A nurse is assessing a toddler who is 18 months of age.
Which of the following developmental milestones should the nurse expect the toddler to demonstrate?

Choice A rationale

Providing passive responses is a non-therapeutic communication style that avoids addressing the client's needs or feelings directly. It can make the nurse appear disinterested or unsupportive, which hinders the development of a trusting nurse-client relationship. Therapeutic communication requires active engagement and the use of specific techniques that encourage the client to express themselves more fully, rather than the nurse remaining emotionally or conversationally detached from the interaction.

Choice B rationale

Using silence is a powerful therapeutic communication technique that allows the client time to organize their thoughts and process their emotions. It demonstrates the nurse's patience and willingness to wait for the client to speak at their own pace. This non-verbal intervention can encourage deeper reflection and show that the nurse is fully present, providing a supportive environment for the client to share sensitive or difficult information without feeling rushed.

Choice C rationale

Offering sympathy involves the nurse taking on the client's feelings as their own, which can blur professional boundaries and limit the nurse's objectivity. Unlike empathy, which is therapeutic and involves understanding the client's perspective, sympathy can lead to pity. Pity can make a client feel powerless or judged. Therapeutic communication focuses on empathetic understanding to empower the client rather than just feeling sorry for their current situation.

Choice D rationale

Offering personal opinions is non-therapeutic because it shifts the focus away from the client and onto the nurse. It can be perceived as giving advice, which may inhibit the client's autonomy and decision-making process. The goal of therapeutic communication is to help the client explore their own feelings and options. Providing a personal opinion can close off the conversation and pressure the client to agree with the nurse's viewpoint.

Choice A rationale

Clostridium difficile is a spore-forming bacterium that causes severe diarrhea and colitis. Because the spores are easily transferred via contaminated surfaces and the hands of healthcare workers, contact precautions are mandatory. Wearing a protective gown prevents the nurse's clothing from becoming a vector for these hardy spores. This barrier is essential because C. difficile spores can persist in the environment for months and are resistant to many common disinfectants used in healthcare settings.

Choice B rationale

Placing the client in a private room is a fundamental component of contact precautions for Clostridium difficile. This isolation helps contain the spread of the infectious spores within a controlled environment and minimizes the risk of cross-contamination to other vulnerable patients. If a private room is unavailable, cohorting with another patient with the same infection is a secondary option, but a private room remains the gold standard for preventing the horizontal transmission of this enteric pathogen.

Choice C rationale

An N-95 respirator is indicated for airborne precautions, which are used for pathogens transmitted through very small droplets that remain suspended in the air, such as tuberculosis or measles. Clostridium difficile is transmitted through the fecal-oral route via direct or indirect contact with contaminated feces or surfaces. It is not an airborne pathogen, so an N-95 respirator is unnecessary and does not align with the established evidence-based guidelines for managing enteric contact-based infections in clinical practice.

Choice D rationale

Negative pressure rooms are specifically designed for patients requiring airborne precautions to prevent contaminated air from flowing into hallways or other patient rooms. Since Clostridium difficile is spread through physical contact with spores and not through the air, a negative pressure environment provides no clinical benefit for preventing its transmission. Using such a specialized resource for a contact-based infection would be an inappropriate allocation of hospital facilities and does not follow standard infection control protocols.

Choice E rationale

Placing a mask on the client during transport is a requirement for droplet precautions, which apply to infections spread by large respiratory droplets like influenza or pertussis. Because Clostridium difficile is an intestinal infection spread through contact with fecal matter and spores, respiratory masking of the patient serves no purpose in preventing transmission. Instead, the focus during transport should be on ensuring the patient's skin is covered and that any active diarrhea is contained to prevent environmental shedding.