A nurse, during a shift report, learns that a patient under their care is blind. What actions by the nurse would demonstrate effective communication?

Introduce self after entering the patient’s room

Use a firm, loud voice when addressing the patient

Lightly touch the patient’s arm

Provide instructions in clear, simple terms .

Answer and Explanation

Correct Answer : A,C,D

Choice A rationale
Introducing oneself after entering the patient’s room is a key aspect of effective communication with a blind patient. This helps the patient identify who is in the room with them.
Choice B rationale
Using a firm, loud voice when addressing the patient is not necessarily effective. While it’s important to speak clearly, raising one’s voice can come off as patronizing or disrespectful. It’s better to speak in a normal tone and adjust as needed based on the patient’s feedback.
Choice C rationale

Lightly touching the patient’s arm can be an effective way to gain their attention, especially if they may not have heard you enter the room. However, it’s important to ask for consent before touching the patient.
Choice D rationale
Providing instructions in clear, simple terms can be very helpful for a blind patient. This can help them understand what is happening and what they need to do.

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Free Nursing Study Resources

Correct Answer is ["2 "]

Explanation

Step 1 is: To calculate the rate at which the IV pump should be set to deliver the PRBCs, we need to divide the total volume of PRBCs by the total time for administration.

Step 2 is: Convert the time for administration from hours to minutes because the rate is typically set in mL/min. So, 3 hours is equivalent to 180 minutes.

Step 3 is: Now, divide the total volume of PRBCs (350 mL) by the total time for administration (180 min). So, the calculation is 350 mL ÷ 180 min.

Step 4 is: The final calculated answer is approximately 1.94 mL/min. However, IV pumps typically only allow whole numbers, so we would round this to 2 mL/min.

A. Follow up by having the client perform the Rinne test B. Reposition the client supine to ensure safety. C. Document successful completion of the assessment. D. Facilitate a referral to a neurologist.

Correct Answer is C

Explanation

Choice A rationale
The Rinne test is a hearing test used to evaluate the difference between sound transmission through air conduction versus bone conduction. It is not typically used following a Romberg test, which evaluates balance.
Choice B rationale
While ensuring the patient’s safety is always important, repositioning the client supine is not the typical response to slight swaying during a Romberg test.
Choice C rationale
Slight swaying during a Romberg test is considered normal. Therefore, documenting successful completion of the assessment would be the appropriate action.
Choice D rationale
A referral to a neurologist is not typically necessary for slight swaying during a Romberg test, as this is considered within normal limits.

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A nurse, during a shift report, learns that a patient under their care is blind. What actions by the nurse would demonstrate effective communication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is administering a 350 mL unit of PRBCs over 3 hours to a client diagnosed with anemia. The nurse should set the IV pump to deliver how many mL/hr?

Correct Answer is ["2 "]

Explanation

During the performance of a Romberg test, the nurse observes the client sway slightly. What action should the nurse take?

Correct Answer is C

Explanation

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