An 84-year-old cognitively-impaired gentleman is admitted from a skilled nursing facility to your acute care facility for increasing agitation and combativeness in the last few days. Which of the following is an example of effective communication with this client?
Speak loudly and use simple words
Address the client by name and reorient client
Challenge the client to refocus his attention when he becomes agitated
Ask the client a series of questions without allowing time for the client to answer
The Correct Answer is B
A. Speak loudly and use simple words: Speaking loudly may be perceived as shouting and can increase agitation. Using simple words is appropriate, but volume should be normal and calm.
B. Address the client by name and reorient client: Addressing the client by name and reorienting him is effective because it respects his dignity and helps him understand his current situation, reducing confusion and agitation. This approach is clear, respectful, and supportive.
C. Challenge the client to refocus his attention when he becomes agitated: Challenging the client can be confrontational and may escalate agitation. It is better to use a calm, reassuring approach.
D. Ask the client a series of questions without allowing time for the client to answer: This can overwhelm and frustrate the client, leading to increased agitation.
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Correct Answer is C
Explanation
A. "I think you should talk with your family about your anger." This response shifts the focus to action without first exploring the client's feelings, which may not be therapeutic initially.
B. "You are probably very depressed, which is understandable with such a diagnosis." This response labels the client's emotions and may not be helpful in allowing the client to explore their feelings further.
C. "Tell me more about how you are feeling." This response uses therapeutic communication by encouraging the client to express feelings and concerns, providing emotional support and validation.
D. "Why haven't you shared your feelings with your family?" This response can sound accusatory and may not encourage open communication.
Correct Answer is B
Explanation
A. Primary prevention: Primary prevention involves measures taken to prevent diseases or injuries before they occur, such as vaccinations or health education to prevent onset of illness. Teaching blood sugar monitoring to someone with diabetes is not primary prevention.
B. Tertiary prevention: Tertiary prevention involves managing disease post-diagnosis to slow or stop disease progression. Teaching a diabetic patient to monitor their blood sugar helps manage their existing condition and prevent complications, making it tertiary prevention.
C. Secondary prevention: Secondary prevention includes screening and early detection of disease to halt or slow its progress. Monitoring blood sugar levels in a diabetic patient is not about early detection but managing an existing condition.
D. Disease surveillance: Disease surveillance involves continuous, systematic collection, analysis, and interpretation of health data. This is not what the nurse is doing when teaching a client to monitor their blood sugar.
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