The nurse cares for a female patient who is trying to gain understanding of her life and her diagnosis of metastatic breast cancer. Which approach by the nurse would best meet this patient's needs?

Correct Answer: D

Rationale: The correct answer is D because actively listening to the patient's stories about her past experiences allows for emotional expression, validation, and building trust. It promotes therapeutic communication and helps the patient gain understanding and cope with her diagnosis. Choice A focuses on group support, which may not address the patient's individual needs. Choice B is not appropriate as it may induce unnecessary fear. Choice C assumes the patient has specific spiritual beliefs and may not be welcomed.

Correct Answer: C

Rationale: The correct answer is C: The nurse should collaborate with the client to develop an individualized plan of action. This is the most likely action to result in a behavior change because it involves actively involving the client in the process, taking into account their unique needs, preferences, and circumstances. By collaborating with the client, the nurse can tailor the smoking cessation plan to be more personalized and therefore more effective. Choice A (contact the national telephone quitline) may be helpful but lacks individualization. Choice B (recommend nicotine replacement and behavioral interventions) is a good approach but may not address the client's specific needs. Choice D (implement a strategy validated by research) is important but may not be as effective if it does not consider the client's individual factors. Overall, choice C is the best option as it promotes client engagement and customization for a higher chance of successful behavior change.

Correct Answer: B

Rationale: The most appropriate action for the nurse is to ask the client to report the amount of fluid intake for the past 24 hours. This is the correct answer because it directly addresses the issue of non-compliance with fluid restrictions. By assessing the actual fluid intake, the nurse can identify the extent of the problem and provide targeted interventions. Option A is not the best choice as teaching about consequences may not address the immediate issue. Option C does not address the root cause of the problem but only provides a temporary solution. Option D is not appropriate as increasing the diuretic dose should be done in collaboration with the healthcare provider after assessing the client's current condition.

Correct Answer: B

Rationale: The correct answer is B because conducting a cultural assessment allows the nurse to understand the client's individual health beliefs and behaviors. This approach promotes culturally competent care by tailoring interventions to the client's specific needs. Option A is incorrect as it assumes all Nigerians have the same health beliefs. Option C is not necessary as the nurse can directly assess the client. Option D does not consider the importance of cultural competence in communication. Conducting a cultural assessment ensures effective communication and respectful care.

Correct Answer: B

Rationale: The correct answer is B, using a direct approach with succinct sentences. This strategy is most effective as it conveys the nurse's concern clearly and efficiently, facilitating better understanding and communication with the physician. Being direct helps to address the issue promptly and allows for a more focused discussion. Choice A, assuming a subservient role, is incorrect as it may lead to a power imbalance and hinder effective communication. Choice C, asking questions instead of making recommendations, could be less effective in conveying the urgency or importance of the concern. Choice D, being polite and expecting politeness, is important but not sufficient for effective communication in this context.