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The nurse plans to use self-disclosure to aid a mother and father in the grieving process after the death of their child. The steps of a helpful self-disclosure appear below. What is the first step?
- A. Succinctly share a personal experience that is a similar grieving experience.
- B. Listen to the parents talk about their child and observe their movements and gestures.
- C. Reflect upon the parent's statements to communicate understanding.
- D. Seek verification that the self-disclosure was helpful to the child's parents.
Correct Answer: B
Rationale: The correct answer is B: Listen to the parents talk about their child and observe their movements and gestures. This is the first step in helpful self-disclosure because it allows the nurse to understand the parents' emotions and experiences before sharing their own. By actively listening and observing, the nurse can establish a connection with the parents and demonstrate empathy. This step sets the foundation for effective communication and builds trust between the nurse and the parents.
Incorrect choices:
A: Succinctly share a personal experience that is a similar grieving experience. This is not the first step because it doesn't consider the parents' feelings and might come across as insensitive or self-centered.
C: Reflect upon the parent's statements to communicate understanding. While reflection is important, it should come after active listening to ensure the nurse fully grasps the parents' emotions.
D: Seek verification that the self-disclosure was helpful to the child's parents. Seeking verification should come at a later stage after the nurse has provided support and guidance through
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The nursing student tearfully reports to the leader, "I took some flowers into Mr. N's (non- Hodgkin lymphoma) room to cheer him up, and he told me that he didn't think he was supposed to have flowers. I took them out of the room right away, and then I realized I had made a mistake." What should the team leader do first?
- A. Direct the student to read the isolation precautions before entering the room.
- B. Call the nursing instructor and report the student for making an error.
- C. Acknowledge and praise the student for taking responsibility for the mistake.
- D. Write an incident report and have the student and instructor sign it.
Correct Answer: C
Rationale: The correct answer is C because it is important to acknowledge and praise the student for taking responsibility for the mistake. By doing this, the team leader can encourage a culture of accountability and learning from errors. This approach supports the student's professional growth and self-awareness.
Option A is incorrect because the immediate focus should be on addressing the emotional response of the student and providing support rather than assigning blame. Option B is inappropriate as it could undermine the student's confidence and discourage future initiative. Option D is premature as it prioritizes paperwork over supporting the student's learning and emotional well-being.
A nurse using active listening techniques would:
- A. use nonverbal cues such as leaning forward, focusing on the speaker's face, and slightly nodding to indicate that the message has been heard.
- B. avoid the use of eye contact to allow the patient to express herself without feeling stared at or demeaned.
- C. anticipate what the speaker is trying to say and help the patient express herself when she has difficulty with finishing a sentence.
- D. ask probing questions to direct the conversation and obtain the information needed as efficiently as possible. Eye contact is a culturally learned behavior and in some cases may not be appropriate. Probing questions or finishing the patient's sentence is not part of active listening and is detrimental to an interview.
Correct Answer: A
Rationale: Answer A is correct because active listening involves using nonverbal cues such as leaning forward, focusing on the speaker's face, and nodding slightly to show that you are engaged and understanding the message. Leaning forward demonstrates interest, focusing on the face shows attentiveness, and nodding indicates acknowledgment. These actions encourage the speaker to continue sharing and feel heard.
Choices B, C, and D are incorrect:
B: Avoiding eye contact can make the speaker feel ignored or disconnected, which goes against the principles of active listening.
C: Anticipating what the speaker is trying to say and finishing their sentences is not active listening; it can be seen as interrupting and not allowing the speaker to express themselves fully.
D: Asking probing questions and directing the conversation towards obtaining specific information efficiently is not active listening. It can come across as controlling the conversation rather than actively listening to the speaker.
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.
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.
A patient is attracted to the nurse and attempts to initiate a social relationship. It is most appropriate for the nurse to take which action?
- A. Encourage the client's behavior to develop a trusting nurse–client relationship.
- B. Inform the charge nurse of the situation and ask for a different patient assignment.
- C. Tell the patient that the relationship must remain professional at all times.
- D. Determine if the patient can be transferred to another nursing care unit.
Correct Answer: C
Rationale: The correct answer is C. It is crucial for healthcare professionals to maintain professional boundaries with patients to ensure ethical practice and prevent potential harm. By telling the patient that the relationship must remain professional, the nurse sets clear boundaries and maintains the integrity of the therapeutic relationship. This approach protects both the patient and the nurse from potential ethical violations.
Choice A is incorrect because encouraging the behavior could lead to boundary violations and harm the therapeutic relationship. Choice B is not the most appropriate immediate action as it does not address the situation directly with the patient. Choice D is also not the best course of action as transferring the patient does not address the underlying issue of maintaining professional boundaries.