The nurse is caring for a patient who has just had a mastectomy (breast removal). The patient expresses concern that her husband will no longer find her attractive because of her mastectomy. The nurse appropriately responds:

Correct Answer: A

Rationale: The correct answer is A because it demonstrates active listening and empathy by reflecting the patient's concern. It shows that the nurse acknowledges the patient's feelings without making assumptions or offering false reassurance. Answer B may invalidate the patient's feelings by assuming the husband will find her attractive. Answer C redirects the focus to the nurse's experience, which may not be relevant to the patient. Answer D is inappropriate as it suggests drastic action and does not address the patient's emotional needs.

Correct Answer: D

Rationale: The correct answer is D because informing the patient about a medication error and symptoms to report demonstrates transparency, honesty, and prioritizing the patient's safety and well-being. It shows genuine concern by ensuring the patient is informed and involved in their care. Choice A is incorrect as it provides false reassurance. Choice B is incorrect as delaying notification can harm the patient emotionally and undermine trust. Choice C is incorrect as it involves deception and risks the patient's well-being for assessment purposes.

Correct Answer: D

Rationale: The correct answer is D: silence. In therapeutic communication, silence can be challenging for students as it requires them to be comfortable with pauses in conversation, which can sometimes feel awkward. However, silence can be a powerful tool in allowing the patient to reflect and express their thoughts. Closed questions (A) limit communication, restating (B) encourages the patient to elaborate, and using general leads (C) helps open up the conversation. Therefore, the practical nursing student will have the most difficulty with silence as it may be perceived as ineffective or uncomfortable.

Correct Answer: A

Rationale: The correct answer is A because using a soft and relaxed tone of voice conveys warmth and concern, creating a welcoming and comforting environment for the patient. This approach helps build rapport and trust. Choice B is incorrect because maintaining a distance of 6 to 8 feet may come off as cold and distant, lacking warmth and concern. Choice C is incorrect because avoiding attentive behaviors can make the patient feel neglected and uncared for, which does not display warmth and concern. Choice D is incorrect because engaging in a verbal exchange without physical contact alone may not be enough to demonstrate genuine warmth and concern towards the patient.

Correct Answer: C

Rationale: The correct answer is C because it acknowledges the patient's specific concerns about taking care of herself and her baby. By reflecting back what the patient has expressed, the nurse shows understanding and empathy. Choice A implies doubt in the patient's perception, B makes an assumption about low self-esteem without evidence, and D does not directly address the patient's immediate worries. Empathy involves actively listening, understanding the patient's emotions, and responding with sensitivity to their unique situation.

Correct Answer: D

Rationale: The correct answer is D because appropriate self-disclosure in a therapeutic setting should be brief, focused, and only used if the experience is similar to the patient's situation. This helps to build rapport and create a sense of empathy without overstepping professional boundaries. Choice A is incorrect because discussing intimate or personal values with patients can lead to boundary issues. Choice B is incorrect because keeping secrets with or for a patient can compromise confidentiality and trust. Choice C is incorrect because expressing that you are the only one who truly understands the patient can create a power dynamic that is not conducive to a therapeutic relationship.

Correct Answer: B

Rationale: The correct answer is B because listening to the patient describe their feelings of anxiety related to severe dyspnea indicates empathy, active listening, and emotional support, which are essential for building a strong nurse-patient bond. By actively listening to the patient's concerns, the nurse shows genuine care and understanding, fostering trust and connection. Choices A, C, and D are incorrect: A: Expects the patient to meet exercise goals - This choice emphasizes a more authoritative approach and does not necessarily indicate a strong bond. C: Develops teaching plan based on learning preferences - While important for effective teaching, this choice focuses on education rather than emotional connection. D: Refrains from touching the patient - Touch can be a comforting gesture and important for physical assessment, but avoiding it altogether may not necessarily indicate bonding.

Correct Answer: B

Rationale: The correct answer is B because it encourages open communication and allows the patient to express their experience of pain. By asking the patient to describe their pain, the nurse gathers valuable information to assess and manage the pain effectively. Choice A may assume the patient's comfort level, Choice C assumes the pain is recurring without patient input, and Choice D dismisses the patient's concerns. Overall, only Choice B promotes active listening and patient-centered care.

Correct Answer: D

Rationale: The correct answer is D because it provides clear, specific instructions for the nursing assistant on when to notify the nurse about Mr. Jones' condition. It includes a specific parameter (heart rate greater than 100) which helps in identifying the urgency of the situation. Options A, B, and C are vague and lack specificity, making it difficult for the nursing assistant to know when to escalate the situation. Option D ensures effective communication and appropriate delegation by setting clear expectations for when the nurse needs to be notified.