The nurse cares for a client with hypertension, and a nurse–client contract is developed outlining the activities and responsibilities of each. Which would be appropriate to include in this contract? (Select all that apply)

Correct Answer: A

Rationale: The correct answer is A: The outcomes should be realistic and measurable. This is appropriate to include in the nurse-client contract because setting realistic and measurable outcomes helps in monitoring progress and evaluating the effectiveness of interventions in managing hypertension. It allows for clear communication between the nurse and the client regarding the goals of treatment. Incorrect choices: B: Progress should be reviewed at regular intervals - While this is important in the management of hypertension, it is a process rather than a specific component of a contract. C: The contract should be written and signed - This is important for legal purposes but not specifically related to setting goals and outcomes. D: The nurse should keep the information confidential - This is a standard ethical practice but not a specific component of a contract outlining activities and responsibilities.

Correct Answer: A

Rationale: The correct answer is A because it acknowledges the cultural communication norms of Native American individuals, who may take longer pauses during conversations to reflect and respond thoughtfully. By waiting patiently through these pauses, the nurse shows respect for the individual's communication style and allows for effective dialogue. Option B is incorrect because maintaining constant eye contact may be perceived as confrontational or disrespectful in some Native American cultures. Option C is incorrect as it assumes the patient needs permission to speak, which may not align with their cultural norms. Option D is incorrect as it undermines the individual's autonomy and may not accurately represent their perspective.

Correct Answer: D

Rationale: The correct answer is D because the patient with a history of violent behavior poses a potential risk to the nurse's safety. Temporarily withdrawing expressions of warmth is important to establish boundaries and ensure safety. Choice A involves an angry patient, but the risk of violence is higher with a history of violent behavior. Choices B and C do not indicate immediate safety concerns.

Correct Answer: B

Rationale: The correct answer is B because offering advice can come off as dismissive to adolescents who value autonomy and independence. Adolescents prefer to feel heard and understood rather than being told what to do. Providing unsolicited advice can hinder trust and communication. Asking embarrassing questions (A) can be inappropriate but can still be necessary for assessment. Interrupting frequently (C) disrupts the flow of communication. Using active listening (D) is important but does not directly relate to avoiding sensitive topics with adolescents.

Correct Answer: A

Rationale: The correct answer is A because speaking slowly allows the older adult patient to process the message at their own pace, considering potential hearing or cognitive impairments. Speaking slowly also shows respect and patience. Option B is incorrect because using the first name may not be culturally appropriate or may not align with the patient's preference for formality. Option C is incorrect because standing in the doorway may be seen as disrespectful and inhibit effective communication by creating physical barriers. Option D is incorrect because speaking in simple sentences is important, but speaking as if to a child may be patronizing and disrespectful to the older adult patient.