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The nurse cares for a patient who has metastatic cancer. Which action(s) by the nurse conveys warmth? (Select all that apply)
- A. Avoid distracting actions such as hand gestures.
- B. Show interest by occasional head nodding.
- C. Lean forward toward the patient at a 45-degree angle.
- D. Place arms across the chest to prevent fidgeting.
Correct Answer: B
Rationale: The correct answer is B: Show interest by occasional head nodding. This action conveys warmth by demonstrating active listening and engagement with the patient. It shows empathy and understanding without being intrusive.
Avoiding distracting actions such as hand gestures (A) may come across as cold or disinterested. Leaning forward toward the patient at a 45-degree angle (C) can be perceived as invading personal space. Placing arms across the chest to prevent fidgeting (D) may appear defensive or closed off, lacking warmth and openness.
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The community health nurse is listening to a client talk about a personal problem. Which of these actions by the nurse is most appropriate?
- A. The nurse should increase the physical distance from the client.
- B. The nurse should lean toward the client and make eye contact.
- C. The nurse should periodically interrupt the client to ask questions.
- D. The nurse should initiate the physical assessment to distract the client.
Correct Answer: B
Rationale: The correct answer is B because leaning towards the client and making eye contact demonstrates active listening and empathy, helping to build rapport and trust. This non-verbal communication shows the client that the nurse is engaged and attentive, creating a safe space for them to share their personal problem. Increasing physical distance (A) may convey disinterest or lack of connection. Periodically interrupting the client (C) can disrupt the flow of conversation and hinder the client's ability to express themselves. Initiating a physical assessment (D) would be inappropriate as it could feel intrusive and insensitive given the context of the client discussing a personal problem. Overall, choice B fosters a supportive environment for effective communication and client-centered care.
The nurse cares for a patient who is scheduled for abdominal surgery. Which action, if taken by the nurse, is most appropriate?
- A. Mandate the use of a complementary therapy such as guided imagery.
- B. Administer opioids for pain rated more than 3 (on a 0 to 10 pain scale).
- C. Ask the patient about expectations for postoperative pain management.
- D. Provide pain management based on a standardized nursing care plan.
Correct Answer: C
Rationale: The correct answer is C. Asking the patient about expectations for postoperative pain management is most appropriate as it involves assessing the patient's preferences and needs, ensuring individualized care. Option A is incorrect as mandating complementary therapy may not align with the patient's preferences or needs. Option B is incorrect as administering opioids based solely on pain rating may not consider individual variations in pain tolerance. Option D is incorrect as providing pain management solely based on a standardized care plan may not address the patient's specific needs and preferences.
According to Kimble and Bamford-Wade, what distinguishes the behavior of one caring and competent nurse from another nurse who is simply competent but not engaged with the patient?
- A. Immediacy, the availability of the nurse
- B. Warmth, the hallmark of compassion
- C. Attention, the focus of the nurse
- D. Communication, the instructional side of the nurse
Correct Answer: B
Rationale: The correct answer is B: Warmth, the hallmark of compassion. Kimble and Bamford-Wade emphasize that warmth, which signifies compassion, is the key factor that distinguishes a caring and competent nurse from one who is solely competent but lacks engagement with the patient. This is because warmth builds trust, fosters connection, and shows genuine concern for the patient's well-being. Immediacy (A) may be important for timely care, attention (C) is vital but doesn't capture the emotional aspect, and communication (D) is essential but focuses more on the delivery of information rather than the emotional connection that warmth provides.
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.
During the initial interview of a patient, the nurse should: (Select all that apply.)
- A. assess the language capabilities of the patient.
- B. use open-ended questions.
- C. limit the interview to approximately 30 minutes.
- D. assess comprehension abilities of the patient.
Correct Answer: A
Rationale: The correct answer is A: assess the language capabilities of the patient. This is crucial to ensure effective communication and understanding. By assessing language capabilities, the nurse can tailor communication strategies appropriately. Option B is helpful but not as essential as language assessment. Option C is incorrect as the interview duration should be based on patient needs, not a set time limit. Option D is relevant, but assessing comprehension abilities alone may not be sufficient if language barriers exist.