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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 cares for a client who has several options for cancer treatment. Which document supports the client's right to have access to information about treatment options?
- A. The Standards of Clinical Practice
- B. An Advance Health Care Directive
- C. The Patient's Bill of Rights
- D. A Client's Living Will
Correct Answer: C
Rationale: The correct answer is C: The Patient's Bill of Rights. This document supports the client's right to access information about treatment options as it ensures that clients have the right to make informed decisions about their healthcare. The Patient's Bill of Rights outlines the rights and responsibilities of patients, including the right to receive information about their medical condition, treatment options, risks, and benefits.
The other choices are incorrect because:
A: The Standards of Clinical Practice provide guidelines for healthcare professionals and do not specifically address the client's right to access information.
B: An Advance Health Care Directive is a legal document that specifies a person's wishes regarding medical treatment in the event they are unable to communicate, but it does not necessarily address the right to access treatment information.
D: A Client's Living Will is a legal document that outlines a person's preferences for medical care in certain situations, but it does not specifically address the right to access information about treatment options.
After the BCG treatment, the team leader delegates disposal of the fluid contents in Mr. B's (bladder cancer) urinary drainage bag to the UAP. What instructions should be given to the UAP?
- A. "No special handling of the bag or its contents is required."
- B. "Wear a lead apron when you are emptying the drainage container."
- C. "Discard the fluid in the toilet and disinfect the toilet with bleach for 6 hours."
- D. "Wear sterile gloves when you are handling the bag and its contents."
Correct Answer: C
Rationale: The correct answer is C because after BCG treatment, the fluid in the urinary drainage bag is considered hazardous due to the live bacteria used in the treatment. Therefore, instructing the UAP to discard the fluid in the toilet and disinfect it with bleach is crucial to prevent the spread of infection. This step helps to ensure proper disposal and minimize the risk of exposure to others.
Choice A is incorrect because special handling is indeed required due to the nature of the contents. Choice B is incorrect as wearing a lead apron is not necessary for handling the fluid in the urinary drainage bag. Choice D is also incorrect as sterile gloves are not specifically required for this task; instead, proper disinfection of the toilet is essential.
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.
Which assessment finding for Mr. L (tracheostomy and partial laryngectomy) would be of greatest concern?
- A. Pulsation of the tracheostomy tube in synchrony with the heartbeat
- B. Increased secretions in and around the tracheostomy
- C. Increased coughing, with difficulty in expectorating secretions
- D. Presence of food particles in tracheal secretions
Correct Answer: A
Rationale: The correct answer is A because pulsation of the tracheostomy tube in synchrony with the heartbeat indicates a potential risk of arterial bleeding, a serious complication that requires immediate intervention. This finding suggests that there may be a nearby major blood vessel that is pulsating due to arterial bleed. Immediate action is needed to prevent further bleeding and ensure patient safety.
Choice B is incorrect because increased secretions in and around the tracheostomy, while concerning, do not represent an immediate life-threatening situation like arterial bleeding.
Choice C is incorrect as increased coughing with difficulty in expectorating secretions could be indicative of respiratory issues but is not as urgent as arterial bleeding.
Choice D is incorrect as the presence of food particles in tracheal secretions may indicate aspiration or improper swallowing, but it is not as immediately life-threatening as arterial bleeding.
Which nonverbal action(s) would be consistent with an assertive style of communication? (Select all that apply)
- A. Relaxed posture
- B. Established eye contact
- C. Hands placed on hips
- D. Distant, soft voice
Correct Answer: A
Rationale: The correct answer is A (Relaxed posture) because assertiveness is about expressing oneself confidently while respecting others. A relaxed posture conveys confidence and self-assurance. Established eye contact (B) is also consistent with assertiveness, showing engagement and sincerity. Choices C (Hands placed on hips) and D (Distant, soft voice) are more indicative of aggression or passivity, respectively, rather than assertiveness. Placing hands on hips can come across as confrontational, while a distant, soft voice lacks the firmness and clarity associated with assertive communication.