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The nurse enters the client's room and assesses that the client's affect appears sad. The client is sitting near the window, staring into the distance with a tear in the eye. The nurse approaches and places a hand on the client's shoulder asking for the client's thoughts. What type of emotion is the nurse projecting?
- A. Sympathy
- B. Empathy
- C. Ambivalence
- D. Pity
Correct Answer: B
Rationale: The nurse is projecting empathy. Empathy is an intuitive awareness of what the client is experiencing. Nurses perceive the client's emotional state and provide support. Sympathy is the projection of understanding the way one may feel, many times by having gone through the experience as well. Ambivalence projects conflicting feelings and uncertainty. Pity projects a feeling of sorrow.
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The student nurse is providing skilled care for a palliative care client. The client is bedbound, requiring skin care during bathing, oral care, and every 2 hours positioning. In which NCLEX-PN test category would the student anticipate finding questions related to this clinical care situation?
- A. Health promotion and maintenance
- B. Psychosocial integrity
- C. Physiologic integrity
- D. Safe and effective care environment
Correct Answer: C
Rationale: The role of the NCLEX-PN is to ensure that the student has sufficient knowledge to progress to a competent entry-level practitioner. Linking clinical experiences to classroom knowledge base is essential. This content falls under the physiologic integrity subcategory of basic care and comfort. This category tests the skill of the nurse in a clinical situation completing basic care and comfort needs. The health promotion and maintenance category has content areas including caring for individuals through life transitions. Psychosocial integrity includes caring for mental health needs and using therapeutic communication. Safe and effective care environment ensures appropriate nursing care and infection control.
The nurse is caring for a geriatric client who has decided to move to a skilled nursing facility. The nurse assisted with the arrangements and, when leaving the room, touched the client on the shoulder. Which therapeutic technique was the nurse demonstrating?
- A. Therapeutic communication
- B. Affective touch
- C. Silence
- D. Task-oriented contact
Correct Answer: B
Rationale: Affective touch is used to demonstrate concern or affection. Its intention is to communicate caring and support. Therapeutic communication and silence can be helpful in this situation but does not fit into the scenario. Task-oriented 'touch' involves the personal contact that is required when performing nursing procedures.
A wound care nurse approaches a client to instruct in home care needs. In which clinical scenario would the nurse delay teaching due to learning readiness?
- A. The client says that a grandchild will be in soon.
- B. The client is eating breakfast.
- C. The client is anxious about physical therapy.
- D. The client is meeting with the priest.
Correct Answer: C
Rationale: Learning readiness pertains to the optimal time for learning. This occurs when a client is in a state of physical and psychological well-being. Being anxious about an upcoming activity distracts the client from learning. Waiting until after the activity allows the client to be more focused on the teaching. Nurses may decide to delay teaching due to visiting family, eating breakfast, and meeting with a priest, but it is not from learning readiness.
Which of the following is a reason why silence is considered therapeutic?
- A. It demonstrates concern or affection.
- B. It communicates caring and support.
- C. It encourages a client's verbal communication.
- D. It is therapeutic when a client is uncomfortable.
Correct Answer: C
Rationale: Silence is the art of remaining quiet. One of its therapeutic uses is to encourage a client's verbal communication. Affective touch is typically used to demonstrate concern or affection. Its intention is to communicate caring and support. The nurse uses affective touch therapeutically in many situations, including when a client is uncomfortable.
A nurse is caring for a client who is newly diagnosed with cancer and receiving a peripherally inserted central catheter (PICC). Upon analysis, the nurse determines that the client is an affective learner. Which type of learning situation would the client learn from best?
- A. Having the client make a poster with the equipment from the PICC line
- B. Having the client prepare notes related to the PICC line to be discussed with the physician
- C. Having the client attend a group support meeting of people with PICC lines
- D. Having the client look online for information related to the PICC line
Correct Answer: C
Rationale: An affective learner learns best when the information is presented with consideration of the client's thoughts/feelings, values, or beliefs. Having a client attend a group support meeting with individuals having similar life struggles provides the opportunity for the client to learn how best to live with the new diagnosis and care for themselves. Making a poster with equipment is helpful for a psychomotor learner. Preparing notes and learning online is helpful for a cognitive learner.