The nurse instructs the nursing assistant to obtain temperatures on four patients and report abnormal findings immediately. Two hours later the nurse discovers that one of the patients had a fever that was not reported. The nurse is upset with the nursing assistant. Which statement, if made by the nurse, is concrete and specifically explains the nurse's feelings?

Correct Answer: C

Rationale: The correct answer is C: "I am disappointed because you did not follow my directions." This statement is the most concrete and specifically explains the nurse's feelings of disappointment towards the nursing assistant for not reporting the fever as instructed. It directly addresses the issue at hand, which is the failure to follow directions, and conveys the nurse's emotions in a clear and concise manner. Choice A: "I am not dissatisfied with your performance, because we all make mistakes." This choice does not address the specific issue of the nursing assistant not following instructions, and it seems to downplay the importance of the mistake. Choice B: "You must have misunderstood. I wanted to know about any elevated temperatures." This choice shifts the blame to the nursing assistant for misunderstanding, rather than holding them accountable for not following instructions. Choice D: "You have made me so angry. Why did you not report the fever to me?" This choice focuses on the nurse's anger rather than disappointment, and it does not

Correct Answer: A

Rationale: The correct answer is A (Relaxed posture) because assertiveness is about expressing oneself confidently while respecting others. A relaxed posture conveys confidence and self-assurance. Established eye contact (B) is also consistent with assertiveness, showing engagement and sincerity. Choices C (Hands placed on hips) and D (Distant, soft voice) are more indicative of aggression or passivity, respectively, rather than assertiveness. Placing hands on hips can come across as confrontational, while a distant, soft voice lacks the firmness and clarity associated with 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 a therapeutic relationship and understanding their concerns, fears, and challenges. By actively listening, the nurse can address the client's emotional and psychological needs, which are essential in managing a chronic condition like type 1 diabetes. This approach fosters trust, enhances communication, and promotes client engagement in their treatment plan. Choices A, B, and C are incorrect because ignoring negative statements, avoiding physical contact, and solely focusing on the physical aspects of care can lead to poor client-nurse communication, lack of trust, and ultimately hinder compliance with the therapeutic regimen. Ignoring negative statements may escalate resistance, avoiding physical contact may create distance, and solely focusing on physical care neglects the holistic needs of the client.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Current information on patient's condition change is crucial for effective communication with the primary care provider. 2. This allows the student nurse to provide accurate and up-to-date information for appropriate decision-making. 3. Assessment of vital signs or information on urinary output may be important, but the question specifically focuses on communication about the patient's condition change. 4. Patient's social security number or hospital identification number is not necessary for communicating about the patient's condition change. In summary, choice A is correct as it ensures accurate communication, while the other choices are not directly related to communicating patient's condition change.

Correct Answer: B

Rationale: The correct answer is B because having another nurse who has a good relationship with the family present can help facilitate effective communication and provide emotional support. This can help alleviate the family's concerns and build trust in the care being provided. Avoiding discussing the treatment plan (A) may lead to increased anxiety and worry for the family. Using medical terms (C) may confuse the family further and hinder effective communication. Assuming that the family wants a detailed explanation (D) without confirming their preferences may not be the most appropriate approach.

Correct Answer: B

Rationale: The correct answer is B: Maintaining belief, being with, doing for, and enabling. Swanson's theory of caring includes these four processes along with "knowing." Maintaining belief refers to having faith in the patient's ability to get through the situation. Being with involves being present and showing emotional support. Doing for means providing physical care and assistance. Enabling focuses on empowering the patient to make decisions and take control of their health. Choice A is incorrect because it includes communication, assertiveness, and responsibility, which are not part of Swanson's caring processes. Choice C is incorrect as it includes understanding, action, information, and comfort, which do not align with Swanson's theory. Choice D is incorrect because it includes supporting, which is not one of the caring processes identified by Swanson.

Correct Answer: D

Rationale: The correct answer is D because the nurse-patient relationship primarily focuses on addressing the assessed health problems of the patient. This relationship is centered around providing care, support, and assistance related to the patient's health needs. Building rapport (A) is important, but not the primary focus. The relationship does not necessarily continue after discharge (B) as it depends on the circumstances. Humor (C) can be included in the relationship but is not a defining characteristic. Thus, D is the correct choice as it aligns with the fundamental purpose of the nurse-patient relationship.

Correct Answer: C

Rationale: The correct answer is C because actively listening to the patient express their feelings related to the sexual assault is essential for providing emotional support and validating their experience. This action shows empathy and helps the patient feel heard and supported. It also allows the nurse to assess the patient's emotional well-being and provide appropriate care. Avoiding decision-making situations (A) may lead to further distress for the patient. While joining a support group (B) can be beneficial, it may not be appropriate or feasible immediately after a traumatic event. Providing detailed information about evidence collection (D) is important but should be done after addressing the patient's emotional needs.

Correct Answer: A

Rationale: The correct answer is A because touch can convey caring and support when words are difficult, enhancing the nurse-patient relationship. This is supported by research showing the positive impact of touch in providing comfort and building trust. Choice B is incorrect as cultural differences can be addressed through communication and understanding. Choice C is incorrect because touch can be appropriate in various situations beyond just young children. Choice D is incorrect as touch should be used judiciously based on individual preferences and boundaries.