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The nurse is caring for a patient who is concerned about living alone. The best response by the nurse is:
- A. "Where have you considered living?"
- B. "Why don't you live with your family?"
- C. "I think you should live with your family."
Correct Answer: A
Rationale: The correct answer is A because it shows empathy by asking for the patient's thoughts first, respecting their autonomy. It promotes open communication and understanding of the patient's concerns. Choice B may come off as judgmental or invasive. Choice C imposes the nurse's opinion on the patient, disregarding their feelings. Choice D is incomplete.
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In the early postoperative period, what is the priority concern for Mr. L, who has a tracheostomy and partial laryngectomy?
- A. Possible infection related to chemotherapy and surgical procedure
- B. Poor nutritional intake related to dysphagia and malignancy
- C. Difficulty communicating needs because of the tracheostomy tube
- D. High risk for aspiration because of secretions and removal of epiglottis
Correct Answer: D
Rationale: The correct answer is D: High risk for aspiration because of secretions and removal of epiglottis. This is the priority concern for Mr. L due to the risk of food or liquid entering the airway, leading to aspiration pneumonia and respiratory distress. The tracheostomy and partial laryngectomy compromise the airway protection mechanism, increasing the risk of aspiration. Options A and B are not the priority as infection and poor nutrition can be managed after addressing the risk of aspiration. Option C, while important for communication, is not as immediately life-threatening as the risk of aspiration.
A patient is attracted to the nurse and attempts to initiate a social relationship. It is most appropriate for the nurse to take which action?
- A. Encourage the client's behavior to develop a trusting nurse–client relationship.
- B. Inform the charge nurse of the situation and ask for a different patient assignment.
- C. Tell the patient that the relationship must remain professional at all times.
- D. Determine if the patient can be transferred to another nursing care unit.
Correct Answer: C
Rationale: The correct answer is C. It is crucial for healthcare professionals to maintain professional boundaries with patients to ensure ethical practice and prevent potential harm. By telling the patient that the relationship must remain professional, the nurse sets clear boundaries and maintains the integrity of the therapeutic relationship. This approach protects both the patient and the nurse from potential ethical violations.
Choice A is incorrect because encouraging the behavior could lead to boundary violations and harm the therapeutic relationship. Choice B is not the most appropriate immediate action as it does not address the situation directly with the patient. Choice D is also not the best course of action as transferring the patient does not address the underlying issue of maintaining professional boundaries.
The nurse explains that the therapeutic nurse-patient relationship differs from the social relationship because:
- A. a social relationship does not have goals or needs to be met.
- B. the nurse-patient relationship ends when the patient is discharged.
- C. the focus is mainly on the nurse in the nurse-patient relationship.
- D. a social relationship does not require trust or sharing of life experiences. The nurse-patient relationship is limited to the patient's stay in the facility and is focused on the patient. A social relationship may have goals or needs and does require trust and sharing of life experiences.
Correct Answer: C
Rationale: The correct answer is C because in a therapeutic nurse-patient relationship, the focus is mainly on the nurse being therapeutically beneficial to the patient. This relationship is professional, goal-oriented, and centered on the patient's needs and well-being. The nurse's primary role is to provide care, support, and help the patient achieve their health goals. Unlike a social relationship, where the focus is mutual and not solely on the nurse, the therapeutic relationship is asymmetrical, with the nurse taking on a more authoritative and guiding role. This ensures that the patient receives the necessary care and support during their healthcare journey.
Choices A, B, and D are incorrect because a social relationship can have goals or needs to be met, the nurse-patient relationship extends beyond the patient's discharge, and trust and sharing of life experiences are essential components of the nurse-patient relationship.
When communicating with an adolescent, the nurse should be very sensitive to avoid:
- A. asking embarrassing questions.
- B. offering advice.
- C. interrupting frequently.
- D. using active listening. An adolescent needs time to talk. The nurse should use active listening, avoid interrupting, and show acceptance. The nurse should try not to give advice.
Correct Answer: B
Rationale: The correct answer is B because offering advice can come off as dismissive to adolescents who value autonomy and independence. Adolescents prefer to feel heard and understood rather than being told what to do. Providing unsolicited advice can hinder trust and communication. Asking embarrassing questions (A) can be inappropriate but can still be necessary for assessment. Interrupting frequently (C) disrupts the flow of communication. Using active listening (D) is important but does not directly relate to avoiding sensitive topics with adolescents.
The nurse cares for the mother of a child who died in the emergency room as a result of an accidental poisoning. Which response by the nurse is appropriate?
- A. Place a greater emphasis on nonverbal aspects of empathy over verbal.
- B. Accurately reflect on the mother's feelings to convey understanding and concern.
- C. Repeat exact phrases stated by the mother to aid in expressions of grief.
- D. Reflect on the expressed feelings of the mother but with the nurse's own words.
Correct Answer: B
Rationale: The correct answer is B because accurately reflecting on the mother's feelings shows understanding and empathy, validating her emotions. This approach helps establish trust and connection, essential in providing emotional support.
A: Placing greater emphasis on nonverbal aspects may not effectively convey empathy and understanding.
C: Merely repeating exact phrases may come off as insincere and robotic, lacking genuine empathy.
D: Reflecting on the mother's feelings using the nurse's own words may not accurately capture the depth of the mother's emotions and may lead to misinterpretation.