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The nurse cares for a female patient who is trying to gain understanding of her life and her diagnosis of metastatic breast cancer. Which approach by the nurse would best meet this patient's needs?
- A. Suggest the patient join a breast cancer support group.
- B. Provide the patient with reading material on death and dying.
- C. Contact the patient's spiritual leader to request daily visits.
- D. Listen to the patient's stories about her past experiences.
Correct Answer: D
Rationale: The correct answer is D because actively listening to the patient's stories about her past experiences allows for emotional expression, validation, and building trust. It promotes therapeutic communication and helps the patient gain understanding and cope with her diagnosis. Choice A focuses on group support, which may not address the patient's individual needs. Choice B is not appropriate as it may induce unnecessary fear. Choice C assumes the patient has specific spiritual beliefs and may not be welcomed.
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A patient who has had a stroke is unable to speak clearly and has right sided hemiplegia. The nurse will design the approach to the assessment interview by:
- A. asking questions and explaining procedures to the patient's daughter.
- B. speaking slowly and giving the patient time to respond.
- C. telling the patient he will get all necessary information from the daughter.
- D. prompting the answers and finishing the sentences for the patient. Speaking slowly recognizes that the patient may process (if able) information more slowly.
Correct Answer: B
Rationale: The correct answer is B because speaking slowly and giving the patient time to respond allows the patient with speech difficulties due to the stroke to process information and formulate a response. Prompting or finishing sentences can hinder the patient's ability to communicate independently. Asking questions to the patient directly, rather than relying on a family member, ensures accurate information is obtained directly from the patient. Telling the patient that all information will come from the daughter undermines the patient's autonomy and may lead to incomplete or inaccurate information.
A nurse preceptor is assigned to help several graduate nurses assess their ability to convey warmth to patients. Which activity, if selected by the nurse preceptor, is best?
- A. Set up sessions for the graduate nurses to practice various nonverbal gestures.
- B. Ask the graduate nurses to record the behaviors of experienced nurses on the unit.
- C. Provide the graduate nurses with a list of nonverbal behaviors that convey warmth.
- D. Have the graduate nurses evaluate each other during simulated patient interviews.
Correct Answer: A
Rationale: The correct answer is A because setting up sessions for the graduate nurses to practice various nonverbal gestures allows for active skill development. By practicing these gestures, they can receive immediate feedback from the preceptor and improve their ability to convey warmth effectively.
Choice B is incorrect because simply observing behaviors of experienced nurses may not actively engage the graduate nurses in practicing and developing their own skills.
Choice C is incorrect because providing a list of nonverbal behaviors may not be as effective as hands-on practice in improving the graduate nurses' ability to convey warmth.
Choice D is incorrect because having the graduate nurses evaluate each other during simulated interviews may not provide structured guidance and feedback from the preceptor to help them improve their nonverbal communication skills effectively.
A patient asks the nurse to make a decision for her about whether or not to continue taking hormone replacement therapy (estrogen). Which response by the nurse is most appropriate?
- A. "You should check with a doctor; I cannot give you advice about drugs."
- B. "My friend has taken estrogen for more than 5 years without any problems."
- C. "I can answer any questions you have but it is up to you to make this decision."
- D. "Herbal supplements were much better for me than prescription-strength estrogen."
Correct Answer: C
Rationale: The correct answer is C because it emphasizes patient autonomy and informed decision-making, aligning with ethical principles. The nurse should not make decisions for the patient but should provide information and support. Choice A deflects responsibility and does not empower the patient. Choice B is anecdotal and not a reliable source of information. Choice D is not relevant to the patient's question and could potentially lead to misinformation. Ultimately, choice C encourages the patient to take an active role in their healthcare decisions, which promotes patient-centered care.
The nurse plans to delegate a client's personal hygiene to a nursing assistant. Which statement if made by the nurse to the nursing assistant is assertive?
- A. "Would you mind helping the client with a bath when you have time? If not, I will skip my lunch and do it myself."
- B. "You never get your work done and are always on the phone. You need to help the client right now with a bath, or I will write you up."
- C. "The client needs help with bathing. I want you to assist the client now, and you can go to lunch when you are finished."
- D. "I have important work to complete this morning. You will assist the client with a bath. Do not take a break until you have finished."
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. The statement in choice C is assertive because it clearly states the task, timeline, and expectation without being aggressive or demeaning.
2. It communicates the need for assistance with the client's bath and sets a clear priority.
3. It provides a specific instruction for the nursing assistant to assist the client immediately and then take a break.
4. This approach demonstrates effective delegation and ensures the client's needs are met promptly and respectfully.
Summary:
A: This choice is not assertive as it presents a conditional statement and implies a personal sacrifice by the nurse if the task is not completed.
B: This choice is aggressive and threatening, which is not appropriate in a professional setting.
D: This choice is directive but lacks consideration for the nursing assistant's well-being and does not communicate the urgency of the task for the client.
Behaviors that indicate to the patient that the nurse is inattentive to the patient's concerns are such activities as: (Select all that apply.)
- A. turning back to straighten the bedside table while the patient is talking.
- B. tapping feet or fingers.
- C. sitting down in a chair near the bed with arms crossed.
- D. leaving a hand on the door to go out.
Correct Answer: A
Rationale: The correct answer, A, is turning back to straighten the bedside table while the patient is talking. This behavior indicates the nurse is not fully engaged in the conversation and prioritizing a task over the patient. Tapping feet or fingers (B) could just be a habit and may not necessarily indicate inattentiveness. Sitting down with arms crossed (C) could be a sign of being defensive but not necessarily inattentive. Leaving a hand on the door (D) could be a signal of readiness to leave but not a direct indicator of inattentiveness.