A. Share information with the patient about other patients and why they are hospitalized. Sharing information about other patients violates confidentiality and does not help establish trust. This is unprofessional and goes against HIPAA guidelines.

B. Share his own personal experiences so that the patient gets to know him as a friend. Although occasional sharing of personal experiences may enhance rapport, extensive sharing can shift focus from the patient to the nurse, which is unprofessional and can create boundary issues.

C. Act in a trustworthy and reliable manner; respect the individuality of the patient. Acting in a trustworthy, reliable manner and respecting the patient's individuality establishes rapport by building trust, ensuring the patient feels valued and respected. This is the most professional approach.

D. Identify himself by name and title each time he introduces himself. Introducing oneself by name and title is essential, but it alone does not fully establish rapport. It is part of a courteous approach, but rapport-building requires deeper engagement.

A. Actions of the nurse are appropriate since his neighbor is his confidante, and the neighbor has assured him the information provided will not be shared. Confidentiality must be maintained regardless of assurances from others; sharing patient information outside a professional context is a violation of privacy.

B. Nurse has not violated the confidentiality of the patient because the patient is terminal; sharing this information will not harm the patient. Confidentiality must be maintained regardless of the patient's condition. Privacy and confidentiality are ethical requirements for all patients, terminal or otherwise.

C. Nurse is actively promoting nursing as a profession, and it is important to share information that might encourage others to pursue a nursing career. While promoting the profession is valuable, using a patient’s personal information is inappropriate and unprofessional. There are ethical ways to promote nursing without breaching confidentiality.

D. Nurse has violated the confidentiality of the patient by discussing personal information about the patient with his neighbor. Sharing patient information with someone who is not involved in the patient’s care violates HIPAA and confidentiality standards. This action is unprofessional and unethical.

A. is packing belongings in preparation for discharge. Although discharge is an appropriate time for patient education, it may be too late to introduce complex information that requires practice or understanding. Teaching moments often occur earlier in the care process.

B. says, "How will I remember all the things about my new diet?" This is an ideal teaching moment as the patient is expressing concern and showing readiness to learn about the diet. The nurse can use this moment to provide guidance on strategies to remember dietary instructions.

C. has just returned from surgery for a deviated septum. Immediately post-surgery, the patient may be under the influence of anesthesia or pain medication, limiting their ability to absorb information. Teaching at this time may not be effective.

D. has just been told of the malignancy of his tumor. Right after receiving bad news, patients may experience shock, grief, or distress, making it difficult for them to process additional information. This may not be the right time for education.

A. wrings her hands and paces around the room while denying that she is upset.
This example reflects incongruence. The patient's body language (pacing, wringing hands) suggests anxiety or distress, which does not match her verbal denial of being upset.

B. states she is comfortable while she frowns, and her teeth are clenched.
This example also reflects incongruence. Her facial expression and clenched teeth contradict her statement of comfort, indicating her communication is not aligned.

C. is tearful and slow in speech when talking about her husband's death.
This example reflects congruence. The patient’s verbal expression and nonverbal cues are aligned, indicating that her communication is consistent with her emotions.

D. smiles and laughs while speaking of feeling lonely and depressed.
This example reflects incongruence. Smiling and laughing contradict the verbal expression of loneliness and depression, indicating a mismatch in her communication.

A. "I don't feel like walking today either."
This response shifts the focus from the patient to the nurse and does not encourage further discussion about the patient's reluctance or explore the reasons behind it.

B. "You have to walk today."
This statement sounds forceful and dismissive, and may make the patient feel pressured rather than supported. It does not invite dialogue or provide understanding.

C. "Why don't you want to walk today?"
This question can sound judgmental and may put the patient on the defensive. A more neutral response would help the nurse understand the patient's reluctance without pressure.

D. "You don't want to walk today?"
This response reflects the patient's own words back, validating their feelings and opening up the opportunity for the patient to explain their reasons. It is empathetic and nonjudgmental, which encourages therapeutic communication.

A. "Blood not drawn because tests are no longer desired by patient."
This statement is vague and lacks specific details regarding the patient's exact refusal and the communication with the doctor.

B. "Refuses to have blood drawn; says tests are 'useless.' Doctor notified."
This response documents the patient's refusal with their exact words ("useless") and also notes that the doctor has been informed, which is essential for clear, complete documentation.

C. "Doctor notified of failure to draw ordered blood work."
This documentation lacks the reason for the blood draw failure (patient refusal) and omits the patient’s specific wording.

D. "Refuses to have blood drawn. Doctor notified."
Although this documents the refusal and the doctor’s notification, it omits the patient’s exact words, which can provide additional context for the healthcare team.

A. Motivated to learn about the health problem of this patient and is appropriately seeking knowledge during his clinical experience.
Accessing information without being the assigned caregiver is inappropriate, regardless of motivation, as it breaches confidentiality and privacy protocols.

B. Doing appropriate research about nursing care as long as information is not divulged. Even without sharing information, accessing a patient’s chart without need-to-know status is a privacy violation and does not constitute appropriate research.

C. Violating the confidentiality of the patient's record.
This choice is correct as the student is breaching confidentiality by accessing patient records without a care-related need to know. Only those involved in the patient's care should access their chart.

D. Neglecting the assigned patient load and should read the unassigned patient’s medical record only after his assigned work is completed.
Reading an unassigned patient’s record, even after finishing other duties, is still a breach of confidentiality.

A. Defensive response
A defensive response would involve protecting oneself or one's position rather than addressing the patient’s concerns. The nurse’s statement here is more dismissive than defensive.

B. Asking probing questions
Probing questions would involve persistent questioning, which does not apply here, as the nurse is not asking questions but making a dismissive comment.

C. Using clichés
"Every cloud has a silver lining" is a cliché, which may come across as dismissive and minimize the patient’s concerns. Using clichés can make the patient feel unheard and invalidated.

D. Changing the subject

Changing the subject would involve diverting attention to an unrelated topic. The nurse here is not introducing a new topic but is using a cliché instead.

A. interrupting frequently.
Interrupting can make adolescents feel disrespected and unheard, which may hinder effective communication and trust.

B. using active listening.
Active listening is essential in communication, especially with adolescents, as it shows respect and builds rapport. The nurse should not avoid this.

C. offering advice.
Offering unsolicited advice can lead to resistance or defensiveness in adolescents. It’s often better to guide them towards their own conclusions.

D. asking embarrassing questions.
Asking questions perceived as embarrassing may make adolescents uncomfortable, leading to reduced openness and cooperation. It is important to be sensitive and respectful when choosing questions to avoid making them feel awkward or judged.

A. write down the steps as she performs them.
Writing down the steps may help the patient review later but does not actively engage the patient in learning during the procedure.

B. read the listed steps written on a poster board on the wall.
Reading steps on a poster board can provide visual support but doesn’t actively involve the patient in recalling or practicing the procedure.

C. verbalize each step until the steps are memorized.
Verbalizing each step is an active form of learning that reinforces memory and helps the patient feel more comfortable with the process, making it an effective teaching strategy.

D. close her eyes and envision the process.
Visualization can help with memory, but it may not be as effective as actively verbalizing each step for practical, hands-on tasks.

A. Scheduling admissions, discharges, and nurse staffing to keep the unit at the best occupancy and utilization. Scheduling and unit staffing are typically tasks for administrative staff rather than the direct responsibilities of an LPN.

B. Educating patients on how to use hospital computers to access information such as discharge instructions or information relative to specific medications. LPNs may be involved in patient education, including showing patients how to access relevant health information, making this a potential area of proficiency.

C. Input of data such as requests for radiographs or laboratory services. LPNs may be responsible for entering basic patient care data and service requests, making this a relevant skill in many clinical settings.

D. Programming the computer to record data from primary care providers and other healthcare workers. Programming tasks are typically not within the scope of LPN duties, as these require advanced computer skills beyond general data input.

A. "Come and get me if Mr. Jones has a high heart rate." This statement lacks specificity, as “high heart rate” is vague. The assistant may not know what range constitutes “high.”

B. "I need to know if Mr. Jones' blood pressure is elevated."
This statement is also too vague, as the assistant may not understand what is considered "elevated."

C. "If Mr. Jones' heart rate is greater than 100, let me know."
This direction is clear and specific, providing a measurable parameter for the assistant to follow, making it the best option.

D. "Let me know if Mr. Jones' temperature is high."
"High" is vague, as it does not provide a specific value or range for temperature.

A. Write down remarks on a clipboard to facilitate later topics of conversation.
Writing down remarks could distract from active listening and might make the patient feel as though the nurse isn’t fully engaged in the conversation.

B. Make a conscious effort to block out other sounds in the immediate environment.
Active listening requires focusing on the speaker by minimizing distractions, allowing the nurse to be fully attentive to the patient.

C. Maintain eye contact by staring at the patient.
Active listening involves natural eye contact, not staring, as staring can be intimidating and may cause discomfort for the patient.

D. Prompt the patient when the patient stops talking for a moment.
Giving the patient time to think and process without prompting respects their pace and encourages them to share more when ready.

A. Writing nursing care plans.
Although care plans are essential in nursing, qsen emphasizes broader competencies beyond just planning, such as teamwork and quality improvement.

B. Informatics. Informatics is a core competency highlighted by qsen to ensure nurses can use technology effectively for patient safety and care quality.

C. Familiarity with medical terms. Medical terminology is basic knowledge for nurses, but qsen emphasizes specific competencies beyond terminology.

D. Effective communication.
Effective communication is a fundamental qsen skill that enhances patient safety, teamwork, and patient-centered care.

A. Judgmental response.
This isn’t necessarily judgmental, as it doesn't express an opinion about the patient’s feelings or concern.

B. Using clichés.
Clichés are general or overused phrases meant to provide comfort but are not present here.

C. Changing the subject.
Changing the subject dismisses the patient's concern without acknowledging it, which is evident here as the nurse diverts to breakfast without addressing the worry.

D. Giving false reassurance.
False reassurance involves saying something unrealistic to make the patient feel better, which isn't directly done here.

A. Asking probing questions. Probing questions can feel invasive, leading to discomfort or defensiveness from the patient.

B. Using nonjudgmental remarks. Nonjudgmental remarks foster open communication, so this is not a communication block.

C. Changing the subject. Changing the subject shows disregard for the patient’s thoughts or feelings, which can block effective communication.

D. Using clichés. Clichés can make patients feel as though their concerns are not truly heard or understood.

E. Giving advice. Giving advice without patient input can make the patient feel undervalued and less autonomous.

F. Offering hope. Offering realistic hope and encouragement can actually facilitate communication, as long as it’s not false reassurance.

A. Oral learning. Oral learning involves verbal instruction, which could be part of the teaching but isn’t the primary method when demonstrating a physical task.

B. Visual learning. Visual learning is present here, as the patient observes the nurse’s demonstration, which can be effective for understanding the technique.

C. Kinesthetic learning. Kinesthetic learning involves a hands-on approach where the patient would actively participate in the task, enhancing skill retention through doing.

D. Auditory learning. Auditory learning occurs through listening, which would be part of an oral explanation but is less emphasized here than visual or kinesthetic methods.

A. Test the patient's reading comprehension before using visual handouts.
Testing reading comprehension can be helpful but is not sufficient on its own to assess the patient’s overall learning preferences or needs.

B. Use a hands-on approach, because it works best for most people.
While hands-on learning is effective, assuming it works best for everyone may overlook individual learning preferences.

C. Ask the patient whether he learns best visually, aurally, or kinesthetically. Asking the patient’s learning preferences enables the nurse to tailor education to the patient's strengths.

D. Use a combination of the three modes of learning to enhance learning. Combining all modes without considering the patient's preferences may not be as effective as directly addressing the patient's specific learning style.

A. Assess the language capabilities of the patient. Understanding the patient’s language capabilities is essential for effective communication and ensuring that the patient can understand the questions being asked.

B. Limit the interview to approximately 30 minutes. While it’s important to manage time, the interview should be flexible based on the patient’s needs and the complexity of the issues being discussed. Rigidly limiting the time could hinder the quality of the assessment.

C. Assess comprehension abilities of the patient. Assessing comprehension helps the nurse determine whether the patient understands the information being provided and can respond appropriately during the interview.

D. Make the patient as comfortable as possible. Creating a comfortable environment is crucial in fostering open communication and trust, which can lead to a more effective interview process.

E. Use open-ended questions. Open-ended questions encourage the patient to provide more detailed responses and express their feelings or concerns, facilitating a better understanding of their situation.

F. Obtain the patient's medical history from the primary care provider. Although obtaining a comprehensive medical history is important, the initial interview should primarily focus on gathering information directly from the patient, as they can provide valuable insights about their experiences, concerns, and context that might not be captured in previous records.

A. Be certain the patient is wearing his glasses and/or hearing aid. Ensuring the patient has optimal hearing and vision aids can improve comprehension and help the patient accurately learn the procedure.

B. Wait for the patient to ask any questions about the procedure. Waiting for questions might lead to gaps in understanding, as the patient may not feel comfortable initiating questions without encouragement.

C. Talk through the process rapidly to keep the patient from becoming tired. Rushing the instruction may cause the patient to miss important details, as learning may be slower in older adults.

D. Point out each mistake during the return demonstration. Correcting every error without constructive feedback can discourage the patient. It’s more effective to provide gentle guidance and support.

A. “The information in your medical record is confidential, and you cannot leave this facility with it." While confidentiality is true, this response may seem dismissive and doesn’t address the patient’s right to access their health information.

B. "Because you are leaving against the medical advice of your primary care provider, you may not have the medical record." Leaving AMA does not negate the patient’s rights to access their medical information.

C. "You are entitled to the information in your medical record, but the medical record is the property of the hospital. I will see about having a copy made for you." This response respects the patient’s rights and explains that while the original record is hospital property, a copy can be made.

D. "Certainly. This hospital doesn't need to keep it if you are leaving and will not be returning here." This response is inaccurate as the original medical record must remain with the hospital per legal guidelines.

A. “Taking fluids poorly, but more than yesterday."
This assessment is vague (“taking fluids poorly”), lacks measurable details, and does not meet the clarity standard required in documentation.

B. "Apparently comfortable all night. Offers no complaints of pain."
“Apparently comfortable” is an assumption rather than an observable, objective statement, which could be legally questionable.

C. "Patient says she is still slightly nauseated, would like to try some toast and tea."
While this is clear, “slightly nauseated” could be more specific, and this does not objectively quantify the patient’s condition.

D. "4 cm reddened area over sacrum. Skin intact, warm, and dry."
This statement is concise, uses precise measurements, and includes objective data, meeting legal documentation guidelines.

A. "What was your daughter's reaction to your desire for hospice?" This is an open-ended question as it invites the patient to share feelings or reactions in a broad, unrestricted way.

B. "Did you sleep all night without waking?" This is a closed-ended question that can be answered with a simple "yes" or "no."

C. "How many bowel movements have you had today?" This is a closed-ended question asking for a specific number.

D. “Is your pain less today than it was yesterday?" This is a closed-ended question that requires a "yes" or "no" answer.

A. Oral. Oral learning is not commonly identified as a distinct mode in learning styles.

B. Visual.
Visual learning involves learning through seeing materials like images, charts, or demonstrations.

C. Gustatory.
Gustatory (taste-based) learning is not a recognized major mode of learning.

D. Auditory.
Auditory learning involves learning by listening to spoken information.

E. Kinesthetic.
Kinesthetic learning involves learning through hands-on activities and physical movement.

F. Tactile. Tactile learning is closely related to kinesthetic learning but refers specifically to hands-on activities involving touch.

A. Silence. Silence can be challenging for nursing students as it requires them to resist the urge to fill quiet moments, allowing the patient time to think or express emotions.

B. Closed questions. Closed questions are relatively straightforward and easy to use, often requiring only simple responses.

C. Using general leads. General leads encourage patients to continue sharing and are easier for most students than silence.

D. Restating. Restating is often easier for students, as it involves repeating back what the patient has said for clarity.