Nokea
The nurse is caring for a client who is diagnosed with type 1 diabetes mellitus. Which nursing action would most likely improve client compliance with the therapeutic regimen?
- A. Consistently ignore negative statements made by the client.
- B. Avoid touching the client to reduce tension and uneasiness.
- C. Focus on the physical aspects of care such as insulin administration.
- D. Listen attentively to the client's perception of having a chronic illness.
Correct Answer: D
Rationale: The correct answer is D because listening attentively to the client's perception of having a chronic illness is crucial for building trust, understanding their concerns, and fostering a therapeutic relationship. By actively listening, the nurse can address any misconceptions, provide education tailored to the client's needs, and involve the client in decision-making, ultimately improving compliance.
Choice A is incorrect as ignoring negative statements can lead to feelings of neglect and hinder communication. Choice B is incorrect as avoiding touching the client may create a barrier to building rapport. Choice C is incorrect as focusing only on physical care neglects the psychological and emotional aspects of managing a chronic condition like diabetes.
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When interacting with an older adult patient, the nurse would enhance communication by:
- A. speaking slowly in order to allow the patient to process the message.
- B. addressing him by his first name to encourage a therapeutic relationship.
- C. standing in the doorway rather than entering the room to give the older adult patient more privacy.
- D. speaking in simple sentences, as if to a child. When interacting with an older adult, the nurse should try not to speak too quickly or expect an immediate answer because the older adult may take more time to process the message. Do not use baby talk or speak to them as if they were children.
Correct Answer: A
Rationale: The correct answer is A because speaking slowly allows the older adult patient to process the message at their own pace, considering potential hearing or cognitive impairments. Speaking slowly also shows respect and patience.
Option B is incorrect because using the first name may not be culturally appropriate or may not align with the patient's preference for formality.
Option C is incorrect because standing in the doorway may be seen as disrespectful and inhibit effective communication by creating physical barriers.
Option D is incorrect because speaking in simple sentences is important, but speaking as if to a child may be patronizing and disrespectful to the older adult patient.
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.
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 can best ensure that communication is understood by:
- A. speaking slowly and clearly in the patient's native language.
- B. asking the family members whether the patient understands.
- C. obtaining feedback from the patient that indicates accurate comprehension.
- D. checking for signs of hearing loss or aphasia before communicating. The best way to determine understanding is to ask the patient. Factors such as anxiety, hearing acuity, language, aphasia, or lack of familiarity with medical jargon or routines can all contribute to misunderstanding.
Correct Answer: C
Rationale: The correct answer is C: obtaining feedback from the patient that indicates accurate comprehension. This is the best way to ensure effective communication because it directly involves the patient in the communication process, allowing for clarification if needed. By receiving feedback from the patient, the nurse can confirm whether the information has been understood correctly. This approach promotes active listening and engagement from the patient, enhancing the likelihood of accurate communication.
Incorrect choices:
A: Speaking slowly and clearly in the patient's native language may help, but it does not guarantee comprehension.
B: Asking family members may not accurately reflect the patient's understanding and could lead to miscommunication.
D: Checking for signs of hearing loss or aphasia is important, but it does not directly assess the patient's understanding of the 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.