The nurse can best communicate to a client that he or she has been listening by:
- A. restating the main feeling or thought the client has expressed.
- B. making a judgment about the client's problem.
- C. offering a leading question such as, 'And then what happened?'
- D. saying, 'I understand what you're saying.'
Correct Answer: A
Rationale: Restating allows the client to validate the nurse's understanding of what has been communicated. It's an active listening technique. Judgments should be suspended in a nurse-client relationship. Leading questions ask for more information rather than showing understanding. Saying 'I understand' communicates understanding, but the client has no way of measuring the understanding.
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The most effective nursing strategy to assist a client in recognizing and using personal strength includes:
- A. encouraging the client's self-identification of strengths
- B. promoting the client's active external thinking
- C. listening to the client and providing advice as needed
- D. assisting the client in maintaining an external locus of control
Correct Answer: A
Rationale: Encouraging self-identification of strengths empowers the client to recognize their capabilities, fostering confidence and resilience. External thinking or locus of control may disempower, and advice-giving is less effective than self-discovery.
The nurse who was not promoted tells another friend, 'I knew I'd never get the job. The hospital administrator hates me.' If she actually believes this of the administrator, who, in reality, knows little of her, she is demonstrating:
- A. compensation.
- B. reaction formation.
- C. projection.
- D. denial.
Correct Answer: C
Rationale: Projection results in unconsciously adopting blaming behavior. It attributes unacceptable attributes to other people.
A hospitalized client has just been informed that he has terminal cancer. He says to the nurse, 'There must be some mistake in the diagnosis.' The nurse determines that the client is demonstrating which of the following?
- A. denial
- B. anger
- C. bargaining
- D. acceptance
Correct Answer: A
Rationale: Denial (Kübler-Ross's Stages of Grieving) is the refusal to believe that loss is happening.
Legal protection of confidentiality:
- A. extends only to written documentation.
- B. extends to the electronic dissemination of information not identifiable to a specific client.
- C. is important only within the court system.
- D. extends to both written and verbal information.
Correct Answer: D
Rationale: Legal protection of confidentiality extends to both written and verbal information identifiable as individual private health information.
When questioning an elder about suspected abuse, the nurse should keep the questions:
- A. nonjudgmental.
- B. probing.
- C. confrontational.
- D. indirect.
Correct Answer: A
Rationale: Questions about suspected abuse should be direct and nonconfrontational. Indirect questions encourage denial.