Nokea
The nurse is caring for a client who is newly diagnosed with atrial fibrillation. The client expresses having many questions. At what point in the client contact experience should the nurse begin client education?
- A. During a morning assessment
- B. When presenting the client with a brochure
- C. Once the health care provider confirms the diagnosis
- D. As soon as possible after admission to the hospital
Correct Answer: D
Rationale: Client teaching should begin as soon as possible after admission to the hospital. Even when the client is in the emergency department, health care providers and staff are explaining testing and procedures. The nurse will continue client education whenever there is an opportunity for teaching, such as during a morning assessment, when presenting the client with new information, or when the health care provider confirms a diagnosis.
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Which of the following is a component of nonverbal communication?
- A. Paralanguage
- B. Hearing acuity
- C. Interpersonal attitudes
- D. Listening
Correct Answer: A
Rationale: Nonverbal communication consists of components such as kinesics, paralanguage (vocal sounds that communicate a message), proxemics (use of space when communicating), touch, and silence. Hearing acuity, interpersonal attitudes, and listening are variables that affect verbal communication.
The nurse is caring for a client who is hard of hearing. The nurse is in the room during a discussion between the client and health care provider. At the end of the discussion, the client asks the nurse to further explain certain terms used by the health care provider. In explaining the terms, which role has the nurse assumed?
- A. Educator
- B. Caregiver
- C. Collaborator
- D. Delegator
Correct Answer: A
Rationale: In this scenario, the nurse will assume the role of educator by explaining information provided during the client/health care provider discussion. The nurse as educator provides client teaching regarding the plan of care, medications, or prescribed tests and procedures. The nurse as a caregiver performs health-related activities that the client is unable to perform independently due to illness. The nurse as a collaborator works with others to achieve a common goal, such as sharing or exchanging information with other health care professionals (dietitians, physical therapists, or respiratory therapists). The nurse as a delegator assigns tasks to someone else such as another nurse, a nursing assistant, or other unlicensed assistive personnel (UAP).
The nurse is evaluating the comprehension of a client's knowledge of the subcutaneous administration of an anticoagulant medication. Which method provides the best feedback?
- A. Having the client explain the medication and injection site
- B. Having the client demonstrate the injection technique on an orange
- C. Having the client watch the nurse prepare the medication and administer it
- D. Having the client prepare the syringe and independently administer the injection
Correct Answer: D
Rationale: Having the client prepare the syringe and independently administer the injection is the 'show back' portion of learning comprehension because it includes demonstrating the skill. By independently demonstrating, the nurse is able to evaluate the knowledge base and skill. Having the client watch the nurse administer the medication involves teaching, but not performing the skill. Having the client explain the medication and injection site or administer the injection into an orange demonstrates parts of the skill but does not allow the nurse to evaluate the entire skill.
An experienced nurse is evaluating a new nurse to the unit who is providing discharge instructions to an adult client. The experienced nurse views the following: The new nurse approaches and decreases the volume on the television and then sits beside the client, presenting the information to the client and spouse. The new nurse states, 'You are to take ciprofloxacin 250 mg, two tablets b.i.d. A regular diet is ordered, and you are to follow up with your physician in 2 weeks. Here is printed information on the medication ordered.' The new nurse obtains appropriate signatures and leaves. Which point would the experienced nurse address?
- A. The nurse should use shorter sentences when teaching.
- B. The nurse should improve professionalism and stand.
- C. The nurse should minimize medical terms when teaching.
- D. The nurse should continue with the same method without changes.
Correct Answer: C
Rationale: When teaching adult clients, it is best to minimize technical terms and medical jargon ('b.i.d.' for example) whenever able. The nurse used appropriate sentence length. Sitting beside the client is appropriate, and it is best to reduce noise and distraction by decreasing the volume of the television. With minimal change, the new nurse can improve with teaching skills.
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.