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The primary care provider informs the student nurse that he would like to give a telephone order. The best response by the student is:
- A. document the telephone order on the primary care provider's orders.
- B. ask another student to listen as a witness to the telephone order.
- C. tape record the primary care provider giving the order to the student nurse.
- D. ask the registered nurse to take the telephone order.
Correct Answer: D
Rationale: The correct answer is D because asking the registered nurse to take the telephone order ensures accuracy and accountability. The registered nurse is trained to accurately transcribe orders and can verify the details with the primary care provider if needed. This also follows the chain of command and delegation principles in healthcare.
Choice A is incorrect because the student nurse should not document the order directly without proper verification. Choice B is incorrect as having another student as a witness does not guarantee accuracy or proper documentation. Choice C is incorrect as recording the order could violate patient privacy laws and does not involve a healthcare professional in the transcription process.
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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.
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.
According to a study by Robinson (2014), three parts of our true presence (how we connect with patients) are found in being:
- A. Friendly, kind, and sweet
- B. Genuine, gifted, and creative
- C. Humorous, partial, and grateful
- D. Genuine, attentive, and immersed
Correct Answer: D
Rationale: The correct answer is D because being genuine shows sincerity and authenticity in interactions with patients. Attentiveness implies active listening and focus on the patient's needs, fostering a strong connection. Immersion signifies being fully engaged and present during patient interactions, enhancing the quality of care provided. In contrast, choices A, B, and C lack the essential components of active listening, authenticity, and full engagement, making them incorrect. Being friendly, kind, and sweet (choice A) may not necessarily reflect genuine presence. Similarly, being humorous, partial, and grateful (choice C) or genuine, gifted, and creative (choice B) do not fully capture the core elements of true presence as outlined in the study by Robinson (2014).
The characteristic that is representative of the nurse-patient relationship is that this relationship:
- A. focuses on the nurse's ability to build rapport.
- B. continues after discharge.
- C. does not include humor.
- D. focuses on the assessed patient health problems.
Correct Answer: D
Rationale: The correct answer is D because the nurse-patient relationship primarily focuses on addressing the assessed health problems of the patient. This relationship is centered around providing care, support, and assistance related to the patient's health needs. Building rapport (A) is important, but not the primary focus. The relationship does not necessarily continue after discharge (B) as it depends on the circumstances. Humor (C) can be included in the relationship but is not a defining characteristic. Thus, D is the correct choice as it aligns with the fundamental purpose of the nurse-patient relationship.
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