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What are the 4 phases of the nurse-client relationship?
- pre-orientation
- orientation
- the working phase
- termination phase
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The nurse is meeting a new client on the unit. Which action, by the nurse, is most effective in initiating the nurse-client relationship?
A.Introduce self and explain the purpose and the plan for the relationship.
B.Describe the nurse’s family and ask the client to describe his/her family.
C.Wait until the client indicates a readiness to establish a relationship.
D.Ask the client why he/she was brought to the hospital.
A.Introduce self and explain the purpose and the plan for the relationship.
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The nurse is preparing the client for the termination phase of the nurse-client relationship. The nurse prepares to implement which nursing task is most appropriate for this phase?
A.Identifying expected outcomes
B.Planning short term goals
C.Making appropriate referrals
D.Developing realistic solutions
C. Making appropriate referrals
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What is one of the most important communication skills for a nurse to have?
Active listening skills
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The nurse is caring for a Native American client who says, “I don’t want you to touch me. I’ll take care of myself.” Which nursing response is most therapeutic?
A.“Okay, if that’s what you want. I’ll just leave this cup for you to collect your urine.”
B.“If you don’t want our care, why did you come here?”
C.“Why are you being so difficult? I only want to help you.”
D.“It sounds as though you want to take care of yourself. Let’s work together so you can do things for yourself.”
D.“It sounds as though you want to take care of yourself. Let’s work together so you can do things for yourself.”
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What are strategies to partner with the patient in their care?
- include patients in bedside rounds
- involve patients in key decisions
- actively enlist patient participation
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The client says to the nurse “I am going to die, I wish my family would stop hoping for a cure! I get so angry when they carry on like this! After all, I’m the one who’s dying.” The most therapeutic response is:
A.“You’re feeling angry that your family continues to hope for you to be cured.”
B.“I think we should talk more about your anger with your family.”
C.“Well, it sounds like you’re being pessimistic. After all, years ago people died of pneumonia.”
D.“Have you shared your feelings with your family?”
A.“You’re feeling angry that your family continues to hope for you to be cured.”
VALIDATE
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A client looks at a mirror and cries out, “I look like a bird. This is not my face.” The nurse responds therapeutically by saying:
A.“What kind of a bird do you think you are?”
B.“That must be very distressing to you, your face does not look different to me.”
C.“Maybe the light is playing tricks on you.”
D.“Why do you think that you look like a bird?”
B.“That must be very distressing to you, your face does not look different to me.”
VALIDATE
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A client relates angrily to the nurse that his wife says he is selfish. Which response by the nurse would be most helpful?
A.“That’s just her opinion.”
B.“I don’t think that you are selfish.”
C.“Everyone is a little bit selfish.”
D.“You sound angry – tell me more about what went on.”
D.“You sound angry – tell me more about what went on.”
VALIDATE
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What is considered the BRN Standards of Competent Performance?
- The Nursing Process
- (ADPIE)
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What is the difference between Medical Diagnosis and Nursing Diagnosis?
- medical diagnosis does not change
- nursing diagnoses change constantly
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Name the 3 parts of the nursing diagnosis?
- Diagnostic label (Problem)
- Related factors (Etiology)
- Defining characteristics (S/S)
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