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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: "I am not able to work an extra shift." This response is assertive because it clearly communicates the staff nurse's inability to work the extra shift without making excuses or apologizing. It sets a boundary based on the staff nurse's current capacity and respects their own needs.
Choice A is incorrect because it prioritizes the nurse manager's feelings over the staff nurse's own needs. Choice B is incorrect as it is confrontational and does not provide a clear reason for not being able to work the extra shift. Choice D is incorrect because it implies a willingness to work based on the unavailability of others, rather than the staff nurse's own limitations.
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The nurse is caring for a client who is diagnosed with type 1 diabetes mellitus. Which nursing action would most likely improve client compliance with the therapeutic regimen?
- A. Consistently ignore negative statements made by the client.
- B. Avoid touching the client to reduce tension and uneasiness.
- C. Focus on the physical aspects of care such as insulin administration.
- D. Listen attentively to the client's perception of having a chronic illness.
Correct Answer: D
Rationale: The correct answer is D because listening attentively to the client's perception of having a chronic illness is crucial for building a therapeutic relationship and understanding their concerns, fears, and challenges. By actively listening, the nurse can address the client's emotional and psychological needs, which are essential in managing a chronic condition like type 1 diabetes. This approach fosters trust, enhances communication, and promotes client engagement in their treatment plan.
Choices A, B, and C are incorrect because ignoring negative statements, avoiding physical contact, and solely focusing on the physical aspects of care can lead to poor client-nurse communication, lack of trust, and ultimately hinder compliance with the therapeutic regimen. Ignoring negative statements may escalate resistance, avoiding physical contact may create distance, and solely focusing on physical care neglects the holistic needs of the client.
The nurse cares for a patient with urinary incontinence after a stroke. Which response by the nurse is best?
- A. "You seem upset about this. We can work together on a bladder retraining program."
- B. "I don't mind cleaning up your mess. I am used to it because my child does this at night."
- C. "Don't be embarrassed. A lot of patients have this problem after a stroke."
- D. "I will bring you some diapers to wear instead of having you wet the bed all the time."
Correct Answer: A
Rationale: The correct answer is A because it demonstrates empathy, collaboration, and a patient-centered approach. By acknowledging the patient's feelings and offering to work together on a solution, the nurse shows respect and support. This response promotes patient dignity and autonomy.
Choice B is incorrect as it is unprofessional and may be perceived as insensitive. Choice C, while acknowledging the commonality of the issue, lacks a proactive approach to address the problem. Choice D does not promote independence or address the patient's emotional needs.
When the nurse observes a resident in a long-term facility pounding his fists on his legs and grinding his teeth, the nurse will validate her perception of the patient's nonverbal expression of anger by:
- A. documenting that the patient was agitated and appeared angry.
- B. asking the male nursing assistant if it is his perception that the patient appears angry.
- C. accessing the nursing care plan to ascertain if there is a nursing diagnosis relative to anger.
- D. sitting down near the patient and saying, "You seem upset…can I help?" All perceptions based on the observation of nonverbal behavior should be validated by consulting the patient.
Correct Answer: D
Rationale: The correct answer is D because it demonstrates active listening and empathy towards the patient's nonverbal cues. By sitting down near the patient and acknowledging his emotions, the nurse opens up a channel for communication and offers support. This approach allows the patient to express his feelings and needs, leading to better understanding and potential resolution of the underlying issue.
Other choices are incorrect because:
A: Simply documenting the observation does not address the patient's emotional state or provide any opportunity for direct communication.
B: Asking another staff member for their perception does not involve the patient directly and may not accurately reflect the patient's emotions.
C: Referring to the care plan does not involve the patient in the process and may not address the immediate emotional needs expressed through nonverbal behavior.
The nurse cares for a patient who becomes confused and a vest restraint is applied. The nurse should take which action when notifying the patient's family?
- A. Avoid discussing the treatment plan to reduce anxiety and worry.
- B. Ask another nurse who has rapport with the family to be present.
- C. Use medical terms to demonstrate competence.
- D. Assume that the family wants a detailed explanation.
Correct Answer: B
Rationale: The correct answer is B because having another nurse who has a good relationship with the family present can help facilitate effective communication and provide emotional support. This can help alleviate the family's concerns and build trust in the care being provided.
Avoiding discussing the treatment plan (A) may lead to increased anxiety and worry for the family. Using medical terms (C) may confuse the family further and hinder effective communication. Assuming that the family wants a detailed explanation (D) without confirming their preferences may not be the most appropriate approach.
The nurse recognizes a verbal response when the patient:
- A. nods her head when asked whether she wants juice.
- B. writes the answer to a question asked by the nurse.
- C. begins sobbing uncontrollably when asked about her daughter.
- D. is moaning and restless and appears to be in pain. Verbal communication involves words, either written or spoken. Nodding, sobbing, and moaning are nonverbal communication.
Correct Answer: B
Rationale: Step-by-step rationale:
1. Verbal communication involves words, either written or spoken.
2. Choice B states that the patient writes the answer to a question asked by the nurse, which involves using words.
3. Therefore, choice B correctly represents verbal communication.
4. Choices A, C, and D involve nonverbal communication methods such as nodding, sobbing, and moaning, which do not involve words.