The RN overbears the nurses' aide speaking in a harsh tone to a client with early Alzheimer's memory loss. Which statement should the EN make to begin addressing this issue?
“Do you think it would be a good idea to have an in-service on dealing with Alzheimer's patients?”
“You must remember to watch your tone of voice with clients. Someone might overhear."
“I have decided to reassign that client to another aide."
“I am concerned about your conversation with the client. It sounded short and impatient”
The Correct Answer is D
A. While suggesting an in-service could be beneficial in the long run, it is not an immediate or direct approach to addressing the specific behavior observed. This statement deflects from the issue at hand and may not convey the urgency needed in correcting the aide's behavior.
B. This statement is somewhat vague and could come across as patronizing or defensive. While it points out the need to be mindful of tone, it does not specifically address the emotional impact of the aide’s behavior on the client or acknowledge the situation effectively. It focuses on appearance rather than the well-being of the patient.
C. This approach does not address the underlying issue of the aide's behavior and may create a confrontational or punitive atmosphere. It can also foster resentment rather than promote learning and improvement. It's essential to address behaviors directly instead of merely reassigning responsibilities.
D. This statement is direct and addresses the specific behavior observed. It expresses concern without being accusatory and opens a dialogue about the aide’s communication style. This approach encourages reflection and offers the aide an opportunity to discuss and understand how their tone may affect clients, especially those with cognitive impairments like Alzheimer's.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. While this situation raises ethical considerations, particularly regarding adolescent confidentiality, the nurse is not justified in overriding the client's right to confidentiality solely based on the request. In many jurisdictions, minors may have the right to confidentiality about reproductive health issues, though this can vary.
B. The nurse is generally required to respect this client's confidentiality. Unless there is a specific safety concern (e.g., domestic violence), the nurse should honor the client's request to keep this information private. Confidentiality should be upheld unless there is a clear and immediate risk of harm.
C. In this situation, the nurse may be justified in overriding the client’s confidentiality due to the disclosure of potential abuse. Healthcare professionals are often mandated reporters in cases of suspected abuse or neglect, particularly involving vulnerable populations such as older adults. The nurse has a duty to report this situation to ensure the safety of the client.
D. A client's wish not to know their diagnostic results does not justify overriding their confidentiality. The nurse must respect the client’s autonomy and decision-making regarding their own health information. The nurse should provide support and discuss the implications of this decision but should not disclose the results without the client’s consent.
Correct Answer is D
Explanation
A. While it's important to obtain a formal DNR order, the nurse should not delay providing emergency care while waiting for the order. The client's immediate needs take precedence.
B. The risk manager can provide guidance and support, but they cannot provide immediate medical care. The nurse's priority should be to provide emergency care to the client.
C. Even in the absence of a formal DNR order, the nurse has a legal and ethical duty to provide emergency care to a client who is in cardiac or respiratory arrest.
D. This is the most appropriate action. The nurse should immediately call the emergency response team to initiate resuscitation efforts. While waiting for the team to arrive, the nurse should continue to provide basic life support measures, such as CPR and rescue breathing. Once the emergency response team arrives, they will take over the resuscitation efforts and obtain a formal DNR order from the provider if necessary.
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