Nokea
The nurse provides care to a client from Nigeria who is visiting the United States. Which should the nurse use to communicate with this client?
- A. Review the predominant health beliefs of the Nigerian population.
- B. Appraise the client's health beliefs and behaviors with a cultural assessment.
- C. Consult with other nurses who have taken care of clients from other countries.
- D. Use standard communication techniques to establish a helping relationship.
Correct Answer: B
Rationale: The correct answer is B because conducting a cultural assessment allows the nurse to understand the client's individual health beliefs and behaviors. This approach promotes culturally competent care by tailoring interventions to the client's specific needs. Option A is incorrect as it assumes all Nigerians have the same health beliefs. Option C is not necessary as the nurse can directly assess the client. Option D does not consider the importance of cultural competence in communication. Conducting a cultural assessment ensures effective communication and respectful care.
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The nurse cares for a patient who has type 2 diabetes mellitus and does not consistently follow the dietary restrictions and exercise recommendations. The patient takes a daily oral hypoglycemic agent as prescribed. Which statement by the nurse is most appropriate?
- A. "It is great that you take your medicine as prescribed."
- B. "It wouldn't be that hard to walk a few blocks every other day."
- C. "You are definitely not one of my good patients."
- D. "It is a waste of time to help you because you will never change."
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Acknowledges adherence to medication, reinforcing positive behavior.
2. Encourages patient compliance without judgment or criticism.
3. Focusing on the patient's effort in taking medication can lead to discussions about improving other aspects of diabetes management.
Summary:
B: While exercise is important, this choice may come across as dismissive and not addressing the patient's current behavior.
C: This choice is judgmental and may damage the therapeutic relationship.
D: This choice is defeatist and does not promote any positive change or motivation.
When a patient begins crying during a conversation with the nurse about the patient's upcoming surgery for possible malignancy, the nurse's most therapeutic response would be:
- A. "Your surgeon is excellent, and I know he'll do a great job."
- B. "Oh, dear, your gown is way too big, let me get you another one."
- C. "Don't cry; think about something else and you'll feel better."
- D. "Here is a tissue. I'd like to sit here for a while if you want to talk."
Correct Answer: D
Rationale: The correct answer is D. This response acknowledges the patient's emotions, offers support, and provides an opportunity for the patient to express their feelings. Offering a tissue shows empathy and readiness to listen. Sitting with the patient shows availability and willingness to engage further. This response validates the patient's emotions and fosters a therapeutic nurse-patient relationship.
Choice A is incorrect because it dismisses the patient's emotions and focuses on the surgeon rather than the patient. Choice B is incorrect as it ignores the patient's emotional distress and focuses on a non-essential issue. Choice C is incorrect as it invalidates the patient's feelings and suggests avoidance rather than addressing the emotions directly.
Which assessment finding is the most critical and needs to be addressed first?
- A. Mr. U has tracheal deviation after a pulmonary resection.
- B. Mr. B, with bladder cancer, has decreased urinary output.
- C. Mr. N, with non-Hodgkin lymphoma, is having dysrhythmias.
- D. Ms. C has severe abdominal pain after a bowel resection.
Correct Answer: A
Rationale: The correct answer is A because tracheal deviation after a pulmonary resection indicates a life-threatening condition like tension pneumothorax. This condition requires immediate intervention to prevent respiratory distress and potential cardiovascular collapse. Tracheal deviation is a red flag sign that signals a medical emergency. Options B, C, and D are important but not as urgent as tracheal deviation. Decreased urinary output in a bladder cancer patient could indicate renal dysfunction, dysrhythmias in a patient with non-Hodgkin lymphoma may need further evaluation, and severe abdominal pain post-bowel resection could signal complications but are not as immediately life-threatening as tracheal deviation.
The nurse is reviewing Mr. N's (non-Hodgkin lymphoma) medication administration record and sees that the combination therapy aprepitant, dexamethasone, and ondansetron was administered during the last shift. What is the nurse most likely to ask to determine efficacy of the therapy?
- A. "On a scale of 1 to 10, with 1 being the least and 10 being the worst, what number is your pain? Where is the pain located?"
- B. "Have the medications improved your appetite? Are there special foods that you would prefer?"
- C. "Are you having any feelings of nausea right now? When was the last time you vomited?"
- D. "After taking the medications, have you experienced any improvement in your energy level? Do you feel fatigued?"
Correct Answer: C
Rationale: The correct answer is C. The nurse would ask about feelings of nausea and vomiting to determine the efficacy of the antiemetic therapy. Nausea and vomiting are common side effects of chemotherapy, which Mr. N would receive for non-Hodgkin lymphoma. Improvement in these symptoms indicates the effectiveness of the antiemetic regimen. Choices A, B, and D are not directly related to the medications administered and would not provide valuable information on the efficacy of the therapy for managing chemotherapy-induced nausea and vomiting. Option A focuses on pain assessment, B on appetite and food preferences, and D on energy levels and fatigue, which are not the primary outcomes to evaluate in this context.
The nurse cares for a patient with a terminal illness. Which way would be the most therapeutic for the nurse to communicate with this patient?
- A. Use an honest, judgmental attitude.
- B. Demonstrate understanding with empathy.
- C. Acknowledge hope by expressions of sympathy.
- D. Consistently evaluate the patient's feelings.
Correct Answer: B
Rationale: The correct answer is B: Demonstrate understanding with empathy. This approach is the most therapeutic as it shows the nurse's genuine care and support for the patient, fostering a sense of trust and emotional connection. By empathizing, the nurse validates the patient's feelings and provides comfort without judgment.
A: Using an honest, judgmental attitude can be harmful and create a barrier in the nurse-patient relationship.
C: Acknowledging hope by expressions of sympathy is important but may not address the patient's immediate emotional needs.
D: Consistently evaluating the patient's feelings is important, but without demonstrating empathy, it may come across as clinical and detached.
In summary, choice B is the best approach as it prioritizes empathy and understanding, essential components in providing effective therapeutic communication.