and why it may be needed.
- A. The C step involves stating consequences to emphasize accountability if the behavior continues.
- B. The C step involves apologizing to maintain rapport.
- C. The C step involves clarifying the behavior again.
- D. The C step involves suggesting alternative behaviors.
Correct Answer: A
Rationale: The C step (consequences) may be needed to underscore the importance of changing the behavior, particularly in serious or repeated issues.
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A patient expresses fears about her upcoming surgery. The nurse responds, 'You really don't have to worry. You have a great doctor and everything will turn out fine.' Why is this statement a barrier to communication?
- A. It diminishes the patient's concerns.
- B. It is not a complete answer, the nurse should provide more information.
- C. It is equivalent to telling the patient to not talk about her fears.
- D. Providing reassurance is not therapeutic.
Correct Answer: A,C
Rationale: This response dismisses the patient's fears and discourages further discussion, blocking therapeutic communication.
Your patient has an infected wound with a lot of dead tissue called eschar that is preventing healing. The doctor plans to debride the wound, which means to remove the dead tissue. You go in to prepare the patient for the procedure, which is done right at the bedside. Which of the following is the best way to communicate what will happen?
- A. The doctor is going to cut away all the black, dead skin.'
- B. The doctor is going to debride the eschar.'
- C. The doctor is going to remove dead tissue so the wound can heal.'
- D. The doctor is going to clean the wound.'
Correct Answer: C
Rationale: Using clear, simple language like 'remove dead tissue so the wound can heal' ensures the patient understands the procedure without causing alarm or using complex medical terms.
Acceptable, polite communication styles between professionals and their patients vary greatly among different cultures. Acceptable styles also vary within cultures. When approaching a patient from a cultural background other than your own, you should
- A. maintain distance and avoid direct eye contact to be on the safe side.
- B. observe how the family interacts and take your cues from that.
- C. ask another professional from that cultural background for advice, if possible.
- D. find out information about that culture from a different source, such as a pertinent Web site or text.
Correct Answer: B,C,D
Rationale: Observing family interactions, consulting a professional from the same cultural background, and researching the culture provide insights into appropriate communication styles, ensuring culturally sensitive care.
Your patient had spine surgery 2 days ago and is scheduled for discharge tomorrow. He has been taking narcotic pain relievers every 4 hours around the clock. You note that the patient has not had a bowel movement since surgery. You know that the narcotics can be constipating and you think it would be best if the problem is handled prior to the patient leaving for home. There is no order on the chart for a laxative. From the following possible actions, choose which you think represents the most focused and necessary thing(s) for you to do as you prepare to call the doctor for a verbal order for a laxative.
- A. Gather information about the patient's usual bowel habits; ask if he feels constipated and if he has used laxatives in the past.
- B. Ask the patient what laxative has worked for him in the past.
- C. Ask the patient to try to have a bowel movement.
- D. Get the chart and have a pen ready.
Correct Answer: A,B
Rationale: Gathering information about bowel habits and past laxative use provides essential data for the doctor to make an informed decision about the verbal order.
Shared meaning refers to two people deciding what another person meant.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: Shared meaning occurs when both parties in a communication understand the message in the same way, not deciding what another person meant.