A home health patient with a bleeding ulcer informs the nurse that she ate a bowl of chili with jalapenos. An inappropriate communication block with a judgmental tone by the nurse would be:

Correct Answer: B

Rationale: The correct answer is B because it demonstrates a judgmental tone towards the patient's actions. The nurse is passing a negative judgment on the patient by stating that eating chili with jalapenos was not a smart decision considering the ulcer. This response can make the patient feel guilty or ashamed, hindering effective communication. Choice A shows frustration and blame towards the patient, which can lead to a defensive response. Choice C is directive and lacks empathy, focusing solely on the medical aspect without considering the patient's feelings. Choice D dismisses the patient's concerns and minimizes the impact of the action, which can be perceived as condescending. In summary, choice B is the correct answer as it highlights the importance of maintaining a non-judgmental and supportive attitude in patient communication.

Correct Answer: C

Rationale: The correct answer is C: Actively listen to the parents talk about their lives and health concerns. This action allows the nurse to directly learn about the parents' health beliefs and values. By listening attentively, the nurse can understand the parents' perspectives, concerns, and priorities regarding their child's health. This approach promotes trust and open communication, enabling the nurse to provide individualized and culturally sensitive care. Explanation for why the other choices are incorrect: A: Having the parents complete the Myers-Briggs Type Indicator survey is not relevant to determining their health beliefs and values. B: Reading the health histories of the child's parents and grandparents may provide some background information but may not reflect their current health beliefs and values. D: Reviewing traditional health practices of the ethnic group identified by the parents assumes that all individuals within that group hold the same beliefs, which may not be accurate.

Correct Answer: B

Rationale: The correct answer is B: Listen to the parents talk about their child and observe their movements and gestures. This is the first step in helpful self-disclosure because it allows the nurse to understand the parents' emotions and experiences before sharing their own. By actively listening and observing, the nurse can establish a connection with the parents and demonstrate empathy. This step sets the foundation for effective communication and builds trust between the nurse and the parents. Incorrect choices: A: Succinctly share a personal experience that is a similar grieving experience. This is not the first step because it doesn't consider the parents' feelings and might come across as insensitive or self-centered. C: Reflect upon the parent's statements to communicate understanding. While reflection is important, it should come after active listening to ensure the nurse fully grasps the parents' emotions. D: Seek verification that the self-disclosure was helpful to the child's parents. Seeking verification should come at a later stage after the nurse has provided support and guidance through

Correct Answer: B

Rationale: The correct answer is B: Assess whether the client is comfortable with eye contact. This is important because different cultures have varying views on eye contact, and it is crucial to respect the client's preferences. By assessing the client's comfort level with eye contact, the nurse can establish rapport and demonstrate cultural sensitivity. A: Maintaining eye contact may not be culturally appropriate for some Native American clients, so it is important to assess their comfort level first. C: Avoiding prolonged eye contact assumes all Native American clients have the same preferences, which is not accurate. D: Sitting next to the patient to avoid eye contact may be perceived as distancing or disrespectful in some cultures.

Correct Answer: B

Rationale: The correct answer is B: Maintaining belief, being with, doing for, and enabling. - Maintaining belief: Involves believing in the patient's capacity for self-care. - Being with: Being present and connecting emotionally with the patient. - Doing for: Providing assistance and meeting the patient's needs. - Enabling: Encouraging and supporting the patient to reach their full potential. Other choices are incorrect: - A: Communication, assertiveness, responsibility, and caring do not align with Swanson's caring processes. - C: Understanding, action, information, and comfort are not the caring processes in Swanson's theory. - D: Maintaining belief, being with, enabling, and supporting is partly correct but lacks the "doing for" process.

Correct Answer: A

Rationale: The correct answer is A (Relaxed posture) because assertive communication involves being confident and composed. A relaxed posture signifies confidence and comfort in oneself. Choices B (Established eye contact) can also be consistent with assertiveness as it shows engagement and confidence. Choices C (Hands placed on hips) may come across as aggressive rather than assertive. Choice D (Distant, soft voice) is more indicative of a passive communication style, lacking the firmness associated with assertiveness. In summary, choices B, C, and D are incorrect because they do not align with the confident and self-assured characteristics of assertive communication.

Correct Answer: D

Rationale: The correct answer is D because listening attentively to the client's perception of having a chronic illness is crucial for building trust, understanding their concerns, and fostering a therapeutic relationship. By actively listening, the nurse can address any misconceptions, provide education tailored to the client's needs, and involve the client in decision-making, ultimately improving compliance. Choice A is incorrect as ignoring negative statements can lead to feelings of neglect and hinder communication. Choice B is incorrect as avoiding touching the client may create a barrier to building rapport. Choice C is incorrect as focusing only on physical care neglects the psychological and emotional aspects of managing a chronic condition like diabetes.

Correct Answer: C

Rationale: The correct answer is C because it directly and assertively communicates the staff nurse's inability to work an extra shift. This response sets clear boundaries and respects the nurse's own limitations and well-being. It is based on rational beliefs as it acknowledges personal capacity without guilt or unnecessary explanations. Explanation of other choices: A: This choice is not assertive as it prioritizes avoiding upsetting the nurse manager over the nurse's own needs and boundaries. B: This response is confrontational and does not address the request directly, focusing instead on questioning past occurrences. D: While this response offers to work the extra shift as a last resort, it does not assert the nurse's own limitations clearly, leaving room for potential guilt or manipulation.

Correct Answer: C

Rationale: The correct answer is C. This response provides constructive feedback by suggesting a specific action for improvement. Here's a step-by-step rationale: 1. Option A is incorrect because it is negative and does not offer guidance for improvement. 2. Option B is incorrect because it is judgmental and may be discouraging to the student nurse. 3. Option D is incorrect because it is vague and lacks specificity on how to change behavior. 4. Option C is the best choice as it offers a positive solution by providing guidance on how to improve through observation and learning from the nurse's warmth towards patients.