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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 cares for a client who does not follow dietary recommendations for treatment of heart failure. Which statement, if made by the nurse, demonstrates respect for the client?
- A. "It doesn't make any difference to me whether you decide to eat healthy or not.=
- B. "You will get more attention from your physician, if you follow diet restrictions.=
- C. "I care about you even if you are not following your dietary restrictions.=
- D. "Have you noticed that patients who eat healthy foods receive better healthcare?=
Correct Answer: C
Rationale: The correct answer is C because it demonstrates empathy and respect for the client's autonomy. By stating "I care about you even if you are not following your dietary restrictions," the nurse acknowledges the client's choice while still showing concern for their well-being. This response fosters a supportive and non-judgmental relationship with the client.
Choices A, B, and D are incorrect because they either show indifference, use coercion, or imply a comparison between patients based on their dietary choices. These responses do not prioritize the client's feelings, choices, or autonomy, which is essential in providing patient-centered care.
While interviewing a Native American man for the admission history, the nurse should expect to:
- A. wait patiently through long pauses in the conversation.
- B. maintain eye contact with the patient.
- C. give the patient permission to speak.
- D. have another family member speak for the patient. Native Americans use long pauses in their conversation to better consider their answer and consider the question. The culturally sensitive nurse would wait quietly through the pauses.
Correct Answer: A
Rationale: The correct answer is A because it acknowledges the cultural communication norms of Native American individuals, who may take longer pauses during conversations to reflect and respond thoughtfully. By waiting patiently through these pauses, the nurse shows respect for the individual's communication style and allows for effective dialogue.
Option B is incorrect because maintaining constant eye contact may be perceived as confrontational or disrespectful in some Native American cultures. Option C is incorrect as it assumes the patient needs permission to speak, which may not align with their cultural norms. Option D is incorrect as it undermines the individual's autonomy and may not accurately represent their perspective.
It would be most important for the nurse to temporarily withdraw expressions of warmth to which patient?
- A. A 20-year-old patient who is angry and throwing objects.
- B. A 32-year-old patient who is withdrawn and refuses nursing care.
- C. A 48-year-old patient who is extremely anxious about surgery.
- D. A 56-year-old patient who has a history of violent behavior.
Correct Answer: D
Rationale: The correct answer is D because the patient with a history of violent behavior poses a potential risk to the nurse's safety. Temporarily withdrawing expressions of warmth is important to establish boundaries and ensure safety. Choice A involves an angry patient, but the risk of violence is higher with a history of violent behavior. Choices B and C do not indicate immediate safety concerns.
The nurse provides care for a male patient. When the nurse addresses the patient, which would be most appropriate?
- A. Use both first and last name with each encounter.
- B. Ask the patient how he prefers to be addressed.
- C. Call the patient by his first name.
- D. Address the patient by his last name.
Correct Answer: B
Rationale: The correct answer is B: Ask the patient how he prefers to be addressed. This approach respects the patient's autonomy and personal preferences, promoting patient-centered care. By asking the patient directly, the nurse acknowledges the patient's individuality and ensures respectful communication.
A: Using both first and last name with each encounter may come across as too formal or impersonal for some patients, potentially creating a barrier in the nurse-patient relationship.
C: Calling the patient by his first name without consent may be perceived as too familiar or disrespectful by some patients, leading to discomfort or a lack of trust in the nurse.
D: Addressing the patient by his last name may be too formal for some patients and can create a sense of distance or hierarchy in the nurse-patient relationship.
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.