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. 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.

3. When a nurse is performing a health interview on a patient with a language barrier and no interpreter is available, which of the following is the best example of an appropriate question for the nurse to ask?

• A. Do you take medicine?
• B. Do you sterilize the bottles?
• C. Do you have nausea and vomiting?
• D. You have been taking your medicine, haven't you?

Correct answer: A

Rationale: The best example of an appropriate question for the nurse to ask in this situation is 'Do you take medicine?' This question is clear, simple, and focused on one topic at a time, which is essential when there is a language barrier and no interpreter available. It follows the recommendation to use simple words, avoid medical jargon, contractions, and pronouns in such situations. Choices B, C, and D involve more complex language, unrelated topics, or assumptions about the patient's actions, making them less suitable for effective communication in this context.

4. During an assessment, the nurse notices that a patient is handling a small charm that is tied to a leather strip around his neck. Which action by the nurse is appropriate?

• A. Ask the patient about the item and its significance.
• B. Ask the patient to lock the item with other valuables in the hospital's safe.
• C. Tell the patient that a family member should take valuables home.
• D. No action is necessary.

Correct answer: A

Rationale: The appropriate action for the nurse in this situation is to ask the patient about the charm and its significance. This helps the nurse understand the patient's cultural beliefs, personal values, and any potential significance the charm holds for the patient. It also shows respect for the patient's personal belongings. Asking about the charm can help establish rapport and cultural competence in the nurse-patient relationship. Choices B and C do not address the patient's attachment to the charm or provide an opportunity for cultural understanding. Choice D is incorrect as it dismisses the importance of acknowledging and respecting the patient's personal belongings.

5. When a female patient who does not speak English well requires an interpreter, what would be the most appropriate choice?

• A. A trained interpreter
• B. A male family member
• C. A female family member
• D. A volunteer college student from the foreign language studies department

Correct answer: A

Rationale: To facilitate effective communication between a female patient with limited English proficiency and healthcare providers, the most appropriate choice is a trained interpreter. Trained interpreters, especially those familiar with medical terminology, ensure accurate transmission of information and maintain patient-provider confidentiality. Using a family member, whether male or female, can lead to misunderstandings, breaches of confidentiality, and potential biases. Volunteer college students may lack the necessary skills and experience to handle sensitive medical conversations professionally. Opting for a trained interpreter is crucial to enhance communication quality, promote understanding, and uphold patient care standards.

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