Which demonstrates the nurse's genuine concern for clients?
- A. Tell a patient who has a terminal illness that everything will be fine.
- B. Delay notifying the patient about the death of a dependent child.
- C. Provide a placebo to a patient in severe pain to assess for substance abuse.
- D. Inform the patient about a medication error along with symptoms to report.
Correct Answer: D
Rationale: The correct answer is D because informing the patient about a medication error and symptoms to report shows transparency, honesty, and prioritizes patient safety. This action also promotes trust in the nurse-patient relationship.
A: Choice A is incorrect because falsely reassuring a terminally ill patient does not demonstrate genuine concern and lacks honesty.
B: Choice B is incorrect because delaying important information about the death of a dependent child is unethical and can cause unnecessary distress to the patient.
C: Choice C is incorrect because providing a placebo without informed consent violates ethical principles and does not prioritize the patient's well-being.
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A patient asks the nurse to make a decision for her about whether or not to continue taking hormone replacement therapy (estrogen). Which response by the nurse is most appropriate?
- A. "You should check with a doctor; I cannot give you advice about drugs."
- B. "My friend has taken estrogen for more than 5 years without any problems."
- C. "I can answer any questions you have but it is up to you to make this decision."
- D. "Herbal supplements were much better for me than prescription-strength estrogen."
Correct Answer: C
Rationale: The correct answer is C because it emphasizes patient autonomy and informed decision-making, aligning with ethical principles. The nurse should not make decisions for the patient but should provide information and support. Choice A deflects responsibility and does not empower the patient. Choice B is anecdotal and not a reliable source of information. Choice D is not relevant to the patient's question and could potentially lead to misinformation. Ultimately, choice C encourages the patient to take an active role in their healthcare decisions, which promotes patient-centered care.
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.
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.
The nurse cares for a female patient who is trying to gain understanding of her life and her diagnosis of metastatic breast cancer. Which approach by the nurse would best meet this patient's needs?
- A. Suggest the patient join a breast cancer support group.
- B. Provide the patient with reading material on death and dying.
- C. Contact the patient's spiritual leader to request daily visits.
- D. Listen to the patient's stories about her past experiences.
Correct Answer: D
Rationale: The correct answer is D because actively listening to the patient's stories about her past experiences allows for emotional expression, validation, and building trust. It promotes therapeutic communication and helps the patient gain understanding and cope with her diagnosis. Choice A focuses on group support, which may not address the patient's individual needs. Choice B is not appropriate as it may induce unnecessary fear. Choice C assumes the patient has specific spiritual beliefs and may not be welcomed.
The first-semester nursing student tells the team leader that her clinical assignment for the day is to take vital signs and obtain a client history that will take about 1 or 2 hours to complete. Which clients would the leader recommend that she approach to fulfill her assignment? (Select all that apply.)
- A. Mr. N (non-Hodgkin lymphoma)
- B. Mr. L (tracheostomy and partial laryngectomy)
- C. Mr. B (bladder cancer)
- D. Ms. C (bowel resection and colostomy)
Correct Answer: B
Rationale: The correct answer is B because Mr. L, who has a tracheostomy and partial laryngectomy, will likely require vital signs monitoring and a detailed client history due to his complex respiratory and communication needs. This assignment will provide the student with valuable experience in caring for clients with specialized needs.
Incorrect choices:
A: Mr. N (non-Hodgkin lymphoma) - While Mr. N may require vital signs monitoring, his condition does not necessarily involve complex care needs that would warrant a 1-2 hour history-taking session.
C: Mr. B (bladder cancer) - Vital signs monitoring and history-taking for a client with bladder cancer may not require as much time as the scenario suggests, as the care needs may not be as complex as those of a client with a tracheostomy and laryngectomy.
D: Ms. C (bowel resection and colostomy) - While Ms. C may require vital signs monitoring and history-taking