Nokea
The nursing supervisor instructs a group of novice nurses about the appropriate use of self-disclosure with patients. The nursing supervisor determines that teaching was successful if the novice nurse makes which statement?
- A. "Self-disclosure provides an opportunity for the patient to understand the nurse."
- B. "It is better to disclose stories about others to maintain professional boundaries."
- C. "Self-disclosure may be used to build a trusting relationship with the patient."
- D. "A fabricated personal experience can be shared if the patient remains the main focus."
Correct Answer: C
Rationale: The correct answer is C. Self-disclosure can be used to build a trusting relationship with the patient. This is because sharing personal information appropriately can help create a connection and foster trust between the nurse and the patient. By being open and genuine, nurses can demonstrate empathy and understanding, leading to better communication and rapport.
Choice A is incorrect because while self-disclosure can help the patient understand the nurse, the primary goal is to build a therapeutic relationship. Choice B is incorrect because disclosing stories about others does not promote genuine connection and may not be relevant to the patient's care. Choice D is incorrect because fabricating personal experiences goes against the principles of honesty and authenticity in therapeutic communication.
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One study of Italian primary care physicians caring for diabetic patients showed that those scoring highest on the empathy test had patients with:
- A. Significantly fewer acute diabetic complications
- B. Statistically fewer acute diabetic complications
- C. Higher rates of chronic diabetic complications
- D. Statistically higher poor outcomes for patients with diabetes
Correct Answer: B
Rationale: The correct answer is B: Statistically fewer acute diabetic complications. This is because the study found a correlation between high empathy scores of physicians and lower occurrences of acute diabetic complications in their patients. The use of the term "statistically" implies a significant and reliable relationship between physician empathy and patient outcomes.
Choice A is incorrect because the study did not specify "significantly" fewer complications, only a correlation with high empathy scores. Choice C is incorrect as there was no evidence of higher rates of chronic complications associated with physician empathy. Choice D is incorrect as the study did not find statistically higher poor outcomes for patients with diabetes, but rather a relationship with fewer acute complications.
A patient is irritable and complains to the nurse about difficulty sleeping last night. Which response by the nurse is most appropriate?
- A. "I know you will sleep better tonight.=
- B. "Tell me more about what happened last night.=
- C. "Did you drink too much caffeine yesterday?=
- D. "No one sleeps well in the hospital.=
Correct Answer: B
Rationale: The correct response is B. Asking the patient to elaborate on what happened last night allows the nurse to gather more information about the situation, which is crucial for assessing the patient's sleep difficulties accurately. It shows active listening and empathy, building rapport and trust with the patient. Options A, C, and D are incorrect because they do not address the patient's concerns effectively or gather relevant information to provide appropriate care. Option A makes an assumption without understanding the root cause of the sleep issue. Option C assumes the cause of sleep difficulty without exploring further. Option D dismisses the patient's concerns without providing support or understanding.
Mr. L (tracheostomy and partial laryngectomy) needs to receive a dose of IV chemotherapy during the shift. What is the most important action to take to prevent extravasation?
- A. Carefully monitor the access site during the administration of the medication.
- B. Hold the medication until an implanted port or central line is established.
- C. Ensure that a chemotherapy-certified nurse is assigned to care for the client.
- D. Call the pharmacy to find out if the prescribed medication has vesicant properties.
Correct Answer: A
Rationale: Step-by-step rationale for the correct answer, A:
1. Monitoring the access site during administration allows for early detection of extravasation.
2. Early detection can prevent serious tissue damage and complications.
3. As Mr. L has a tracheostomy and partial laryngectomy, his airway is compromised, making prevention of extravasation crucial.
4. This action is within the nurse's scope of practice and promotes patient safety.
Summary:
- Choice B is incorrect as delaying treatment can impact Mr. L's health.
- Choice C is not directly related to preventing extravasation.
- Choice D, though important, does not directly address preventing extravasation during administration.
According to the Workplace Bullying Institute, nurses are also exposed to this type of behavior within their professional environment. In teaching the possibility to an incoming graduate nurse, you know that the nurse understands when he or she includes which of the following as abusive conduct? (Select all that apply)
- A. Threats
- B. Humiliation
- C. Intimidation
- D. Physical abuse
Correct Answer: A
Rationale: The correct answer is A: Threats. Threats are considered abusive conduct in the context of workplace bullying. Nurses may be subjected to threats that create a hostile work environment. Threats can instill fear and distress in the victim, affecting their well-being and performance.
Summary of why other choices are incorrect:
B: Humiliation - While humiliation is a form of abuse, the question specifically asks about abusive conduct in the context of workplace bullying for nurses.
C: Intimidation - Intimidation is another form of abusive behavior, but the question focuses on identifying abusive conduct in the workplace environment for nurses.
D: Physical abuse - While physical abuse is a serious issue, the question pertains to identifying abusive conduct within the professional environment for nurses, where physical abuse may not be as common as other forms of bullying behavior.
When communicating with a hearing impaired patient, the nurse appropriately:
- A. shouts repeatedly at the patient.
- B. speaks directly into the patient's ear.
- C. uses long, complex sentences.
- D. uses short, simple sentences.
Correct Answer: D
Rationale: The correct answer is D: uses short, simple sentences. This is the most appropriate approach because hearing-impaired patients may have difficulty processing complex information. Using short, simple sentences helps improve comprehension. Shouting repeatedly (choice A) can be distressing and ineffective. Speaking directly into the patient's ear (choice B) may be invasive and uncomfortable. Using long, complex sentences (choice C) can overwhelm the patient and lead to confusion. Therefore, option D is the best choice for effective communication with a hearing-impaired patient.