A client has been on the nursing unit for a few weeks because of complications after surgery, including the need for extensive wound care. During the last dressing change before discharge to home with home health services, the client becomes angry and says, “You don’t have to be so careful. I’m being sent home anyway!” Which response, if made by the nurse WOULD NOT be therapeutic? Select one answer

“I hear frustration or perhaps anger in your voice. Could you tell me more about how you are feeling right now?”

“It sounds as though you are nervous about going home, but the wound care nurse who will see you also uses excellent technique I am sure your wound will continue to heal.”

“Do you have any concerns about what will happen after discharge that you would like to talk about?”

“Many people who have been in the hospital for an extended period have mixed feelings about going home. Can you tell me how you are feeling about discharge?”

Answer and Explanation

The Correct Answer is B

Choice A reason: “I hear frustration or perhaps anger in your voice. Could you tell me more about how you are feeling right now?” is a therapeutic response, not a non-therapeutic one. This response shows active listening, which is a communication skill that involves hearing, understanding, and responding to the client’s verbal and nonverbal messages. It also shows empathy, which is the ability to understand and share the feelings of another person. It acknowledges and validates the client’s emotions, and invites them to express their concerns or fears. Therefore, this choice is incorrect.

Choice B reason: “It sounds as though you are nervous about going home, but the wound care nurse who will see you also uses excellent technique I am sure your wound will continue to heal.” is a non-therapeutic response, not a therapeutic one. This response shows false reassurance, which is a communication technique that involves minimizing or dismissing the other person’s feelings or situation. It also shows assumption, which is a communication barrier that involves making judgments or guesses about what the other person thinks or feels. It does not address the client’s emotions or needs, and may sound vague or insincere. Therefore, this choice is correct.

Choice C reason: “Do you have any concerns about what will happen after discharge that you would like to talk about?” is a therapeutic response, not a non-therapeutic one. This response shows open-ended questioning, which is a communication technique that involves asking questions that require more than a yes or no answer. It also shows support, which is a communication technique that involves providing emotional or practical assistance to the client, and helping them cope with their situation or problem. It encourages the client to share their thoughts and feelings, and shows that the nurse is interested, supportive, and empathetic. Therefore, this choice is incorrect.

Choice D reason: “Many people who have been in the hospital for an extended period have mixed feelings about going home. Can you tell me how you are feeling about discharge?” is a therapeutic response, not a non-therapeutic one. This response shows generalization, which is a communication technique that involves using statements that apply to most people in similar situations. It also shows reﬂection, which is a communication technique that involves restating or paraphrasing what the client has said to show understanding and clarify meaning. It helps the client to feel less alone or isolated, and to explore their own feelings or thoughts. Therefore, this choice is incorrect.

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Correct Answer is D

Explanation

Choice A reason: Restating is a therapeutic communication technique that involves repeating or paraphrasing what the client has said to show understanding and clarify meaning. It is not an appropriate intervention to provide comfort during a painful procedure, especially when the client does not speak English. Therefore, this choice is incorrect.

Choice B reason: Listening is a therapeutic communication technique that involves paying atention and showing interest in what the client has to say. It is an important skill for building rapport and trust, but it is not an eﬀective intervention to provide comfort during a painful procedure, especially when the client does not speak English.

Therefore, this choice is incorrect.

Choice C reason: Silence is a therapeutic communication technique that involves allowing pauses or gaps in the conversation to give the client time to think, reﬂect, or express emotions. It can be useful in some situations, but it is not a sufficient intervention to provide comfort during a painful procedure, especially when the client does not speak English. Therefore, this choice is incorrect.

Choice D reason: Touch is a nonverbal communication technique that involves using physical contact to convey empathy, support, or reassurance. It can be a powerful intervention to provide comfort during a painful procedure, as long as it is done with respect, consent, and cultural sensitivity. It can also transcend language barriers and communicate caring and compassion. Therefore, this choice is correct.

A. An abduction pillow is placed between the client's legs when positioned. B. The client is told to keep both legs straight and together while turning. C. A turning sheet is used under the client for turning and repositioning. D. The UAPs keep their backs straight and knees bent when moving the client.

Correct Answer is B

Explanation

This is the observation that indicates that the UAPs need additional information about the turning procedure because it is incorrect and may cause complications for the client. The client who had a hip arthroplasty with prosthesis placement should not keep both legs straight and together while turning because this may cause dislocation of the prosthesis, nerve damage, or bleeding. The client should keep the aﬀected leg slightly abducted and supported with pillows or an abduction device.

A. An abduction pillow is placed between the client's legs when positioned is correct and does not indicate a need for additional information. This helps to maintain proper alignment and prevent dislocation of the prosthesis.

C. A turning sheet used under the client for turning and repositioning is correct and does not indicate a need for additional information. This helps to reduce friction and shear forces on the skin and prevent pressure ulcers.

D. The UAPs keep their backs straight and knees bent when moving the client is correct and does not indicate a need for additional information. This helps to protect their own musculoskeletal health and prevent injuries.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client does not speak English; therefore, the Practical Nurse (PN) cannot use words to provide comfort during a painful procedure. The PN selects another intervention to provide comfort, which is: * Select one answer

Correct Answer is D

Explanation

The practical nurse (PN) observes two unlicensed assistive personnel (UAP) turning an older client who had a hip arthroplasty with prosthesis placement four hours ago. Which observation by the PN indicates that the UAPs need additional information about the turning procedure?

Correct Answer is B

Explanation

A nurse who is assigned to care for six clients is administering a tube feeding to a client when another client spills breakfast coﬀee on her chest and abdomen. What actions by the nurse are best? (Select all that apply)

When a problem is suspected, but lacks enough data to support it, the nursing diagnosis is:

A client is admited with the following vital signs: temperature 102oF (38.9oC); heart rate 144 beats/minute and irregular;, and respiratory rate 22 breaths/minute. Which nursing diagnosis takes highest priority when planning this client’s care? Select one answer

The husband of a client who has a Sengstaken-Blakemore tube states to the nurse, “I thought having this tube down her nose the first time would convince my wife to quit drinking.” The nurse should make which response to the client’s husband? Select one answer

Although the client denies pain, the Practical Nurse (PN) observes the client is breathing rapidly with clenched fists and is grimacing. The PN’s best response to his observations would be: * Select one answer

When writing expected outcomes, the Practical Nurse (PN) should adhere to accepted criteria, such as which of the following? (Select all that apply)

The Practical Nurse (PN) explains that the major eﬀect of maintaining eye contact for 2 to 6 seconds during communication is to:

The Practical Nurse (PN) is caring for a client with dementia and memory loss. Which of the following communication techniques would be most eﬀective? (Select all that apply)