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

Choice A reason: "There is no reason to worry. This surgeon has an excellent reputation.” is not the best nursing response. 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 authority, which is a communication barrier that involves using one’s position or status to influence or persuade the other person. It does not address the client’s emotions or needs, and may sound patronizing or condescending. Therefore, this choice is incorrect.

Choice B reason: “It sounds as though you have mixed feelings about the surgery. Can you tell me more about how you feel?” is the best nursing response. 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 correct.

Choice C reason: "The benefits outweigh the risks. You can be confident that the surgery should be done.” is not the best nursing response. This response shows persuasion, which is a communication technique that involves using logic or evidence to convince or influence the other person. 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 coercive or manipulative. Therefore, this choice is incorrect.

Choice D reason: "You are bound to feel much beter once it is all over with.” is not the best nursing response. This response shows cliché, which is a communication technique that involves using overused or trite expressions that lack meaning or sincerity. It also shows avoidance, which is a communication barrier that involves shifting the focus away from the other person’s feelings or situation. It does not address the client’s emotions or needs, and may sound vague or insincere. Therefore, this choice is incorrect.

Choice A reason: Client O2 saturation will be maintained at 95% the entire day is an example of an expected outcome that adheres to accepted criteria. An expected outcome is a measurable and realistic goal that the client should achieve as a result of the nursing interventions. Accepted criteria for writing expected outcomes include being client- centered, specific, observable, measurable, time-limited, and realistic. This outcome meets all these criteria, as it focuses on the client’s condition, states a specific value and time frame, and can be observed and measured.

Therefore, this choice is correct.

Choice B reason: Client will observe safety guidelines while smoking is not an example of an expected outcome that adheres to accepted criteria. This outcome is not specific, observable, or measurable, as it does not state what the safety guidelines are, how they will be observed, or how they will be evaluated. It is also not realistic, as smoking is a harmful behavior that should be discouraged or eliminated, not made safer. Therefore, this choice is incorrect.

Choice C reason: PN will assess vital signs every day is not an example of an expected outcome that adheres to accepted criteria. This outcome is not client-centered, as it focuses on the nurse’s action, not the client’s condition or response. It is also not an outcome, but rather an intervention or activity that the nurse will perform to monitor the client’s status. Therefore, this choice is incorrect.

Choice D reason: Client will take part in one activity daily for the next 90 days is an example of an expected outcome that adheres to accepted criteria. This outcome is client-centered, specific, observable, measurable, time-limited, and realistic, as it focuses on the client’s participation, states a specific frequency and duration, and can be observed and measured. It also implies a positive change in the client’s behavior or lifestyle that may improve their health or well- being. Therefore, this choice is correct.