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The nurse manager asks the staff nurse to work an extra shift. Which response by the staff nurse is assertive and based on rational beliefs?
- A. "I don't want you upset, so I will work extra."
- B. "Why do I always have to cover extra shifts?"
- C. "I am not able to work an extra shift."
- D. "If you can't find anyone else, I will do it."
Correct Answer: C
Rationale: The correct answer is C because it directly and assertively communicates the staff nurse's inability to work an extra shift. This response sets clear boundaries and respects the nurse's own limitations and well-being. It is based on rational beliefs as it acknowledges personal capacity without guilt or unnecessary explanations.
Explanation of other choices:
A: This choice is not assertive as it prioritizes avoiding upsetting the nurse manager over the nurse's own needs and boundaries.
B: This response is confrontational and does not address the request directly, focusing instead on questioning past occurrences.
D: While this response offers to work the extra shift as a last resort, it does not assert the nurse's own limitations clearly, leaving room for potential guilt or manipulation.
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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.
The home care nurse visits a mother and her newborn 2 days after discharge from the hospital. The mother states, "My baby cries all the time. I must not be a very good mother.= Which response by the nurse is nontherapeutic?
- A. "It sounds as if you are concerned about your ability to care for your baby.=
- B. "The nurse moves closer to the mother and places a hand on her shoulder."
- C. "You just need to get away for a few hours. Find a babysitter and go to a movie.=
- D. "I am not sure that I understand what you mean. Tell me more about how you feel.=
Correct Answer: C
Rationale: The correct answer is C because it dismisses the mother's feelings and suggests a temporary distraction instead of addressing her concerns. Choice A validates the mother's feelings and promotes open communication. Choice B demonstrates empathy and physical support. Choice D encourages the mother to express her emotions further for better understanding. Overall, choice C is nontherapeutic as it does not address the underlying issue of the mother's feelings of inadequacy and instead offers a superficial solution.
A home health patient with a bleeding ulcer informs the nurse that she ate a bowl of chili with jalapenos. An inappropriate communication block with a judgmental tone by the nurse would be:
- A. "Well, you have had this problem long enough to know what will happen—you certainly can't blame me!"
- B. "I don't think that was a smart thing for you to do considering your ulcer."
- C. "Well, you better watch your stool for evidence of blood so you can notify your primary care provider."
- D. "Oh, poo! A bowl of chili every now and then won't make a lot of difference to your ulcer." Judgmental response is a block to effective communication in which the nurse is judging the patient's action. It implies that the patient must take on the nurse's values and is demeaning to the patient.
Correct Answer: B
Rationale: The correct answer is B because it demonstrates a judgmental tone towards the patient's actions. The nurse is passing a negative judgment on the patient by stating that eating chili with jalapenos was not a smart decision considering the ulcer. This response can make the patient feel guilty or ashamed, hindering effective communication.
Choice A shows frustration and blame towards the patient, which can lead to a defensive response. Choice C is directive and lacks empathy, focusing solely on the medical aspect without considering the patient's feelings. Choice D dismisses the patient's concerns and minimizes the impact of the action, which can be perceived as condescending.
In summary, choice B is the correct answer as it highlights the importance of maintaining a non-judgmental and supportive attitude in patient communication.
The nurse can best ensure that communication is understood by:
- A. speaking slowly and clearly in the patient's native language.
- B. asking the family members whether the patient understands.
- C. obtaining feedback from the patient that indicates accurate comprehension.
- D. checking for signs of hearing loss or aphasia before communicating. The best way to determine understanding is to ask the patient. Factors such as anxiety, hearing acuity, language, aphasia, or lack of familiarity with medical jargon or routines can all contribute to misunderstanding.
Correct Answer: C
Rationale: The correct answer is C: obtaining feedback from the patient that indicates accurate comprehension. This is the best way to ensure effective communication because it directly involves the patient in the communication process, allowing for clarification if needed. By receiving feedback from the patient, the nurse can confirm whether the information has been understood correctly. This approach promotes active listening and engagement from the patient, enhancing the likelihood of accurate communication.
Incorrect choices:
A: Speaking slowly and clearly in the patient's native language may help, but it does not guarantee comprehension.
B: Asking family members may not accurately reflect the patient's understanding and could lead to miscommunication.
D: Checking for signs of hearing loss or aphasia is important, but it does not directly assess the patient's understanding of the communication.
the HCP because the client deserves to have adequate pain relief.
- A. Wait until the change of medication occurs and then monitor the client's response.
Correct Answer: A
Rationale: The correct answer is A because it demonstrates a proactive approach to ensuring the client receives adequate pain relief. By waiting until the medication change occurs and then monitoring the client's response, the healthcare provider can assess the effectiveness of the new medication and make any necessary adjustments promptly. This approach prioritizes the client's well-being by addressing their pain management needs in a timely and thorough manner. Choices B, C, and D are not as effective as they do not involve actively monitoring the client's response to the medication change, which is crucial in ensuring optimal pain relief for the client.