Nursing Elites

1. When communicating with a patient who has a hearing impairment, what technique would be most beneficial?

• A. Determine the communication method he prefers.
• B. Avoid using facial and hand gestures as they can be degrading to most hearing-impaired individuals.
• C. Request a sign language interpreter before meeting to facilitate communication.
• D. Speak loudly and with exaggerated facial movement, as this helps with lip reading.

Correct answer: A

Rationale: When communicating with a patient who has a hearing impairment, it is crucial to determine the preferred communication method, whether it involves signing, lip reading, or writing. By directly asking the patient for their preferred method of communication, the healthcare provider can ensure effective and respectful interaction tailored to the individual's specific needs and preferences. Option B is incorrect because using facial and hand gestures can actually aid in communication for some individuals with hearing impairments. Option C is not always necessary and may not be the preferred method for all patients. Option D is incorrect because speaking loudly and with exaggerated facial movements is not necessary and may not be preferred by the patient.

2. When conducting an interview in an outpatient clinic using a computer to record data, what is the best use of the computer in this situation? Select all that apply.

• A. Collect the patient's data in a direct, face-to-face manner.
• B. Enter all the data as the patient states it.
• C. Ask the patient to wait as the data is entered.
• D. Type the data into the computer after establishing a connection.

Correct answer: A

Rationale: A. Collect the patient's data in a direct, face-to-face manner: When conducting an interview in an outpatient clinic, it is essential to engage with the patient face-to-face to establish a rapport, gather their narrative, and ensure accurate data collection. Entering all the data as the patient states it (choice B) may lead to missing important details or misinterpretation. Asking the patient to wait as the data is entered (choice C) can create a disconnect in communication and reduce patient engagement. Typing the data into the computer after establishing a connection (choice D) is not ideal as it is important to collect data actively while interacting with the patient.

3. When providing culturally competent care, how should nurses incorporate cultural assessments into health assessments? Which statement is most appropriate when initiating an assessment of cultural beliefs with an elderly American Indian patient?

• A. "Are you of the Christian faith?"
• B. "Do you want to see a medicine man?"
• C. "How often do you seek help from medical providers?"
• D. "What cultural or spiritual beliefs are important to you?"

Correct answer: D

Rationale: The most appropriate statement to initiate an assessment of cultural beliefs with an elderly American Indian patient is to ask, "What cultural or spiritual beliefs are important to you?" This question encourages the patient to share their personal beliefs without assuming stereotypes or making generalizations. It allows the patient to express their individual cultural and spiritual practices, enabling nurses to deliver more personalized and culturally competent care. Choices A, B, and C are not as suitable. Choice A assumes a specific faith without considering the patient's actual beliefs. Choice B relies on a stereotype about American Indian culture, and Choice C focuses more on seeking medical help rather than exploring cultural beliefs.

4. What would be an appropriate nursing response when a mother reports that her 16-month-old toddler has an earache?

• A. Maybe the toddler is just teething.
• B. I will check her ear for an ear infection.
• C. Are you sure the toddler is really in pain?
• D. Please describe what the toddler is doing to indicate she is in pain.

Correct answer: B

Rationale: The appropriate nursing response would be to assess the toddler's ear to determine if there is indeed an ear infection causing the earache. It is crucial to provide timely and suitable care for the child's pain and discomfort. Checking for an ear infection is a necessary step in evaluating the source of the toddler's earache. Choice A is incorrect as it assumes the earache is due to teething without proper assessment. Choice C questions the mother's report rather than focusing on the child's condition. Choice D is not as direct and focused as directly examining the ear for a possible infection.

5. When recording the childhood illnesses of a patient who denies having had any, which note by the nurse would be most accurate?

• A. Patient denies usual childhood illnesses.
• B. Patient states he was a 'very healthy' child.
• C. Patient states sister had measles, but he didn't.
• D. Patient denies measles, mumps, rubella, chickenpox, pertussis, and strep throat.

Correct answer: D

Rationale: Choice D is the most accurate note by the nurse as it lists specific childhood illnesses commonly experienced by children. By documenting that the patient denies having had these specific illnesses, the healthcare provider establishes a clear medical history record regarding these common childhood illnesses. This detailed documentation is essential for providing comprehensive care and evaluating potential risks or complications associated with these illnesses in the future. Choices A, B, and C are not as accurate as they do not provide a comprehensive list of common childhood illnesses that are routinely evaluated by healthcare providers. Choice A is too vague, Choice B focuses on the patient's perception of their health rather than specific illnesses, and Choice C only mentions measles, lacking the breadth of information provided in Choice D.

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