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: Needs medical intervention is not the major diﬀerence between the two diagnoses. Both diagnoses may require medical intervention, depending on the severity and cause of the vomiting and the nutritional deficiency. Medical intervention is not a criterion for distinguishing between diﬀerent types of nursing diagnoses.

Therefore, this choice is incorrect.

Choice B reason: Needs no defined nursing interventions is not the major diﬀerence between the two diagnoses. Both diagnoses need defined nursing interventions, such as monitoring, teaching, counseling, or providing ﬂuids and electrolytes. Nursing interventions are essential for addressing any nursing diagnosis, whether actual or potential.

Therefore, this choice is incorrect.

Choice C reason: Will not need to be evaluated is not the major diﬀerence between the two diagnoses. Both diagnoses need to be evaluated, which involves measuring the outcomes and determining whether the interventions were eﬀective in resolving or preventing the problem. Evaluation is a vital step of the nursing process for any nursing diagnosis, whether actual or potential. Therefore, this choice is incorrect.

Choice D reason: Reﬂects a problem that does not yet exist is the major diﬀerence between the two diagnoses. Diagnosis #1 is an actual nursing diagnosis, which reﬂects a problem that exists at the present time and has signs and symptoms that can be observed or measured. Diagnosis #2 is a risk for nursing diagnosis, which reﬂects a problem that does not exist at the present time but may develop in the future if preventive measures are not taken.

Therefore, this choice is correct.

A. Select one answer B. “I am sure they are all beef hot dogs. Would you like me to get a substitution from the kitchen?” C. “I don’t understand why that should make a diﬀerence.” D. “So you don’t want anything to eat, then?”

Correct Answer is D

Explanation

Choice A reason: “I am sure they are all beef hot dogs. Would you like me to get a substitution from the kitchen?” is not the best response by the PN. 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 respect the client’s dietary preferences, and may sound patronizing or condescending. Therefore, this choice is incorrect.

Choice B reason: “I don’t understand why that should make a diﬀerence.” is not the best response by the PN. This response shows lack of knowledge, which is a communication barrier that involves being unaware or ignorant of the other person’s culture, beliefs, or values. It also shows indiﬀerence, which is a communication barrier that involves showing no interest or concern for the other person’s feelings or situation. It does not respect the client’s dietary preferences, and may sound rude or oﬀensive. Therefore, this choice is incorrect.

Choice C reason: “So you don’t want anything to eat, then?” is not the best response by the PN. This response shows closed-ended questioning, which is a communication technique that involves asking questions that require a yes or no answer or a specific piece of information. It also shows sarcasm, which is a communication barrier that involves using irony or mockery to hurt or ridicule the other person. It does not respect the client’s dietary preferences, and may sound hostile or aggressive. Therefore, this choice is incorrect.

Choice D reason: “I respect your dietary preferences. Let me see what else I can oﬀer you.” is the best response by the PN. This response shows respect, which is a value or attitude that involves showing consideration, appreciation, and recognition for the other person as a unique and holistic person. It also shows support, which is a communication technique that involves providing emotional or practical assistance to the other person, and helping them cope with their situation or problem. It respects the client’s dietary preferences, and shows that the PN is caring, helpful, and empathetic. Therefore, this choice is correct.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The Practical Nurse (PN) uses the “risk for” nursing diagnoses as identified from the: Select all that apply

Correct Answer is ["D"]

Explanation

A client of the Islamic faith refuses to eat a hot dog on his tray because he is afraid that it may contain pork products. Which of the following is the best response by the Practical Nurse (PN)?

Correct Answer is D

Explanation

A client is to be discharged from an acute care facility after treatment for right leg thrombophlebitis. The nurse notes that the client’s leg is pain free, without redness or edema. The nurse’s actions reﬂect which phase of the nursing process? Select one answer

Which of the following types of posture is best for the nurse to use when communicating with the patient? (Select all that apply)

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)

Which statement best defines the nursing process? Select one answer

A patient roughly asks the nurse to bring him some ice cream. An assertive response by the nurse is:

A nurse is caring for a client who is hearing-impaired and takes which approach to best facilitate communication? (Select all that apply)

Which statements describe a desired patient outcome or expected outcome? (Select all that apply)

During a physical examination, the Practical Nurse (PN) discovers that the client demonstrates signs of ﬂushed, dry, hot skin; dry oral mucus membranes; and temperature elevation. The PN will treat these data as the basis of a nursing diagnosis plan, as they represent: