The nurse greets a patient who is admitted to the hospital. Which action by the nurse displays warmth and concern?
- A. Use a soft and relaxed tone of voice when speaking.
- B. Maintain a distance of 6 to 8 feet from the patient.
- C. Avoid attentive behaviors when interacting with the patient.
- D. Engage in a verbal exchange without physical contact.
Correct Answer: A
Rationale: The correct answer is A because using a soft and relaxed tone of voice conveys warmth and concern, making the patient feel welcomed and cared for. It helps build rapport and comfort. Maintaining a distance of 6 to 8 feet (B) may create a sense of coldness and detachment. Avoiding attentive behaviors (C) will make the patient feel neglected and uncared for. Engaging in verbal exchange without physical contact (D) lacks the personal touch needed to show warmth and concern.
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The nurse sees that Mr. B (bladder cancer) has received docusate for the past 2 days. Which question is the nurse most likely to ask to evaluate the effectiveness of the docusate?
- A. "Are you experiencing any burning with urination?"
- B. "Did you have a bowel movement today or yesterday?"
- C. "Has the medication helped to relieve the nausea?"
- D. "Were you able to sleep soundly the last couple of nights?"
Correct Answer: B
Rationale: The correct answer is B. Docusate is a stool softener commonly used to prevent constipation, which is a common side effect of opioid pain medications. By asking if the patient had a bowel movement today or yesterday, the nurse can evaluate the effectiveness of docusate in facilitating bowel movements. This question directly assesses the expected outcome of the medication.
A: "Are you experiencing any burning with urination?" - This question is more relevant to urinary tract infections, not related to docusate use for constipation.
C: "Has the medication helped to relieve the nausea?" - Docusate is not typically used to relieve nausea, so this question is not relevant to evaluating its effectiveness.
D: "Were you able to sleep soundly the last couple of nights?" - This question is not directly related to the expected outcome of docusate in treating constipation.
The nurse makes a home visit to a client with chronic kidney disease. The client asks the nurse to make the decision about whether or not to start dialysis. Which action by the nurse is most appropriate?
- A. Encourage the client to appoint a durable power of attorney.
- B. Invite the client to make a decision after reviewing options.
- C. Direct the client to have the physician make a decision.
- D. Have the client visit with an individual receiving dialysis.
Correct Answer: B
Rationale: Step 1: The nurse should respect the client's autonomy and involve them in decision-making.
Step 2: By inviting the client to make a decision after reviewing options, the nurse promotes client-centered care.
Step 3: This approach empowers the client to participate actively in their healthcare decisions.
Step 4: It aligns with ethical principles of beneficence and nonmaleficence.
Summary:
Choice B is correct as it respects the client's autonomy and promotes shared decision-making. Choice A is not appropriate as it bypasses the client's involvement. Choice C is not ideal as the client should be actively involved. Choice D may provide information but doesn't involve the client in decision-making.
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.
When a patient states, "My son hasn't been to see me in months," the nurse's best verbal response is:
- A. "Don't worry; I'm sure your son will visit."
- B. "Your son hasn't been around much lately?"
- C. "My son doesn't come to visit me either."
- D. "How terrible that he doesn't visit you." Restating in different words what the patient said encourages further communication on that topic.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Reflective listening: Restating the patient's statement shows empathy and understanding.
2. Open-ended question: Encourages patient to share more without assumptions.
3. Non-judgmental: Neutral tone promotes trust and openness.
4. Validates patient's feelings: Acknowledges patient's concerns without dismissing them.
Summary:
A: Provides false reassurance, does not address the patient's feelings.
C: Shifts focus to the nurse, not patient-centered.
D: Implies judgment, may shut down communication.
The nurse has implemented a plan to improve expression of warmth to other nurses. It is most important for the nurse to include which evaluation method?
- A. Self-monitor interactions with colleagues for feelings of relaxation and caring.
- B. Ask patients for their perception of the interactions that occur among nurses.
- C. Invite a supervisor to evaluate interactions and provide suggestions for improvement.
- D. Seek nominations for an award at the organizational level or from an association.
Correct Answer: A
Rationale: The correct answer is A because self-monitoring interactions with colleagues allows for personal reflection and assessment of warmth expression. This method promotes self-awareness and self-improvement. Asking patients (B) is not relevant for evaluating interactions among nurses. Inviting a supervisor (C) may introduce bias and may not accurately reflect warmth expression. Seeking nominations for an award (D) focuses on recognition rather than genuine improvement. Therefore, A is the most suitable method for evaluating the nurse's plan.
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