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When the patient says, "I don't want to go home," the nurse's best therapeutic verbal response would be:
- A. "I'm sure everything will be fine once you get home."
- B. "You don't want to go home?"
- C. "Doesn't your family want you to come home?"
- D. "I felt like that when I had surgery last year." The use of reflecting encourages the patient to expand on his or her feelings or thoughts.
Correct Answer: B
Rationale: The correct answer is B because it demonstrates active listening and empathy by reflecting the patient's statement. It shows the nurse is engaged and seeking to understand the patient's feelings. Choice A dismisses the patient's concerns. Choice C implies the patient is being pressured by their family. Choice D shifts the focus to the nurse's experience, not the patient's feelings.
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When the nurse observes a resident in a long-term facility pounding his fists on his legs and grinding his teeth, the nurse will validate her perception of the patient's nonverbal expression of anger by:
- A. documenting that the patient was agitated and appeared angry.
- B. asking the male nursing assistant if it is his perception that the patient appears angry.
- C. accessing the nursing care plan to ascertain if there is a nursing diagnosis relative to anger.
- D. sitting down near the patient and saying, "You seem upset…can I help?" All perceptions based on the observation of nonverbal behavior should be validated by consulting the patient.
Correct Answer: D
Rationale: The correct answer is D because it demonstrates active listening and empathy towards the patient's nonverbal cues. By sitting down near the patient and acknowledging his emotions, the nurse opens up a channel for communication and offers support. This approach allows the patient to express his feelings and needs, leading to better understanding and potential resolution of the underlying issue.
Other choices are incorrect because:
A: Simply documenting the observation does not address the patient's emotional state or provide any opportunity for direct communication.
B: Asking another staff member for their perception does not involve the patient directly and may not accurately reflect the patient's emotions.
C: Referring to the care plan does not involve the patient in the process and may not address the immediate emotional needs expressed through nonverbal behavior.
When using the telephone to communicate with a primary care provider about a patient, the student nurse should have ready: (Select all that apply.)
- A. current information relative to patient's condition change.
- B. assessment of vital signs.
- C. information on urinary output.
- D. patient's social security number or hospital identification number.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Current information on patient's condition change is crucial for effective communication with the primary care provider.
2. This allows the student nurse to provide accurate and up-to-date information for appropriate decision-making.
3. Assessment of vital signs or information on urinary output may be important, but the question specifically focuses on communication about the patient's condition change.
4. Patient's social security number or hospital identification number is not necessary for communicating about the patient's condition change.
In summary, choice A is correct as it ensures accurate communication, while the other choices are not directly related to communicating patient's condition change.
The home care nurse is assigned to make the first home visit to a new client who has been discharged from the hospital. After initial introductions, the nurse should take which action to convey respect?
- A. Ask the client to develop a list of needs to discuss at the next visit.
- B. Wear a name badge that clearly identifies the home care agency.
- C. Provide contact information for several other clients who can serve as references.
- D. Tell the client that information obtained will not be shared with others.
Correct Answer: B
Rationale: The correct answer is B because wearing a name badge that clearly identifies the home care agency conveys professionalism and respect. It helps establish trust and credibility with the client. This action also ensures transparency and allows the client to easily identify and verify the nurse's credentials.
Choices A, C, and D are incorrect:
A: Asking the client to develop a list of needs for the next visit is not about conveying respect but rather about gathering information. It does not focus on establishing a professional and respectful relationship.
C: Providing contact information for other clients as references is inappropriate and breaches confidentiality. It does not demonstrate respect for the client's privacy.
D: Assuring the client that information obtained will not be shared with others is expected as part of maintaining confidentiality and privacy. However, it does not specifically address conveying respect during the initial visit.
The nurse is aware that the purpose of therapeutic communication is to:
- A. gather as much information as possible about the patient's problem.
- B. direct the patient to communicate about his deepest concerns.
- C. focus on the patient and the patient needs to facilitate interaction.
- D. gain specific medical information and history of illness.
Correct Answer: C
Rationale: The correct answer is C because therapeutic communication aims to focus on the patient and their needs to facilitate a therapeutic interaction. This involves active listening, empathy, and creating a supportive environment for the patient to express their thoughts and feelings. Gathering information (choice A) is important but not the sole purpose of therapeutic communication. Directing the patient to communicate about deepest concerns (choice B) may not always be appropriate or helpful. Lastly, gaining specific medical information and history of illness (choice D) is part of a comprehensive assessment but not the primary goal of therapeutic communication.
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.