Nokea
The home care nurse visits a mother and her newborn 2 days after discharge from the hospital. The mother states, "My baby cries all the time. I must not be a very good mother.= Which response by the nurse is nontherapeutic?
- A. "It sounds as if you are concerned about your ability to care for your baby.=
- B. "The nurse moves closer to the mother and places a hand on her shoulder."
- C. "You just need to get away for a few hours. Find a babysitter and go to a movie.=
- D. "I am not sure that I understand what you mean. Tell me more about how you feel.=
Correct Answer: C
Rationale: The correct answer is C because it dismisses the mother's feelings and suggests a temporary distraction instead of addressing her concerns. Choice A validates the mother's feelings and promotes open communication. Choice B demonstrates empathy and physical support. Choice D encourages the mother to express her emotions further for better understanding. Overall, choice C is nontherapeutic as it does not address the underlying issue of the mother's feelings of inadequacy and instead offers a superficial solution.
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The nurse cares for a patient who becomes confused and a vest restraint is applied. The nurse should take which action when notifying the patient's family?
- A. Avoid discussing the treatment plan to reduce anxiety and worry.
- B. Ask another nurse who has rapport with the family to be present.
- C. Use medical terms to demonstrate competence.
- D. Assume that the family wants a detailed explanation.
Correct Answer: B
Rationale: The correct answer is B because having another nurse who has a good relationship with the family present can help facilitate effective communication and address any concerns or questions the family may have. This approach can help build trust and provide emotional support during a potentially difficult situation.
A: Avoiding discussing the treatment plan can lead to confusion and distrust.
C: Using medical terms may confuse or intimidate the family and hinder effective communication.
D: Assuming the family wants a detailed explanation may not be accurate and can result in information overload.
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.
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.
Which statement describes the affective aspect of learning effective communication strategies?
- A. "The nurse should use clear, direct statements using objective words.=
- B. "The nurse uses body language that is congruent with the verbal message.=
- C. "The nurse believes that positive communication strategies build confidence.=
- D. "The nurse practices assertive and responsible communication strategies.=
Correct Answer: C
Rationale: The correct answer is C because it addresses the emotional or attitudinal aspect of learning effective communication strategies. Believing that positive communication strategies build confidence reflects the affective domain of learning, which involves feelings, attitudes, and beliefs. This statement emphasizes the importance of mindset and attitude in communication effectiveness.
Explanation of why other choices are incorrect:
A: Choice A focuses on the behavioral aspect of communication strategies, not the affective aspect.
B: Choice B emphasizes the non-verbal communication aspect, which is related to the behavioral domain, not the affective domain.
D: Choice D highlights the behavioral aspect of using assertive and responsible communication strategies, not the affective aspect.
A non-Hispanic white nurse provides care to mostly Hispanic patients. It would be most important for the nurse to take which action?
- A. Discover cultural influences on healthcare perceptions and behaviors.
- B. Assist the patients to adapt to American culture and health beliefs.
- C. Avoid confrontation of underlying issues of discrimination.
- D. Improve communication by learning how to speak Spanish.
Correct Answer: A
Rationale: Step 1: Understanding cultural influences is crucial for providing effective care to diverse patients.
Step 2: By discovering healthcare perceptions and behaviors, the nurse can tailor care to meet the patients' needs.
Step 3: This approach promotes cultural competence and improves patient outcomes.
Step 4: Other choices are incorrect as they do not address the core issue of cultural understanding and sensitivity.