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 because active listening involves making a conscious effort to block out other sounds in the immediate environment, demonstrating full focus on the speaker. This allows the nurse to truly understand the patient's perspective and feelings. Maintaining eye contact (A) is important but staring can be intimidating. Prompting the patient (B) may disrupt their train of thought. Writing down remarks (D) can be perceived as disengagement. In summary, active listening requires focused attention and empathy, which choice C exemplifies.

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: C

Rationale: The correct answer is C: changing the subject. The nurse's response shifts the conversation away from the patient's expression of worry about having cancer to a completely unrelated topic - eating breakfast. This technique blocks effective communication as it disregards the patient's concerns and prevents further exploration of the underlying issue. By redirecting the conversation, the nurse fails to address the patient's emotional needs and misses an opportunity to provide support and reassurance. Choices A, B, and D are incorrect as they do not accurately reflect the nurse's response in this scenario.

Correct Answer: D

Rationale: The correct answer is D. This response acknowledges the patient's emotions, offers support, and provides an opportunity for the patient to express their feelings. Offering a tissue shows empathy and readiness to listen. Sitting with the patient shows availability and willingness to engage further. This response validates the patient's emotions and fosters a therapeutic nurse-patient relationship. Choice A is incorrect because it dismisses the patient's emotions and focuses on the surgeon rather than the patient. Choice B is incorrect as it ignores the patient's emotional distress and focuses on a non-essential issue. Choice C is incorrect as it invalidates the patient's feelings and suggests avoidance rather than addressing the emotions directly.

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 helping a client communicate about discontinuing chemotherapy shows responsible communication. This action respects the client's autonomy and involves them in decision-making. This choice prioritizes the client's well-being and supports open and honest communication. Incorrect choices: A: Using profanity is unprofessional and disrespectful, violating ethical standards. C: While using interpersonal strategies to help a client cope is important, it doesn't specifically address responsible communication. D: Sharing a client's health information without consent breaches confidentiality and violates privacy rights.

Correct Answer: B

Rationale: The correct answer is B because speaking slowly and giving the patient time to respond allows the patient with speech difficulties due to the stroke to process information and formulate a response. Prompting or finishing sentences can hinder the patient's ability to communicate independently. Asking questions to the patient directly, rather than relying on a family member, ensures accurate information is obtained directly from the patient. Telling the patient that all information will come from the daughter undermines the patient's autonomy and may lead to incomplete or inaccurate information.

Correct Answer: B

Rationale: The correct answer is B. Docusate is a stool softener commonly used to prevent constipation, which is a common side effect of opioid pain medications. By asking if the patient had a bowel movement today or yesterday, the nurse can evaluate the effectiveness of docusate in facilitating bowel movements. This question directly assesses the expected outcome of the medication. A: "Are you experiencing any burning with urination?" - This question is more relevant to urinary tract infections, not related to docusate use for constipation. C: "Has the medication helped to relieve the nausea?" - Docusate is not typically used to relieve nausea, so this question is not relevant to evaluating its effectiveness. D: "Were you able to sleep soundly the last couple of nights?" - This question is not directly related to the expected outcome of docusate in treating constipation.