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Which of the following is one of the four categories of client needs identified by the National Council of State Boards of Nursing?
- A. Maintenance of function
- B. Restoration of wellness
- C. Psychosocial integrity
- D. Reduction of fear and worry
Correct Answer: C
Rationale: The National Council of State Boards of Nursing identifies four categories of client needs as the structure for its test plan: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiologic integrity. Nursing care provides skills that help restore wellness, especially during an acute illness, or maintain as much function as possible. The supportive relationship that develops reduces fear and worry.
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Which of the following is a reason why silence is considered therapeutic?
- A. It demonstrates concern or affection.
- B. It communicates caring and support.
- C. It encourages a client's verbal communication.
- D. It is therapeutic when a client is uncomfortable.
Correct Answer: C
Rationale: Silence is the art of remaining quiet. One of its therapeutic uses is to encourage a client's verbal communication. Affective touch is typically used to demonstrate concern or affection. Its intention is to communicate caring and support. The nurse uses affective touch therapeutically in many situations, including when a client is uncomfortable.
The nurse is caring for a client who received a poor prognosis when the physician made rounds. The client is quiet, tearful at times, and prefers to be in a darkened room. The nurse observes a nursing assistant entering the room, turning on the lights, and stating 'Are we ready to get out of bed yet, the day is half over?' When addressing the statement of the nursing assistant, which communication technique would the nurse be most correct to discuss?
- A. Giving disapproval
- B. Belittling
- C. Using clich?©s
- D. Patronizing
Correct Answer: D
Rationale: Patronizing treats the client condescendingly as if incapable of making a decision. Giving disapproval holds the client to a rigid standard and is sarcastic in response. Belittling disregards how the client is responding as an individual and groups them with others in the similar position. Using clich?©s provides worthless advice and curtails exploring alternatives.
The nurse is caring for a geriatric client who has decided to move to a skilled nursing facility. The nurse assisted with the arrangements and, when leaving the room, touched the client on the shoulder. Which therapeutic technique was the nurse demonstrating?
- A. Therapeutic communication
- B. Affective touch
- C. Silence
- D. Task-oriented contact
Correct Answer: B
Rationale: Affective touch is used to demonstrate concern or affection. Its intention is to communicate caring and support. Therapeutic communication and silence can be helpful in this situation but does not fit into the scenario. Task-oriented 'touch' involves the personal contact that is required when performing nursing procedures.
The nurse enters the client's room and assesses that the client's affect appears sad. The client is sitting near the window, staring into the distance with a tear in the eye. The nurse approaches and places a hand on the client's shoulder asking for the client's thoughts. What type of emotion is the nurse projecting?
- A. Sympathy
- B. Empathy
- C. Ambivalence
- D. Pity
Correct Answer: B
Rationale: The nurse is projecting empathy. Empathy is an intuitive awareness of what the client is experiencing. Nurses perceive the client's emotional state and provide support. Sympathy is the projection of understanding the way one may feel, many times by having gone through the experience as well. Ambivalence projects conflicting feelings and uncertainty. Pity projects a feeling of sorrow.
The nurse is evaluating the comprehension of a client's knowledge of the subcutaneous administration of an anticoagulant medication. Which method provides the best feedback?
- A. Having the client explain the medication and injection site
- B. Having the client demonstrate the injection technique on an orange
- C. Having the client watch the nurse prepare the medication and administer it
- D. Having the client prepare the syringe and independently administer the injection
Correct Answer: D
Rationale: Having the client prepare the syringe and independently administer the injection is the 'show back' portion of learning comprehension because it includes demonstrating the skill. By independently demonstrating, the nurse is able to evaluate the knowledge base and skill. Having the client watch the nurse administer the medication involves teaching, but not performing the skill. Having the client explain the medication and injection site or administer the injection into an orange demonstrates parts of the skill but does not allow the nurse to evaluate the entire skill.