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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.
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Which nonverbal action(s) would be consistent with an assertive style of communication? (Select all that apply)
- A. Relaxed posture
- B. Established eye contact
- C. Hands placed on hips
- D. Distant, soft voice
Correct Answer: A
Rationale: The correct answer is A (Relaxed posture) because assertive communication involves being confident and composed. A relaxed posture signifies confidence and comfort in oneself. Choices B (Established eye contact) can also be consistent with assertiveness as it shows engagement and confidence. Choices C (Hands placed on hips) may come across as aggressive rather than assertive. Choice D (Distant, soft voice) is more indicative of a passive communication style, lacking the firmness associated with assertiveness. In summary, choices B, C, and D are incorrect because they do not align with the confident and self-assured characteristics of assertive communication.
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.
Ms. G (breast lumpectomy) continues to be anxious and tearful, and she says that she has changed her mind about the surgery, saying, "I'm going to go home. I just can't deal with everything that is going on right now. I need some time to think about things." What is the best response?
- A. "It's okay to change your mind. You have the right to make your own decisions."
- B. "Please reconsider. This surgery is very important, and your health is the priority."
- C. "Would you like me to call your HCP, so you can discuss your concerns?"
- D. "I see you are very concerned. What things are you dealing with and thinking about?"
Correct Answer: A
Rationale: The correct answer is A because it acknowledges Ms. G's autonomy and respects her right to make decisions about her own body. By validating her feelings and choices, it helps build trust and rapport. Choice B is incorrect as it disregards Ms. G's emotional state and can come off as dismissive. Choice C assumes Ms. G needs immediate medical intervention without exploring her concerns further. Choice D, although showing empathy, does not directly address Ms. G's decision to change her mind about the surgery.
The nurse instructs a client who is diagnosed with hypertension about weight reduction and dietary guidelines. Which action by the nurse would most likely improve the client's willingness to lose weight and eat healthy foods?
- A. Avoid interacting with the client during meals to prevent embarrassment.
- B. Ignore the client's requests for foods that are high in fat or calories.
- C. Give genuine praise to the client for trying to improve dietary habits.
- D. Warn the client that individuals who are overweight will be treated differently.
Correct Answer: C
Rationale: The correct answer is C because giving genuine praise to the client for trying to improve dietary habits can positively reinforce their efforts and motivation to continue making healthy choices. This positive reinforcement can help the client feel supported and encouraged in their weight reduction and dietary goals.
Choice A is incorrect because avoiding interaction during meals may make the client feel isolated and unsupported. Choice B is incorrect because ignoring the client's requests for high-fat or high-calorie foods may lead to feelings of deprivation and resistance to dietary changes. Choice D is incorrect because warning the client about potential negative consequences of being overweight can induce fear and may not be effective in promoting long-term behavior change.
Ms. C (bowel resection) repeatedly refuses to perform a return demonstration of any aspect of colostomy care. Despite steady improvement and independent resumption of other ADLs, she protests, "I'm too weak. You'll have to do it for me." At this point, what is the priority nursing concept to consider in planning interventions for Ms. C?
- A. Mobility
- B. Tissue integrity
- C. Functional ability
- D. Coping
Correct Answer: C
Rationale: The correct answer is C: Functional ability. This is because the priority nursing concept to consider in planning interventions for Ms. C is her ability to independently perform colostomy care. By refusing to demonstrate, she may be indicating a lack of functional ability to manage this aspect of self-care. This is essential for her long-term independence and quality of life. Mobility (choice A) is important but not the priority in this case. Tissue integrity (choice B) is also crucial but not as immediate as ensuring functional ability. Coping (choice D) is important for emotional well-being but does not address the primary issue of functional ability for self-care.