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 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.

3. 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.

4. 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.

5. 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.

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