Nokea
The nursing staff are making suggestions about how to help Ms. C (bowel resection) overcome her reluctance to perform colostomy care. Which suggestion will the team leader try first?
- A. Verbally reexplain the procedure and give her written material.
- B. Have a family member come in and do it for her.
- C. Continue to do it for her until she is ready.
- D. Ask her to hold the clamp while the bag is being emptied.
Correct Answer: A
Rationale: The correct answer is A because it involves providing Ms. C with information and resources to help her understand and feel more comfortable with the colostomy care procedure. Verbally reexplaining the procedure and providing written material will empower her with knowledge and autonomy. Choice B undermines her independence and may not address her reluctance. Choice C promotes dependency rather than encouraging her to take ownership of her care. Choice D involves a hands-on approach that may not address her underlying concerns or fears about the procedure. Overall, choice A is the most appropriate initial step to support Ms. C in overcoming her reluctance.
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A patient tells the nurse that she dislikes the food that is served in the hospital. The nurse responds, "Our cooks work very hard; the food that is served is very good." The nurse's response is an example of the communication block of:
- A. judgmental response.
- B. giving advice.
- C. defensive response.
- D. using clichés.
Correct Answer: C
Rationale: The correct answer is C: defensive response. The nurse's response deflects the patient's complaint about the food quality by defending the cooks' efforts instead of addressing the patient's concerns. This can create a barrier to effective communication by dismissing the patient's feelings and not acknowledging their perspective.
A: Judgmental response involves criticizing or making assumptions about the patient, which is not evident in the nurse's reply.
B: Giving advice would involve offering suggestions on how to improve the situation, which the nurse did not do.
D: Using clichés would involve using overused phrases that may not directly relate to the patient's concern, which is not the case in this scenario.
In summary, the nurse's defensive response fails to address the patient's complaint and can hinder effective communication by dismissing the patient's feelings.
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 nurse has selected an outcome for the patient to eat all of the food on the breakfast tray each day. Assessing that the patient has eaten all of the breakfast, the nurse would give positive feedback by saying:
- A. "Wow! That breakfast must have been pretty good."
- B. "I like pancakes too. Everyone on the hall seemed to enjoy them."
- C. "I hope you can keep all that breakfast down."
- D. "Hurray! You finished your whole meal! What would you like for tomorrow?" Giving positive feedback increases the likelihood of the desired behavior to be repeated. Commenting on the tastiness of the food or the fact that others liked it is not responding directly to the patient's having eaten the whole meal.
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the patient's achievement of finishing the whole meal, provides positive reinforcement, and invites the patient to make choices for the next meal, encouraging continued compliance with the desired outcome. This response directly reinforces the behavior that was targeted, making it more likely for the patient to repeat the behavior in the future. Choices A, B, and C do not specifically address the patient's accomplishment of eating all the food, therefore they do not provide effective positive feedback for reinforcing the desired behavior.
The nurse cares for a patient who has just been diagnosed with lung cancer. Which statement by the nurse is therapeutic?
- A. "You sound really frightened about your diagnosis of cancer."
- B. "You will get better because the treatment will be started this week."
- C. "I think you should take a vacation and try to forget about the cancer."
- D. "An apple a day will keep the doctor away."
Correct Answer: A
Rationale: Answer A is correct because it shows empathy and validation of the patient's feelings. It acknowledges the patient's fear, which is important for building trust and rapport. Answer B is incorrect because it offers false reassurance. Answer C is incorrect because it suggests avoidance, which is not helpful for coping with a cancer diagnosis. Answer D is incorrect because it is a generic and unrelated statement.
The nurse instructs the nursing assistant to obtain temperatures on four patients and report abnormal findings immediately. Two hours later the nurse discovers that one of the patients had a fever that was not reported. The nurse is upset with the nursing assistant. Which statement, if made by the nurse, is concrete and specifically explains the nurse's feelings?
- A. "I am not dissatisfied with your performance, because we all make mistakes."
- B. "You must have misunderstood. I wanted to know about any elevated temperatures."
- C. "I am disappointed because you did not follow my directions."
- D. "You have made me so angry. Why did you not report the fever to me?"
Correct Answer: C
Rationale: The correct answer is C: "I am disappointed because you did not follow my directions." This statement is the most concrete and specifically explains the nurse's feelings of disappointment towards the nursing assistant for not reporting the fever as instructed. It directly addresses the issue at hand, which is the failure to follow directions, and conveys the nurse's emotions in a clear and concise manner.
Choice A: "I am not dissatisfied with your performance, because we all make mistakes." This choice does not address the specific issue of the nursing assistant not following instructions, and it seems to downplay the importance of the mistake.
Choice B: "You must have misunderstood. I wanted to know about any elevated temperatures." This choice shifts the blame to the nursing assistant for misunderstanding, rather than holding them accountable for not following instructions.
Choice D: "You have made me so angry. Why did you not report the fever to me?" This choice focuses on the nurse's anger rather than disappointment, and it does not