Therapeutic Communication
The nurse in the mental health unit recognizes which of the following as therapeutic communication techniques? Select all that apply.
Correct Answer: A, B, D, and E.
A nurse manager has a staff nurse who observes certain religious holidays. The manager tries to make sure that these observances can be met if possible. Which value is the manager practicing?
1. Human dignity
2. Social justice
3. Autonomy
4. Altruism
Answer: 4
Explanation: 4. Altruism is a concern for the welfare and well-being of others. A professional behavior of this value is demonstrating understanding of the cultures, beliefs, and perspectives of others.
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A client with a sexually transmitted illness (STI) asks the nurse to not tell anyone about the diagnosis. According to the Health Insurance Portability and Accountability Act (HIPAA) of 1996, what must the nurse do?
1. Honor the client's wishes.
2. Not disclose any information to anyone.
3. Respect the client's privacy and confidentiality.
4. Communicate only necessary information.
Answer: 4
Explanation: 4. HIPAA includes standards that protect the confidentiality, integrity, and availability of data as well as standards that define appropriate disclosures of identifiable health information and patient rights protection. Nurses are entrusted with sensitive information that, at times, must be revealed to other health care personnel in order to provide appropriate health care. In this case, the nurse may be required to report information to the state health department.
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Requesting assistance
Expressing belief
Sharing time, opinions, and experiences
Trust vs Mistrust
9) A home health client having difficulty keeping his medication schedule organized says "There are so many pills and the names are all confusing to me. I don't even understand what they're for." What should the nurse do?
1. Help the client remember color and size in relationship to dosing time.
2. Write out the generic and trade name of all the pills for the client.
3. Fill a pill bar and tell the client not to worry, and just take the pills according to that system.
4. Have the physician talk to the client about his medications.
Answer: 1
Explanation: Learning is facilitated by material that is logically organized and proceeds from the simple to the complex. This helps the learner comprehend new information, apply it to previous learning, and form new understandings. Naming the pills by color and size and dosing time helps the client move from that level to learning what each medication is for and why he is taking it– simple to complex.
Which therapeutic communication technique is being used in this nurse-client interaction?
Client: “When I get angry, I get into a fistfight with my wife, or I take it out of the kids.”
Nurse: “I notice that you are smiling as you talk about this physical violence.”
Correct Answer: D. Making observations
A nurse is working with a local agency to provide care to the inadequately insured by helping to staff an after-hours clinic. Which professional value is the nurse demonstrating?
1. Human dignity
2. Altruism
3. Social justice
4. Integrity
Answer: 3
Explanation: 3. Social justice is upholding moral, legal, and humanistic principles. This value is demonstrated in professional practice when the nurse works to ensure equal treatment under the law and equal access to quality health care.
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1. The nurse forgets to put the call light within the client's reach and then leaves the room. The client reaches for it and falls out of bed. With what should the nurse expect to be charged?
1. Assault
2. Battery
3. Negligence
4. Criminal intent
Explanation: 3. Negligence is an example of a tort law. Negligence occurs when something is accidental and harm results, as in this case. Another example of negligence would be if surgical instruments or bandages are accidentally left in a client during surgery.
using past experences to help others
being productive
knowing limitations
Intergrity vs Despair
11) A client with an incision necessitating a complex dressing change is being discharged and will require continued dressings at home. Which statement by the client indicates a need to postpone teaching?
1. "It's going to take time for me to understand this whole thing."
2. "Let's make sure my spouse is around before you start explaining."
3. "I wish my doctor would have explained this more in depth."
4. "I'm feeling nauseous, but go ahead and start anyway."
Answer: 4
Explanation: Learning can be inhibited by physiologic events such as illness, pain, or sensory deficits. The client must be able to concentrate and apply adequate energy to the learning or the learning itself will be impaired. If the client is experiencing nausea, the nurse should first try to reduce this symptom before beginning the teaching session.
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Which therapeutic communication technique is being used in this nurse-client interaction?
Client: “My father spanked me often.”
Nurse: “Your father was a harsh disciplinarian.”
Correct Answer: A. Restatement The nurse is using the therapeutic communication technique of restatement. Restatement involves repeating the main idea of what the client has said. The nurse uses this technique to communicate that the client's statement has been heard and understood.
5) A nurse mistakenly gave a client who was NPO a breakfast tray. After realizing the mistake, the nurse notified the physician as well as the client; explained the consequences of this mistake, which included a delay in the client's scheduled procedure; and documented the situation in the client's medical record. What did this nurse demonstrate?
1. Altruism
2. Integrity
3. Social justice
4. Human dignity
Answer: 2
Explanation: 2. Integrity is acting in accordance with an appropriate code of ethics and accepted standards of practice.
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The nurse documents in a client's medical record: "The client is a drug addict and is always asking for more medication than what is necessary." With what might the nurse be charged?
1. Defamation
2. Slander
3. Libel
4. Incompetence
Answer: 3
Explanation: 3. Libel is defamation of character by means of print, writing, or pictures. Putting a statement such as this in the client's medical record is, first, making a diagnosis, which the nurse is not qualified to do, and, second, making an assumption about the client's need for medication, which is a personal attitude about how the client responds.
Autonomy vs Shame and doubt is what age group?
Toddlerhood 2-3
accepts rules
expresses rules and opinions
accepting derfermint
12) A nurse is working with the family of a child who is hospitalized with asthma. The family members speak little English, and the child is being sent home on nebulizer treatments as well as an inhaler. In addition to enlisting an interpreter to help with the language barrier, which action is the nurse's highest priority?
1. provide written instructions before discharge.
2. address any healing beliefs the family has.
3. make sure the child comes back for the follow-up appointment.
4. make sure the parents can set up the treatments for their child.
Answer: 2
Explanation: If the prescribed treatment conflicts with the client/family's cultural healing beliefs, the client/family may adhere to the recommended treatment plan. To be effective, nurses must deal directly with any conflicts and differing values held by the client.
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Which therapeutic communication technique is being used in this nurse-client interaction?
Client: “When I am anxious, the only thing that calms me down is alcohol.”
Nurse: “Other than drinking, what alternatives have you explored to decrease anxiety?”
Correct Answer: C. Formulating a plan of action The nurse is using the therapeutic communication technique of formulating a plan of action to help the client explore alternatives to drinking alcohol. The use of this technique, rather than direct confrontation regarding the client's poor coping choice, may serve to prevent anger or anxiety from escalating.
A client has chosen to discontinue hemodialysis. His family is not supportive of his decision. Which statement should the nurse make that demonstrates the theory of principles-based reasoning?
1. "This client is of sound mind and is capable of making his own decisions regarding health care. It really is his decision to make."
2. "I need to try and help the family understand the client's decision so they can work through this situation together."
3. "This client's health is so deteriorated that the treatment is not saving his life. It is prolonging the ultimate outcome, which is his death."
4. "The client understands his decision and the advanced stage of his disease. If he quits treatment, he will die."
Answer: 1
Explanation: 1. Principles-based theories stress individual rights, such as autonomy. The client has the ability to make the decision and it is his right to autonomy to do that.
An adult client who cannot read needs surgery and is competent to make his own decisions. What is the best action that the nurse should take?
1. Tell the client in the nurse's own words what the surgical procedure involves.
2. Read the consent form to the client and have the client state understanding.
3. Make sure the physician explains the procedure to the client.
4. Have a family member who can read sign the consent form.
Answer: 2
Explanation: 2. If a client cannot read, the consent form must be read to the client and the client must state understanding before the form is signed
Lack of positive feedback from others
repeated failures
inrealistic expectations
abusive relationship
loss of financial security
are all examples of?
1. Idenity stressors
2. Self esteem stressors
3. Body image stressors
4. Role stressors
2
3 drugs that alter sexual function
cocaine, narcotics, amphentamines
all the other DECREASE
Nurse Patrick is interviewing a newly admitted psychiatric client. Which nursing statement is an example of offering a general lead?
Correct Answer: C. "Yes, I see. Go on." The nurse's statement, "Yes, I see. Go on." is an example of the therapeutic communication technique of a general lead. Offering a general lead encourages the client to continue sharing information. General leads indicate that the nurse is listening and following what the client is saying without taking away the initiative for the interaction.
A decision has been made for an older client to receive aggressive cancer therapy despite knowing that the therapy will actually be more harmful than the disease and subject the client to harmful chemicals. With which ethical principle is this nurse caring for this client struggling?
1. Autonomy
2. Justice
3. Beneficence
4. Nonmaleficence
Answer: 4
Explanation: 4. Nonmaleficence is the duty to "do no harm." Doing intentional harm is never acceptable in nursing. Placing a client at risk of harm is what is depicted in this scenario, and it occurs as a known consequence of a nursing intervention or some other type of treatment. It is unknown how much therapy will be of benefit to the client or whether it will actually do more harm.
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Do no harm
Non- maleficence
willling to share
guides others
prioritizes needs for both self and others is?
Middle aged adults: Generativity vs Stagnation
What is insomnia
Being unable to stay asleep at night
A nurse states to a client, “Things will look better tomorrow after a good night’s sleep.” This is an example of which communication technique?
Correct Answer: D. The non-therapeutic technique of "giving false reassurance." The nurse's statement, "Things will look better tomorrow after a good night's sleep." is an example of the nontherapeutic technique of giving false reassurance. Giving false reassurance indicates to the client that there is no cause for anxiety, thereby devaluing the client's feelings.
The nurse needs to insert an intravenous access device into a toddler who is crying and scared. The parent asks if the procedure is painful. When practicing veracity, what should the nurse respond to the parent?
1. "I won't lie to you. It may be easier for you if you step out until we get the line in."
2. "We'll take every care not to hurt your child."
3. "It shouldn't be too bad and I'll be quick."
4. "We do this all the time, so don't worry."
Answer: 1
Explanation: 1. Veracity refers to telling the truth. Even though telling the truth may frighten the parent, starting an IV on a frightened, scared, ill child is a difficult task. Because of the child's developmental stage, any explanation given by the nurse won't be understood. Being honest with the parent will help the nurse gain trust and will outweigh any benefits that may be gained by downplaying the situation.
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dont lie
veracity
Which vitamin is for neurostransmitter synthesis?
B6 Pyridoxine
A nurse maintains an uncrossed arm and leg posture. This nonverbal behavior is reflective of which letter of the SOLER acronym for active listening?
Correct Answer: B. O. The nurse should identify that maintaining an uncrossed arm and leg posture is nonverbal behavior that reflects the "O" in the active-listening acronym SOLER. Open posture when interacting with the client (O). Crossing the arms would make the nurse anxious or defensive. The acronym SOLER includes:
The nurse is reviewing the ANA (American Nurses Association) Code of Ethics for Nurses. What should the nurse identify as a characteristic of this code?
1. It is a formal statement.
2. It contains the same standards as legal standards.
3. It is shared by group members.
4. It reflects legal judgments.
5. It serves as a standard for professional actions.
Answer: 5
Explanation: 5. A code of ethics is a formal statement of a group's ideals and values. It is a set of ethical principles that (a) is shared by members of the group, (b) reflects their moral (not legal) judgments over time, and (c) serves as a standard for their professional actions. Codes of ethics usually have higher requirements than legal standards, and they are never lower than the legal standards of the profession.
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The client presents her hand when the nurse makes this statement: "I need to start an IV so you can get your antibiotics." Which behavior did the client demonstrate?
1. Informed consent
2. Express consent
3. Implied consent
4. Compliance
Answer: 3
Explanation: 3. Implied consent exists when the individual's nonverbal behavior indicates agreement. In this case, presenting the hand for IV initiation would be a nonverbal behavior indicating agreement with the treatment.
Remaing alone
avoiding close interpersonal relationships is?
Early adulthood: Intimacy vs Isolations
Too much of this vitamin reduces night vision.
vitamin A