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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 because it respects the patient's autonomy and preferences. By asking how the patient prefers to be addressed, the nurse demonstrates respect for the patient's individuality and dignity. This approach promotes a patient-centered care environment.
A: Using both first and last names with each encounter may come off as overly formal and impersonal.
C: Calling the patient by his first name without consent may be perceived as disrespectful and too informal.
D: Addressing the patient by his last name may be too formal and distant, not fostering a therapeutic nurse-patient relationship.
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There are 2 hours left before the shift ends. The new UAP tells the team leader that she must leave now because she has a family emergency. What should the team leader do? Select all that apply.
- A. Ask her what tasks and duties are pending for the next 2 hours.
- B. Call a UAP who is scheduled for the next shift to come early.
- C. Allow her to leave but remind her she is still on probation as a new staff member.
- D. Call another unit and see if there is a UAP who could float to the unit.
Correct Answer: A
Rationale: The correct answer is A. The team leader should ask the UAP what tasks and duties are pending for the next 2 hours to assess the workload and determine if it's possible for the UAP to leave immediately. By understanding the pending tasks, the team leader can make an informed decision on whether the UAP leaving will impact patient care or workload. This approach ensures that patient care is not compromised and that the team's responsibilities are managed effectively.
Choices B, C, and D are incorrect because they do not directly address the immediate situation of the UAP needing to leave due to a family emergency. Calling another UAP, reminding the UAP of probation status, or seeking assistance from another unit may not be necessary or relevant if the tasks can be managed effectively without the UAP who needs to leave. These options do not prioritize understanding the pending tasks and duties to make an informed decision.
A nurse manager asks a colleague for advice on strategies to improve communication with staff nurses. Which response by the nurse manager's colleague is best?
- A. "Be sensitive, show respect, and be genuine."
- B. "You need to be consistently nice to the staff nurses."
- C. "Work as a staff nurse every month to develop empathy."
- D. "Staff nurses need a leader who is not emotional."
Correct Answer: A
Rationale: The correct answer is A because it emphasizes essential components of effective communication: sensitivity, respect, and genuineness. Sensitivity helps in understanding others' emotions, respect fosters a positive relationship, and genuineness promotes trust. Choice B is too simplistic and lacks depth. Choice C is impractical as working as a staff nurse monthly may not be feasible for a manager. Choice D is incorrect as emotional intelligence and empathy are crucial for effective leadership, not being emotionless. Thus, choice A is the best response due to its focus on key communication principles.
The nurse chooses to use touch in the nurse-patient relationship because touch:
- A. can convey caring and support when words are difficult.
- B. should be avoided because of problems of cultural misinterpretation.
- C. is appropriate only in special circumstances, such as with young children.
- D. is a nursing intervention of choice in almost all situations.
Correct Answer: A
Rationale: The correct answer is A because touch can convey caring and support when words are difficult, enhancing the nurse-patient relationship. This is supported by research showing the positive impact of touch in providing comfort and building trust. Choice B is incorrect as cultural differences can be addressed through communication and understanding. Choice C is incorrect because touch can be appropriate in various situations beyond just young children. Choice D is incorrect as touch should be used judiciously based on individual preferences and boundaries.
A nurse manager offers a staff nurse a choice between working 8- or 12-hour shifts. Which statement, if made by the staff nurse, is nonassertive and may result in a frustrated response from the nurse manager?
- A. "I want to decide the shifts for all of the other staff nurses."
- B. "Do whatever you want. It doesn't really matter to me."
- C. "Thank you for offering me a choice. I prefer 12-hour shifts."
- D. "You will never be able to give me what I really want to work."
Correct Answer: A
Rationale: The correct answer is A because it shows an attempt to control others' decisions, which is nonassertive and inappropriate in a professional setting. Assertiveness involves expressing one's own needs and preferences while respecting others' choices. Option A implies a desire for power over others' schedules, leading to potential conflict and frustration. In contrast, options B and D show indifference and negativity, respectively, without clearly stating preferences. Option C is assertive and appreciative of the choice offered, clearly stating a preference for 12-hour shifts without imposing on others.
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.