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The nurse is providing therapeutic communication while changing a client's linen. The client states, 'Every time I urinate, I still feel the need to urinate again. This is so disappointing.' The nurse states, 'You don't feel that you are emptying your bladder.' Which communication technique has the nurse used?
- A. Open-ended questioning
- B. Paraphrasing
- C. Reflecting
- D. Broad opening
Correct Answer: B
Rationale: Paraphrasing restates what the client is saying to demonstrate listening. This communication technique also allows the client to offer further information on the subject. Open-ended questioning provides an open-ended question for the client to provide further information. Reflecting states the content back to the client and confirms that the nurse is following the conversation. A broad opening starts the interaction and relieves tension before addressing other issues.
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Which of the following means of comprehending new information best describes a cognitive learner?
- A. The learner learns through information that appeals to feelings.
- B. The learner likes to learn by doing
- C. The learner learns by combining three styles of learning
- D. The learner processes information by listening to facts
Correct Answer: D
Rationale: The cognitive learner processes information best by listening to or reading facts and descriptions. The affective learner is more attuned to learning when presented with information that appeals to feelings. The psychomotor learner typically likes to learn by doing. A combination of the three styles tends to optimize learning, although most people favor one style of learning.
A nurse is caring for a client who is newly diagnosed with cancer and receiving a peripherally inserted central catheter (PICC). Upon analysis, the nurse determines that the client is an affective learner. Which type of learning situation would the client learn from best?
- A. Having the client make a poster with the equipment from the PICC line
- B. Having the client prepare notes related to the PICC line to be discussed with the physician
- C. Having the client attend a group support meeting of people with PICC lines
- D. Having the client look online for information related to the PICC line
Correct Answer: C
Rationale: An affective learner learns best when the information is presented with consideration of the client's thoughts/feelings, values, or beliefs. Having a client attend a group support meeting with individuals having similar life struggles provides the opportunity for the client to learn how best to live with the new diagnosis and care for themselves. Making a poster with equipment is helpful for a psychomotor learner. Preparing notes and learning online is helpful for a cognitive learner.
The nurse enters the client's room and assesses that the client's affect appears sad. The client is sitting near the window, staring into the distance with a tear in the eye. The nurse approaches and places a hand on the client's shoulder asking for the client's thoughts. What type of emotion is the nurse projecting?
- A. Sympathy
- B. Empathy
- C. Ambivalence
- D. Pity
Correct Answer: B
Rationale: The nurse is projecting empathy. Empathy is an intuitive awareness of what the client is experiencing. Nurses perceive the client's emotional state and provide support. Sympathy is the projection of understanding the way one may feel, many times by having gone through the experience as well. Ambivalence projects conflicting feelings and uncertainty. Pity projects a feeling of sorrow.
The student nurse is providing skilled care for a palliative care client. The client is bedbound, requiring skin care during bathing, oral care, and every 2 hours positioning. In which NCLEX-PN test category would the student anticipate finding questions related to this clinical care situation?
- A. Health promotion and maintenance
- B. Psychosocial integrity
- C. Physiologic integrity
- D. Safe and effective care environment
Correct Answer: C
Rationale: The role of the NCLEX-PN is to ensure that the student has sufficient knowledge to progress to a competent entry-level practitioner. Linking clinical experiences to classroom knowledge base is essential. This content falls under the physiologic integrity subcategory of basic care and comfort. This category tests the skill of the nurse in a clinical situation completing basic care and comfort needs. The health promotion and maintenance category has content areas including caring for individuals through life transitions. Psychosocial integrity includes caring for mental health needs and using therapeutic communication. Safe and effective care environment ensures appropriate nursing care and infection control.
Which of the following nurse statements is completed in the working phase of the nurse-client relationship?
- A. Tell me about your religious beliefs during this season of the year.
- B. I will put a chair in the bathroom so you can begin personal care. I will return to assist you as needed.
- C. I understand that you are feeling anxious about going home. Let me assess you before we talk.
- D. Let's talk about a way to assist you to a standing position so you can walk in the hall.
Correct Answer: B
Rationale: During the working phase of the nurse-client relationship, the nurse and the client puts the mutually developed plan into action. Each person shares in performing the task that leads to the desired outcome, which supports the client's independence. In the introductory phase, the nurse should be gathering information regarding religious beliefs. In the terminating phase, the client may feel apprehensive about assuming independent activity or self-care. Developing the plan with activities such as assisting to a standing position to walk in the hall is completed in the introductory phase.