Nursing Elites

1. During an interview, note-taking may impede the nurse's observation of the patient's nonverbal behaviors. Which statement is true regarding note-taking?

• A. Note-taking may impede the nurse's observation of the patient's nonverbal behaviors.
• B. Note-taking allows the patient to continue at their own pace as the nurse records what is said.
• C. Note-taking allows the nurse to shift attention away from the patient, resulting in an increased comfort level.
• D. Note-taking allows the nurse to break eye contact with the patient, which may increase their level of comfort.

Correct answer: A

Rationale: Note-taking during an interview can impede the nurse's ability to observe the patient's nonverbal behaviors, such as body language and facial expressions, which are important aspects of communication. It may break eye contact too often, shift attention away from the patient, interrupt the patient's narrative flow, and diminish the patient's sense of importance. Therefore, it is crucial for the nurse to balance the need for note-taking with maintaining active listening and observation skills to ensure effective communication and rapport building with the patient. Choices B, C, and D are incorrect because note-taking can actually hinder the patient's narrative flow, decrease the nurse's observation of nonverbal cues, and potentially make the patient feel less important or attended to due to distractions caused by the note-taking process.

2. When evaluating the reliability of a patient's responses, which of these statements would be correct? The patient:

• A. has a history of drug abuse and therefore is not reliable.
• B. provided consistent information and therefore is reliable.
• C. smiled throughout the interview and therefore is assumed reliable.
• D. would not answer questions concerning stress and therefore is not reliable.

Correct answer: B

Rationale: In evaluating the reliability of a patient's responses, consistency in the information provided by the patient is crucial. When a patient provides consistent information, it indicates that their responses are trustworthy and reliable. In this scenario, the nurse can consider the patient as reliable based on the consistency of the information provided. Other factors such as a history of drug abuse, smiling behavior, or refusal to answer certain questions may not necessarily determine the reliability of the patient's responses. Therefore, the correct choice is B as consistency in responses is a more reliable indicator of trustworthiness than other factors mentioned in the choices.

3. In the majority culture of America, coughing, sweating, and diarrhea are symptoms of an illness. For some individuals of Mexican-American origin, however, these symptoms are a normal part of living. The nurse recognizes that this is true, probably because Mexican-Americans:

• A. have less efficient immune systems and are often ill.
• B. consider these symptoms a part of normal living, not symptoms of ill health.
• C. come from Mexico where coughing is normal and healthy.
• D. are usually in a lower socioeconomic group and are more likely to be sick.

Correct answer: B

Rationale: In Mexican-American culture, coughing, sweating, and diarrhea are often considered normal bodily functions and not necessarily indicative of illness. This cultural perspective shapes their understanding of health and illness, leading them to view these symptoms differently than the majority culture in America. Choice A is incorrect because it generalizes Mexican-Americans as having less efficient immune systems, which is not supported by evidence. Choice C is incorrect as it oversimplifies by attributing the perception solely to coming from Mexico. Choice D is incorrect as it makes unwarranted assumptions about the socioeconomic status and health status of Mexican-Americans.

4. During an interview, the nurse states, 'You mentioned shortness of breath. Tell me more about that.' Which verbal skill is used with this statement?

• A. Reflection
• B. Facilitation
• C. Direct question
• D. Open-ended question

Correct answer: D

Rationale: The nurse's statement, 'Tell me more about that,' is an example of an open-ended question. Open-ended questions encourage the interviewee to provide detailed information and expand on their responses. This type of question is useful for gathering narrative information and allows the interviewee to express themselves freely. Reflection involves restating or paraphrasing the client's words, facilitation encourages the client to say more, and direct questions typically elicit specific, close-ended responses, unlike open-ended questions.

5. Before a child undergoes a tonsillectomy, what information should the nurse collect?

• A. The child's birth weight
• B. The age at which they crawled
• C. Whether they have had the measles
• D. Reactions to previous hospitalizations

Correct answer: D

Rationale: Before a child undergoes a tonsillectomy, it is crucial for the nurse to gather information on the child's reactions to previous hospitalizations. This data helps in assessing potential fears or anxiety and in providing the necessary support and preparation for the upcoming tonsillectomy. Understanding the child's past reactions is vital for ensuring their comfort and well-being during the hospital admission and procedure. The other options provided are not directly relevant to the child's upcoming tonsillectomy procedure. Birth weight (Choice A) is not typically a factor considered before a tonsillectomy. The age at which a child crawled (Choice B) is a developmental milestone but not pertinent to the tonsillectomy. Having had measles (Choice C) is important for overall health history but not specifically crucial before a tonsillectomy.

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