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The nurse is providing care to a patient who was admitted with heart failure. The patient has not been following the prescribed diet or taking the prescribed medications. Which type of communication approach is most important for the nurse to use with this patient to facilitate a change in self-care behavior?
- A. Authoritative, honest, and outright communication
- B. Assertive, responsible, and caring communication
- C. Aggressive, sympathetic, and realistic communication
- D. Positive, expert, and focused communication
Correct Answer: B
Rationale: The correct answer is B: Assertive, responsible, and caring communication.
Rationale:
1. Assertive communication is important to clearly express expectations and boundaries.
2. Being responsible conveys accountability and encourages the patient to take ownership of their care.
3. Caring communication fosters trust and empathy, crucial for building a therapeutic relationship.
Summary:
A: Authoritative communication may come across as controlling and may not promote patient cooperation.
C: Aggressive communication can be intimidating and may lead to resistance rather than cooperation.
D: Positive communication is beneficial, but being an expert alone may not address the patient's underlying issues or barriers to self-care.
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A patient reports to the nurse, "My doctor is not doing anything about my pain." Which response by the nurse is assertive and expresses warmth?
- A. "If I were you, I would see a different doctor."
- B. "What you really mean is you do not like your doctor."
- C. "It is wrong for you to blame your doctor."
- D. "You seem frustrated with your doctor."
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the patient's feelings without judgment and expresses empathy. The nurse reflects the patient's emotions by stating, "You seem frustrated with your doctor," showing understanding. Option A is dismissive, suggesting the patient change doctors. Option B assumes the patient's feelings and could come off as confrontational. Option C is accusatory and could make the patient defensive. Overall, option D is assertive, warm, and empathetic, making it the best response in this situation.
The home health nurse visits a client with heart failure who has increased dyspnea and peripheral edema and weight gain. The nurse suspects the client is not restricting fluids as prescribed. Which action by the nurse is most appropriate?
- A. Teach the client about the consequences of not following the fluid restrictions.
- B. Ask the client to report the amount of fluid intake for the past 24 hours.
- C. Provide the client with sugarless candy or gum to decrease the thirst sensation.
- D. Consult with the healthcare provider about increasing the dose of the diuretic.
Correct Answer: B
Rationale: The most appropriate action for the nurse is to ask the client to report the amount of fluid intake for the past 24 hours. This is the correct answer because it directly addresses the issue of non-compliance with fluid restrictions. By assessing the actual fluid intake, the nurse can identify the extent of the problem and provide targeted interventions.
Option A is not the best choice as teaching about consequences may not address the immediate issue. Option C does not address the root cause of the problem but only provides a temporary solution. Option D is not appropriate as increasing the diuretic dose should be done in collaboration with the healthcare provider after assessing the client's current condition.
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.
To convey the intervention of active listening, the nurse would:
- A. maintain eye contact by staring at the patient.
- B. prompt the patient when the patient stops talking for a moment.
- C. make a conscious effort to block out other sounds in the immediate environment.
- D. write down remarks on a clipboard to facilitate later topics of conversation. An active listener maintains eye contact without staring, gives the patient full attention, and makes a conscious effort to block out other sounds and distractions.
Correct Answer: C
Rationale: The correct answer is C because active listening involves making a conscious effort to block out other sounds in the immediate environment, demonstrating full focus on the speaker. This allows the nurse to truly understand the patient's perspective and feelings. Maintaining eye contact (A) is important but staring can be intimidating. Prompting the patient (B) may disrupt their train of thought. Writing down remarks (D) can be perceived as disengagement. In summary, active listening requires focused attention and empathy, which choice C exemplifies.
The nurse cares for a patient with a terminal illness. Which way would be the most therapeutic for the nurse to communicate with this patient?
- A. Use an honest, judgmental attitude.
- B. Demonstrate understanding with empathy.
- C. Acknowledge hope by expressions of sympathy.
- D. Consistently evaluate the patient's feelings.
Correct Answer: B
Rationale: The correct answer is B: Demonstrate understanding with empathy. This approach is the most therapeutic as it shows the nurse's genuine care and support for the patient, fostering a sense of trust and emotional connection. By empathizing, the nurse validates the patient's feelings and provides comfort without judgment.
A: Using an honest, judgmental attitude can be harmful and create a barrier in the nurse-patient relationship.
C: Acknowledging hope by expressions of sympathy is important but may not address the patient's immediate emotional needs.
D: Consistently evaluating the patient's feelings is important, but without demonstrating empathy, it may come across as clinical and detached.
In summary, choice B is the best approach as it prioritizes empathy and understanding, essential components in providing effective therapeutic communication.