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The nurse needs to obtain a health history from a Spanish-speaking patient. Which action by the nurse is best?
- A. Ask a bilingual friend of the patient to interpret.
- B. Use nonverbal communication and draw pictures.
- C. Request a Spanish-speaking medical interpreter.
- D. Interview the patient's English-speaking daughter.
Correct Answer: C
Rationale: The correct answer is C because using a professional medical interpreter ensures accurate communication, maintains patient confidentiality, and upholds ethical standards. Step 1: Requesting a Spanish-speaking medical interpreter ensures clear understanding of the patient's health history. Step 2: Using a professional interpreter avoids potential misinterpretations that may arise from using untrained individuals. Step 3: Interviewing the patient's English-speaking daughter may lead to inaccuracies and breaches patient confidentiality. Step 4: Asking a bilingual friend of the patient to interpret lacks professionalism and may result in miscommunication.
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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.
As a part of the F.O.C.U.S. model, the "C" stands for
- A. Communicate
- B. Connect
- C. Concern
- D. Convince
Correct Answer: A
Rationale: The correct answer is A: Communicate. In the F.O.C.U.S. model, the "C" stands for Communicate because effective communication is essential in any situation requiring focus. By communicating clearly and efficiently, individuals can convey their thoughts, ideas, and goals effectively, leading to better understanding and collaboration. This helps in achieving the desired outcomes and staying on track.
Summary of other choices:
B: Connect - While connecting with others is important, it is not the central aspect of focus in the F.O.C.U.S. model.
C: Concern - Concern may be relevant in some contexts, but it is not the primary focus in the F.O.C.U.S. model.
D: Convince - While persuasion can be a part of communication, the primary emphasis in the F.O.C.U.S. model is on effective communication rather than convincing others.
The team leader is reviewing what the HCP has just prescribed for Mr. N (non-Hodgkin lymphoma). What will the team leader question?
- A. Administer filgrastim 5 mcg/kg subcutaneously every day
- B. Catheterize to obtain a urinalysis specimen.
- C. Flush the IV saline lock every shift.
- D. Monitor vital signs every 4 hours.
Correct Answer: A
Rationale: The correct answer is A: Administer filgrastim 5 mcg/kg subcutaneously every day. The rationale for this is that filgrastim is a medication commonly prescribed for patients with non-Hodgkin lymphoma to stimulate the production of white blood cells. Therefore, the team leader should question the dosage, route of administration, and frequency to ensure it aligns with the prescribed treatment plan.
Incorrect choices:
B: Catheterize to obtain a urinalysis specimen - This is not relevant to the prescribed treatment for non-Hodgkin lymphoma.
C: Flush the IV saline lock every shift - Important for maintaining IV access but not directly related to the prescribed medication.
D: Monitor vital signs every 4 hours - Monitoring vital signs is important but not the primary concern when reviewing a prescribed medication for non-Hodgkin lymphoma.
The nurse cares for an elderly patient in a long-term care center. Which would be inappropriate for the nurse to share with the client?
- A. Reminisce about birthday celebrations and inquire about the client's traditions.
- B. Use high levels of intimacy to help the client feel more comfortable with the nurse.
- C. Establish a helping relationship based on trust by sharing a personal story with the client.
- D. Share with the client how meditation decreased nausea during chemotherapy treatment.
Correct Answer: B
Rationale: The correct answer is B because using high levels of intimacy with a client, especially in a professional setting like a long-term care center, can violate boundaries and be inappropriate. The nurse should maintain a professional and therapeutic relationship with the client. Reminiscing about birthday celebrations (A) can help establish rapport and show interest in the client's life. Sharing personal stories (C) can build trust and connection. Sharing a relevant experience about meditation (D) can provide valuable information and support. In summary, maintaining appropriate boundaries and professionalism is crucial in a nurse-client relationship.
The team leader is reviewing the pain management plan for Mr. U. He is having significant pain related to the cancer and the pulmonary resection. Which option would be the best for Mr. U?
- A. Mr. U is instructed to ask for pain medication whenever he needs it.
- B. Mr. U is to receive around-the-clock fixed doses of opioid analgesics.
- C. Mr. U should be offered the nonopioid medication first to see it if works.
- D. Mr. U has a high risk for respiratory distress, so opioids are not prescribed.
Correct Answer: B
Rationale: The correct answer is B because Mr. U is experiencing significant pain related to cancer and pulmonary resection, which typically requires continuous pain management. Around-the-clock fixed doses of opioid analgesics provide consistent pain relief and can be adjusted based on his pain levels. This approach ensures adequate pain control without the need for Mr. U to wait until the pain becomes severe before asking for medication. Option A may lead to undertreatment of pain. Option C delays effective pain relief for Mr. U who is already experiencing significant pain. Option D is incorrect as opioids can be safely administered with proper monitoring, even in patients at high risk for respiratory distress.