Nokea
The nurse caring for a patient who is concerned about her 10-pound weight loss relative to her chemotherapy tells the patient, "Lucky you! Every cloud has a silver lining." The nurse's statement is an example of which type of communication block?
- A. Defensive response
- B. Asking probing questions
- C. Using clichés
- D. Changing the subject
Correct Answer: C
Rationale: The correct answer is C: Using clichés. The nurse's statement, "Lucky you! Every cloud has a silver lining," is a cliché that minimizes the patient's concerns about her weight loss and chemotherapy. Clichés are overused phrases that lack originality and can be dismissive or unhelpful in communication. In this case, the nurse's response does not address the patient's emotional or physical needs and fails to provide meaningful support.
Incorrect choices:
A: Defensive response - This choice involves reacting defensively to the patient's concerns, which is not demonstrated in the nurse's statement.
B: Asking probing questions - This choice involves seeking further information from the patient, which is not reflected in the nurse's cliché response.
D: Changing the subject - This choice involves diverting the conversation away from the patient's concerns, which is not explicitly done in the given scenario.
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According to the ANA's Standards of Clinical Nursing Practice, there are several steps within the nursing process that surround patient care. However, one of the most important steps is the one in which the nurse partners with the patient, family, and other caregivers to create an acceptable path that meets the patient's needs and is specific to the disease process. This important step is identified as:
- A. Evaluation
- B. Planning
- C. Implementation
- D. Nursing diagnosis
Correct Answer: B
Rationale: The correct answer is B: Planning. In the nursing process, planning is a crucial step where the nurse collaborates with the patient, family, and caregivers to develop a comprehensive care plan tailored to the patient's needs and specific disease process. This step involves setting goals, determining interventions, and creating a roadmap for the patient's care. Planning ensures that the care provided is individualized, evidence-based, and addresses the patient's unique circumstances. Evaluation (A) comes after planning to assess the effectiveness of interventions. Implementation (C) involves carrying out the planned interventions. Nursing diagnosis (D) is an earlier step where the nurse identifies the patient's health problems and needs. Planning stands out as the most important step as it guides the entire care process.
A young mother who fractured her leg is sobbing with her face hidden behind her hands. She says to the nurse, "I will not be able to work for at least 2 months. Without my job, I cannot pay my bills or take care of my baby. I am alone and do not have anyone to help me.= Which response by the nurse accurately conveys empathy?
- A. "Why do you think that no one cares about you or will refuse to help you?=
- B. "I can see that you are hesitant about relying on others because of low self-esteem.=
- C. "You seem worried about how you will be able to take care of yourself and your baby.=
- D. "I am sorry that you are uncomfortable with asking others for help right now.=
Correct Answer: C
Rationale: The correct answer is C because it reflects active listening and understanding the mother's concerns without making assumptions or judgments. The nurse accurately acknowledges the mother's worries about taking care of herself and her baby, showing empathy and validation. Choice A assumes the mother feels uncared for, choice B presumes low self-esteem, and choice D focuses on discomfort with asking for help rather than addressing the mother's specific concerns. Hence, choice C is the most empathetic and appropriate response in this scenario.
A Hispanic patient approaches the Asian nurse and, standing very close, touches the nurse's shoulder during their conversation. The nurse begins to step back to 18 to 24 inches, while smiling and nodding to the patient. This situation is most likely an example of:
- A. the nurse's need to maintain a professional role rather than a social role.
- B. a patient's attempt to keep the nurse's attention.
- C. a nurse's need to establish a more appropriate location for conversation.
- D. a difference in culturally learned personal space of the nurse and the patient.
Correct Answer: D
Rationale: The correct answer is D: a difference in culturally learned personal space of the nurse and the patient. This is because different cultures have varying norms regarding personal space. In this scenario, the Hispanic patient touching the Asian nurse's shoulder and standing very close suggests a cultural difference in personal space expectations. The nurse stepping back to establish a distance of 18 to 24 inches is a respectful response to accommodate the patient's cultural norm. It demonstrates cultural competence and understanding.
Explanation for why the other choices are incorrect:
A: the nurse's need to maintain a professional role rather than a social role - This choice does not address the cultural aspect of personal space and assumes the nurse's response is solely professional.
B: a patient's attempt to keep the nurse's attention - This choice does not consider the cultural factor influencing the patient's behavior.
C: a nurse's need to establish a more appropriate location for conversation - This choice does not acknowledge the cultural difference in personal space as the primary reason for the nurse
A teacher at a local elementary school asks a nurse to talk to the students about nutrition. Which response by the nurse is most appropriate?
- A. "I will teach the students how to read nutrition labels.=
- B. "What would you like the students to learn about nutrition?=
- C. "The students need to know about the consequences of obesity.=
- D. "I will enjoy teaching the students everything I know about nutrition.=
Correct Answer: B
Rationale: The correct answer is B because it shows the nurse's willingness to understand the teacher's specific objectives and tailor the nutrition talk accordingly. This approach ensures that the nurse addresses the teacher's concerns and meets the students' needs effectively.
Explanation for why the other choices are incorrect:
A: Teaching students how to read nutrition labels may be important, but it assumes that this is the teacher's primary goal without confirming it first.
C: Focusing on the consequences of obesity may not align with the teacher's desired focus on general nutrition education.
D: While enthusiasm for teaching is positive, this response does not address the teacher's specific request for the nutrition talk.
The nursing supervisor instructs a group of novice nurses about the appropriate use of self-disclosure with patients. The nursing supervisor determines that teaching was successful if the novice nurse makes which statement?
- A. "Self-disclosure provides an opportunity for the patient to understand the nurse."
- B. "It is better to disclose stories about others to maintain professional boundaries."
- C. "Self-disclosure may be used to build a trusting relationship with the patient."
- D. "A fabricated personal experience can be shared if the patient remains the main focus."
Correct Answer: C
Rationale: The correct answer is C. Self-disclosure can be used to build a trusting relationship with the patient. This is because sharing personal information appropriately can help create a connection and foster trust between the nurse and the patient. By being open and genuine, nurses can demonstrate empathy and understanding, leading to better communication and rapport.
Choice A is incorrect because while self-disclosure can help the patient understand the nurse, the primary goal is to build a therapeutic relationship. Choice B is incorrect because disclosing stories about others does not promote genuine connection and may not be relevant to the patient's care. Choice D is incorrect because fabricating personal experiences goes against the principles of honesty and authenticity in therapeutic communication.