A nurse is caring for a client who is postoperative.

Vital Signs.

0800: Nurses' Notes.

BP 118/72 mm Hg. Heart rate 82/min.

Respiratory rate 16/min.

Temperature 36.7°C (98°F). SaO2 98% on room air.

1000: BP 128/82 mm Hg. Heart rate 94/min.

Respiratory rate 18/min.

Temperature 36.7°C (98°F). SaO2 98% on room air.

Vital Signs.

Nurses' Notes.

0745: Client awake and eating breakfast while watching the news on television.

Client has hearing loss, does not wear a hearing aid, and TV volume is loud.

Rates pain as a 2 on a 0 to 10 pain scale.

Incisional dressing dry and intact.

1000: Nurses' Notes.

Client ambulated in the hallway with a physical therapist.

Client grimacing, appears upset, and is guarding incisional site.

Reports pain as 5 on a 0 to 10 pain scale.

Opioid analgesic administered.

1045: Client resting with eyes closed and listening to music with earphones.

Reports feeling "very sleepy" after pain medication.

Now rates pain as a 3 on a 0 to 10 pain scale.

1300: Ate 75% of lunch.

Several visitors at the bedside.

Which of the following factors could present a barrier to the nurse effectively communicating with the client? Select all that apply.

Client's hearing deficit.

Volume of the client's television.

Numerous visitors in the client's room.

Increase in pain after ambulation.

Adverse effects of opioid analgesic.

Using earphones while listening to music.

Answer and Explanation

Correct Answer : A,B,C,E,F

The correct answers are a. Client's hearing deficit, b. Volume of the client's television, c. Numerous visitors in the client's room, e. Adverse effects of opioid analgesic, and f. Using earphones while listening to music.

Choice A rationale: A client with hearing loss who does not wear a hearing aid may experience difficulty understanding spoken communication, especially in noisy environments, leading to potential miscommunication or misunderstanding.

Choice B rationale: Loud television volume can make it difficult for both the nurse and the client to hear each other, causing interference in their communication and potentially leading to errors in information exchange.

Choice C rationale: The presence of numerous visitors in the room can cause distractions, background noise, and overall interference with the nurse-client communication process, potentially affecting the quality and accuracy of the information exchanged.

Choice E rationale: Opioid analgesics can cause adverse effects such as drowsiness, confusion, or cognitive impairment, hindering effective communication between the nurse and the client, as the client's ability to comprehend, retain, and convey information may be impaired.

Choice F rationale: The use of earphones while listening to music can impair the client's ability to hear the nurse, creating a barrier to effective communication. This could potentially lead to missed or misunderstood information and, consequently, affect the quality of care.

Choice D rationale (Incorrect choice): While an increase in pain after ambulation could affect the client's mood, cooperation, and ability to engage in effective communication, it does not directly create a barrier to the nurse's ability to communicate with the client. Pain management is an essential aspect of postoperative care, and effective communication can actually facilitate pain assessment, management, and overall client well-being.

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Correct Answer is B

Explanation

Choice A rationale:

TJC (The Joint Commission) does not provide licensure for healthcare providers. Licensing is typically issued by state regulatory bodies, and it ensures that healthcare professionals meet the minimum qualifications and standards to practice within their respective states. TJC's role is different from providing licensure.

Choice B rationale:

TJC is primarily responsible for accrediting healthcare facilities, including hospitals and clinics, to ensure that they meet specific quality and safety standards. Accreditation by TJC is a mark of quality and demonstrates that the facility complies with nationally recognized healthcare standards.

Choice C rationale:

TJC is not a for-profit organization. It is an independent, non-profit organization dedicated to improving healthcare quality and safety. It does not seek to generate profits but rather focuses on enhancing the quality of care provided to patients.

Choice D rationale:

TJC is not an organization that monitors insurance claims. Monitoring insurance claims is typically the responsibility of insurance companies and regulatory agencies. TJC's primary role is to assess and accredit healthcare facilities to promote patient safety and quality care.

A. Encourage family members to call the client. B. Schedule home visits with the client. C. Instruct the client to join an online support group. D. Ask the client's friends to text the client.

Correct Answer is B

Explanation

Choice A rationale:

Encouraging family members to call the client is a valuable emotional and social support, but it may not be as effective in reducing social isolation for a client at the end of life. While communication with loved ones is important, it may not fully address the client's need for personal interaction.

Choice C rationale:

Instructing the client to join an online support group can be a useful intervention to reduce social isolation, especially in cases where physical interaction is limited. However, it may not be as effective for all clients, as comfort with technology and online groups can vary. Additionally, it should be one of several strategies used to address social isolation.

Choice D rationale:

Asking the client's friends to text the client is a positive gesture, but it may not be as effective as scheduling home visits with the client. Text messages may not provide the same level of personal interaction and emotional support that physical visits can offer.

Choice B rationale:

Scheduling home visits with the client is the most effective intervention to reduce social isolation in a client at the end of life. It allows for in-person interaction, emotional support, and the opportunity to address the client's physical and emotional needs directly. Face-to-face contact can significantly improve the client's sense of connectedness and reduce feelings of isolation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing an educational session about The Joint Commission (TJC). Which of the following information should the nurse include?

Correct Answer is B

Explanation

A nurse is caring for a client who is at the end of life.Which of the following interventions is most effective in reducing the client's social isolation?

Correct Answer is B

Explanation

A nurse is teaching a class about reducing the risk of medication errors. Which of the following information should the nurse include?

A nurse administers the wrong medication to a client.After assessing the client, the nurse contacts the provider and completes an incident report.Which of the following components of professionalism is the nurse demonstrating?

A nurse is preparing an in-service about communication for a group of staff nurses.Which of the following techniques should the nurse include when discussing therapeutic communication?

A charge nurse is discussing evidence-based practice (EBP) and the hierarchy of evidence with a newly licensed nurse.Which of the following examples should the nurse provide when discussing Level I evidence?

A nurse is designing a poster presentation for staff nurses about therapeutic communication. Which of the following techniques should the nurse include?

A nurse is teaching a client about the benefits of an electronic health record. Which of the following information should the nurse include in the teaching?

A nurse is assessing a client who is receiving continuous IV therapy through a peripheral IV. The catheter site is cool and taut, and there is IV fluid leaking.The nurse should identify that the client has manifestations of which of the following complications?

A nurse is teaching a newly hired nurse about cell phone use in the workplace. Which of the following information should the nurse include in the teaching?