Nokea
The nurse is reviewing Mr. N's (non-Hodgkin lymphoma) medication administration record and sees that the combination therapy aprepitant, dexamethasone, and ondansetron was administered during the last shift. What is the nurse most likely to ask to determine efficacy of the therapy?
- A. "On a scale of 1 to 10, with 1 being the least and 10 being the worst, what number is your pain? Where is the pain located?"
- B. "Have the medications improved your appetite? Are there special foods that you would prefer?"
- C. "Are you having any feelings of nausea right now? When was the last time you vomited?"
- D. "After taking the medications, have you experienced any improvement in your energy level? Do you feel fatigued?"
Correct Answer: C
Rationale: The correct answer is C. The nurse would ask about feelings of nausea and vomiting to determine the efficacy of the antiemetic therapy. Nausea and vomiting are common side effects of chemotherapy, which Mr. N would receive for non-Hodgkin lymphoma. Improvement in these symptoms indicates the effectiveness of the antiemetic regimen. Choices A, B, and D are not directly related to the medications administered and would not provide valuable information on the efficacy of the therapy for managing chemotherapy-induced nausea and vomiting. Option A focuses on pain assessment, B on appetite and food preferences, and D on energy levels and fatigue, which are not the primary outcomes to evaluate in this context.
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A patient states, "I'm so worried that I might have cancer." The nurse responds, "It is time for you to eat breakfast." The nurse's response is an example of:
- A. using clichés.
- B. judgmental response.
- C. changing the subject.
- D. giving false reassurance. Changing the subject is a block to effective communication in which the patient is deprived of the chance to verbalize concerns.
Correct Answer: C
Rationale: The correct answer is C: changing the subject. The nurse's response shifts the conversation away from the patient's expression of worry about having cancer to a completely unrelated topic - eating breakfast. This technique blocks effective communication as it disregards the patient's concerns and prevents further exploration of the underlying issue. By redirecting the conversation, the nurse fails to address the patient's emotional needs and misses an opportunity to provide support and reassurance. Choices A, B, and D are incorrect as they do not accurately reflect the nurse's response in this scenario.
A female nurse discusses a concern related to client care with a male physician. Which communication strategy, if used by the nurse, is most effective?
- A. Assume a subservient role to the physician.
- B. Use a direct approach with succinct sentences.
- C. Ask questions instead of making recommendations.
- D. Be polite and expect politeness from the physician.
Correct Answer: B
Rationale: The correct answer is B, using a direct approach with succinct sentences. This strategy is most effective as it conveys the nurse's concern clearly and efficiently, facilitating better understanding and communication with the physician. Being direct helps to address the issue promptly and allows for a more focused discussion.
Choice A, assuming a subservient role, is incorrect as it may lead to a power imbalance and hinder effective communication. Choice C, asking questions instead of making recommendations, could be less effective in conveying the urgency or importance of the concern. Choice D, being polite and expecting politeness, is important but not sufficient for effective communication in this context.
A patient is irritable and complains to the nurse about difficulty sleeping last night. Which response by the nurse is most appropriate?
- A. "I know you will sleep better tonight.=
- B. "Tell me more about what happened last night.=
- C. "Did you drink too much caffeine yesterday?=
- D. "No one sleeps well in the hospital.=
Correct Answer: B
Rationale: The correct response is B. Asking the patient to elaborate on what happened last night allows the nurse to gather more information about the situation, which is crucial for assessing the patient's sleep difficulties accurately. It shows active listening and empathy, building rapport and trust with the patient. Options A, C, and D are incorrect because they do not address the patient's concerns effectively or gather relevant information to provide appropriate care. Option A makes an assumption without understanding the root cause of the sleep issue. Option C assumes the cause of sleep difficulty without exploring further. Option D dismisses the patient's concerns without providing support or understanding.
Which are examples of a nurse who is communicating responsibly? (Select all that apply)
- A. The nurse uses profanity to respond to a client who is intoxicated and verbally abusive.
- B. The nurse helps a client talk to family members about discontinuing chemotherapy.
- C. The nurse uses interpersonal strategies to help a client develop methods of coping.
- D. The nurse provides a client's health information to a close relative who is visiting.
Correct Answer: B
Rationale: The correct answer is B because helping a client communicate about discontinuing chemotherapy shows responsible communication. This action respects the client's autonomy and involves them in decision-making. This choice prioritizes the client's well-being and supports open and honest communication.
Incorrect choices:
A: Using profanity is unprofessional and disrespectful, violating ethical standards.
C: While using interpersonal strategies to help a client cope is important, it doesn't specifically address responsible communication.
D: Sharing a client's health information without consent breaches confidentiality and violates privacy rights.
The nurse discusses smoking cessation with a client. Which action, if taken by the nurse, would most likely result in a behavior change?
- A. The nurse should advise the client to contact the national telephone quitline.
- B. The nurse should recommend nicotine replacement and behavioral interventions.
- C. The nurse should collaborate with the client to develop an individualized plan of action.
- D. The nurse should implement a strategy that has been validated by research.
Correct Answer: C
Rationale: The correct answer is C: The nurse should collaborate with the client to develop an individualized plan of action. This is the most likely action to result in a behavior change because it involves actively involving the client in the process, taking into account their unique needs, preferences, and circumstances. By collaborating with the client, the nurse can tailor the smoking cessation plan to be more personalized and therefore more effective.
Choice A (contact the national telephone quitline) may be helpful but lacks individualization. Choice B (recommend nicotine replacement and behavioral interventions) is a good approach but may not address the client's specific needs. Choice D (implement a strategy validated by research) is important but may not be as effective if it does not consider the client's individual factors. Overall, choice C is the best option as it promotes client engagement and customization for a higher chance of successful behavior change.