Which patient would most likely be uncomfortable with close personal space during an interaction with the nurse?

Correct Answer: A

Rationale: The correct answer is A because cultural background and individual preferences influence personal space comfort. In this case, the 19-year-old white female patient standing only 2 feet away may feel uncomfortable with close personal space. Different cultures and age groups have varying norms regarding personal space. The other choices are less likely to be uncomfortable based on cultural norms and distance from the nurse. The 40-year-old African-American male patient sitting next to the nurse, the 60-year-old Latin-American female patient seated across, and the 82-year-old patient from France lying in bed with the nurse sitting next to them are all at a comfortable distance, thus less likely to be uncomfortable with personal space.

Correct Answer: C

Rationale: The correct answer is C because after BCG treatment, the fluid in the urinary drainage bag is considered hazardous due to the live bacteria used in the treatment. Therefore, instructing the UAP to discard the fluid in the toilet and disinfect it with bleach is crucial to prevent the spread of infection. This step helps to ensure proper disposal and minimize the risk of exposure to others. Choice A is incorrect because special handling is indeed required due to the nature of the contents. Choice B is incorrect as wearing a lead apron is not necessary for handling the fluid in the urinary drainage bag. Choice D is also incorrect as sterile gloves are not specifically required for this task; instead, proper disinfection of the toilet is essential.

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: B

Rationale: The correct answer is B because a nurse should communicate with empathy when dealing with a patient who is anxious about a change in body image after a mastectomy. Empathy allows the nurse to connect emotionally with the patient, show understanding, and provide support. In this situation, the patient needs compassionate communication to feel heard and cared for. Choices A, C, and D are incorrect because empathy is not necessary in those scenarios. For choice A, the acquaintance seeking a superficial social relationship does not require empathetic communication. For choice C, the supervisor seeking approval and recognition would benefit more from professional feedback and recognition of achievements. For choice D, the colleague expecting a promotion needs clear communication and feedback but not necessarily empathy.

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 therapeutic communication aims to focus on the patient and their needs to facilitate a therapeutic interaction. This involves active listening, empathy, and creating a supportive environment for the patient to express their thoughts and feelings. Gathering information (choice A) is important but not the sole purpose of therapeutic communication. Directing the patient to communicate about deepest concerns (choice B) may not always be appropriate or helpful. Lastly, gaining specific medical information and history of illness (choice D) is part of a comprehensive assessment but not the primary goal of therapeutic communication.

Correct Answer: A

Rationale: The correct answer is A: Administer filgrastim 5 mcg/kg subcutaneously every day. The rationale for this is that filgrastim is a medication commonly prescribed for patients with non-Hodgkin lymphoma to stimulate the production of white blood cells. Therefore, the team leader should question the dosage, route of administration, and frequency to ensure it aligns with the prescribed treatment plan. Incorrect choices: B: Catheterize to obtain a urinalysis specimen - This is not relevant to the prescribed treatment for non-Hodgkin lymphoma. C: Flush the IV saline lock every shift - Important for maintaining IV access but not directly related to the prescribed medication. D: Monitor vital signs every 4 hours - Monitoring vital signs is important but not the primary concern when reviewing a prescribed medication for non-Hodgkin lymphoma.

Correct Answer: C

Rationale: The correct answer is C because using a professional medical interpreter ensures accurate communication, maintains patient confidentiality, and upholds ethical standards. Step 1: Requesting a Spanish-speaking medical interpreter ensures clear understanding of the patient's health history. Step 2: Using a professional interpreter avoids potential misinterpretations that may arise from using untrained individuals. Step 3: Interviewing the patient's English-speaking daughter may lead to inaccuracies and breaches patient confidentiality. Step 4: Asking a bilingual friend of the patient to interpret lacks professionalism and may result in miscommunication.

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.