A nurse is observing a client’s nonverbal behavior. When evaluating this behavior, the nurse should factor in which of the following principles influencing nonverbal communication?

Choice A reason:

The statement “Rinse mouth 2 times per day with an alcohol-based mouthwash” is incorrect. Methotrexate can cause mouth sores and irritation, and using an alcohol-based mouthwash can exacerbate these symptoms. Instead, patients are often advised to use a non-alcoholic mouthwash or a saline rinse to help prevent and soothe mouth sores.

Choice B reason:

The statement “Take the medication with an NSAID” is incorrect. Methotrexate should not be taken with nonsteroidal anti-inflammatory drugs (NSAIDs) without medical supervision because this combination can increase the risk of severe side effects, including bone marrow suppression and gastrointestinal toxicity. Patients should always consult their healthcare provider before combining these medications.

Choice C reason:

The statement “Take an antiemetic 1 hour following administration” is not standard advice for methotrexate. While methotrexate can cause nausea, antiemetics are typically taken before or at the same time as the methotrexate dose to prevent nausea, not after. Patients should follow their healthcare provider’s instructions regarding the timing of antiemetics.

Choice D reason:

The statement “Drink 2 to 3 liters of water per day” is correct. Methotrexate can cause kidney damage, and staying well-hydrated helps to prevent this by promoting the excretion of the drug and reducing its concentration in the kidneys. Drinking plenty of fluids is an important part of managing methotrexate therapy safely.

Choice A reason:

The statement “Please do not raise your voice at the children. I am the one who left the dishes in the sink.” is an example of effective communication. It demonstrates taking responsibility for one’s actions and addressing the issue calmly and directly. This approach helps to de-escalate potential conflict and promotes a respectful and constructive dialogue among family members. Effective communication in family therapy involves clear, honest, and respectful exchanges that foster understanding and resolution of issues.

Choice B reason:

The statement “If you keep saying that, I will tell everyone what you did last night.” is an example of ineffective communication. It is threatening and manipulative, which can escalate conflict and create a hostile environment. Such statements undermine trust and respect among family members, making it difficult to resolve issues constructively. Effective communication should avoid threats and focus on expressing feelings and concerns in a non-confrontational manner.

Choice C reason:

The statement “Can you tell me the reason you get upset each time I go to the mall?” is a step towards effective communication as it seeks to understand the other person’s feelings. However, it could be improved by using “I” statements to express personal feelings and concerns. For example, “I feel concerned when you get upset each time I go to the mall. Can we talk about it?” This approach reduces defensiveness and encourages open dialogue.

Choice D reason:

The statement “She is always bossing me around. Should she do that?” is an example of ineffective communication. It is accusatory and does not address the issue constructively. Effective communication should focus on specific behaviors and how they affect the individual, rather than making general accusations. For example, “I feel frustrated when I am told what to do. Can we discuss how we can share responsibilities more fairly?” This approach promotes understanding and cooperation.