The nurse caring for a patient who is concerned about her 10-pound weight loss relative to her chemotherapy tells the patient, "Lucky you! Every cloud has a silver lining." The nurse's statement is an example of which type of communication block?

Correct Answer: C

Rationale: The correct answer is C: Using clichés. The nurse's statement, "Lucky you! Every cloud has a silver lining," is a cliché that minimizes the patient's concerns about her weight loss and chemotherapy. Clichés are overused phrases that lack originality and can be dismissive or unhelpful in communication. In this case, the nurse's response does not address the patient's emotional or physical needs and fails to provide meaningful support. Incorrect choices: A: Defensive response - This choice involves reacting defensively to the patient's concerns, which is not demonstrated in the nurse's statement. B: Asking probing questions - This choice involves seeking further information from the patient, which is not reflected in the nurse's cliché response. D: Changing the subject - This choice involves diverting the conversation away from the patient's concerns, which is not explicitly done in the given scenario.

Correct Answer: C

Rationale: The correct answer is C. The nurse would ask about feelings of nausea and vomiting to determine the efficacy of the antiemetic therapy. Nausea and vomiting are common side effects of chemotherapy, which Mr. N would receive for non-Hodgkin lymphoma. Improvement in these symptoms indicates the effectiveness of the antiemetic regimen. Choices A, B, and D are not directly related to the medications administered and would not provide valuable information on the efficacy of the therapy for managing chemotherapy-induced nausea and vomiting. Option A focuses on pain assessment, B on appetite and food preferences, and D on energy levels and fatigue, which are not the primary outcomes to evaluate in this context.

Correct Answer: D

Rationale: The correct answer is D because appropriate self-disclosure in a therapeutic setting should be brief, focused, and only shared if it enhances the therapeutic relationship. This helps maintain professional boundaries and keeps the focus on the patient's needs. Choice A is incorrect because discussing intimate or personal values with patients can blur boundaries and shift the focus away from the patient. Choice B is incorrect because keeping secrets with or for a patient can lead to ethical dilemmas and compromise trust. Choice C is incorrect because expressing that you are the only one who truly understands the patient can create a power imbalance and hinder the therapeutic process.

Correct Answer: D

Rationale: The correct answer is D because informing the patient about a medication error and symptoms to report shows transparency, honesty, and prioritizes patient safety. This action also promotes trust in the nurse-patient relationship. A: Choice A is incorrect because falsely reassuring a terminally ill patient does not demonstrate genuine concern and lacks honesty. B: Choice B is incorrect because delaying important information about the death of a dependent child is unethical and can cause unnecessary distress to the patient. C: Choice C is incorrect because providing a placebo without informed consent violates ethical principles and does not prioritize the patient's well-being.

Correct Answer: B

Rationale: The correct answer is B because actively listening to the patient describe their feelings of anxiety related to severe dyspnea demonstrates empathy and a deeper connection between the nurse and patient. This behavior shows understanding and support, fostering trust and rapport. It indicates that the nurse is attentive to the patient's emotional needs, which is essential for effective care in chronic conditions like COPD. Option A is incorrect because expecting the patient to meet exercise goals set by the nurse does not necessarily indicate bonding. It may reflect a more authoritative approach rather than a collaborative relationship. Option C, while important for individualized education, does not specifically indicate bonding unless it involves understanding the patient's preferences on a personal level. Option D is incorrect because refraining from touching the patient may be necessary in some situations, but it does not directly relate to establishing a bond.

Correct Answer: A

Rationale: Step-by-step rationale for the correct answer, A: 1. Monitoring the access site during administration allows for early detection of extravasation. 2. Early detection can prevent serious tissue damage and complications. 3. As Mr. L has a tracheostomy and partial laryngectomy, his airway is compromised, making prevention of extravasation crucial. 4. This action is within the nurse's scope of practice and promotes patient safety. Summary: - Choice B is incorrect as delaying treatment can impact Mr. L's health. - Choice C is not directly related to preventing extravasation. - Choice D, though important, does not directly address preventing extravasation during administration.

Correct Answer: B

Rationale: The correct answer is B because it shows the nurse's willingness to understand the teacher's specific objectives and tailor the nutrition talk accordingly. This approach ensures that the nurse addresses the teacher's concerns and meets the students' needs effectively. Explanation for why the other choices are incorrect: A: Teaching students how to read nutrition labels may be important, but it assumes that this is the teacher's primary goal without confirming it first. C: Focusing on the consequences of obesity may not align with the teacher's desired focus on general nutrition education. D: While enthusiasm for teaching is positive, this response does not address the teacher's specific request for the nutrition talk.

Correct Answer: B

Rationale: The correct answer is B: Demonstrate understanding with empathy. This approach is the most therapeutic as it shows the nurse's genuine care and support for the patient, fostering a sense of trust and emotional connection. By empathizing, the nurse validates the patient's feelings and provides comfort without judgment. A: Using an honest, judgmental attitude can be harmful and create a barrier in the nurse-patient relationship. C: Acknowledging hope by expressions of sympathy is important but may not address the patient's immediate emotional needs. D: Consistently evaluating the patient's feelings is important, but without demonstrating empathy, it may come across as clinical and detached. In summary, choice B is the best approach as it prioritizes empathy and understanding, essential components in providing effective therapeutic communication.

Correct Answer: B

Rationale: The correct answer is B: Collaboration. Mutuality in the nurse-client relationship involves working together as partners towards shared goals, with both parties contributing equally. Collaboration fosters empowerment, respect, and shared decision-making. Dependency (A) implies an unequal power dynamic, which is not characteristic of mutuality. Paternalism (C) involves a one-sided decision-making process, conflicting with the collaborative nature of mutuality. Acceptance of differences (D) is important but does not solely define mutuality. In summary, collaboration best reflects the principles of mutuality by emphasizing partnership, equality, and shared responsibility.