A 67-year-old woman had major abdominal surgery yesterday. She has IV lines, a urinary catheter, and an abdominal wound dressing, and she is receiving PRN pain medication. The end of shift report that best conveys the patient status is:

Correct Answer: C

Rationale: The correct answer is C because it provides the most detailed and comprehensive information about the patient's status, including specific details about the abdominal dressing, IV fluid status, urine output, pain management, comfort level, and vital signs. This level of detail is crucial for understanding the patient's condition post-surgery. Choice A is incorrect because it lacks specific details regarding the patient's clinical status. Choice B is more detailed but still lacks key information such as urine output and specific pain medication doses. Choice D is incorrect as it focuses more on non-clinical information and does not provide essential details about the patient's medical condition. In summary, choice C is correct because it offers a thorough and detailed overview of the patient's medical status, making it the most appropriate choice for an end-of-shift report in a healthcare setting.

Correct Answer: C

Rationale: The correct answer is C. By saying, "We can come back to that later—right now I need to know about when your symptoms started," the nurse is refocusing the patient to the issue at hand when the conversation has wandered. This response helps maintain the focus of the conversation on gathering important information about the patient's symptoms, which is crucial for providing appropriate care. It acknowledges the patient's concerns while redirecting the conversation back to the main topic. Choices A, B, and D are incorrect because they do not accurately reflect the nurse's intention in the given statement. Choice A implies judgment on the patient's conversation topic, choice B suggests limiting the patient's emotional expression, and choice D implies a rushed or dismissive attitude towards the conversation, none of which are demonstrated by the nurse's response.

Correct Answer: D

Rationale: The correct answer is D: silence. In therapeutic communication, silence can be challenging for students as it requires them to be comfortable with pauses in conversation, which can sometimes feel awkward. However, silence can be a powerful tool in allowing the patient to reflect and express their thoughts. Closed questions (A) limit communication, restating (B) encourages the patient to elaborate, and using general leads (C) helps open up the conversation. Therefore, the practical nursing student will have the most difficulty with silence as it may be perceived as ineffective or uncomfortable.

Correct Answer: B

Rationale: The correct answer is B: "You don't want to walk today?" This response shows empathy and encourages the patient to express their feelings further. It validates the patient's emotions without judgment, fostering a therapeutic relationship. Choice A is directive and dismisses the patient's feelings. Choice C shifts the focus to the nurse's feelings, not addressing the patient's concerns. Choice D is confrontational and may make the patient defensive instead of exploring their feelings. In summary, option B demonstrates active listening and promotes open communication, making it the most therapeutic response.

Correct Answer: A

Rationale: The correct answer is A because it demonstrates active listening and empathy by reflecting the patient's concern. It shows that the nurse acknowledges the patient's feelings without making assumptions or offering false reassurance. Answer B may invalidate the patient's feelings by assuming the husband will find her attractive. Answer C redirects the focus to the nurse's experience, which may not be relevant to the patient. Answer D is inappropriate as it suggests drastic action and does not address the patient's emotional needs.