A nurse is caring for a terminally ill patient during the 2300 to 0700 shift.
The patient says, "I just can't go to sleep.
I keep thinking about what my family will do when I am gone.”. What response by the nurse would be most appropriate?
"I have talked with your wife and she told me she will be fine.”.
"Oh, don't worry about that now.
"Can I get you the sleeping pill your doctor prescribed, so that you can get some rest?".
"What seems to be concerning you the most?". .
The Correct Answer is D
Choice A rationale:
Telling the patient that their wife will be fine does not address the patient's concerns and may come across as dismissive. It does not encourage further communication about the patient's fears and worries.
Choice B rationale:
Dismissing the patient's concerns and instructing them to sleep does not address the underlying issue. It fails to acknowledge the patient's emotional distress and may make the patient feel unheard and unsupported.
Choice C rationale:
Offering medication without exploring the patient's concerns further does not address the root cause of the patient's anxiety. It is important to assess the patient's emotional state and concerns before resorting to medication.
Choice D rationale:
Asking the patient, "What seems to be concerning you the most?" demonstrates active listening and empathy. It encourages the patient to express their feelings and fears, allowing the nurse to provide appropriate emotional support and interventions. Open-ended questions like this facilitate therapeutic communication and help establish trust between the nurse and the patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
Choice A rationale:
The nurse verifies the recipient's fax number before faxing private patient information. This action is appropriate and ensures that patient information is sent to the correct recipient, maintaining patient confidentiality and privacy. Verifying recipient information is a standard practice in healthcare settings to prevent data breaches.
Choice B rationale:
The nurse documents the patient assessment using objective data. This action is appropriate and follows evidence-based practice guidelines. Objective data are measurable and observable, providing a clear picture of the patient's condition. Objective documentation enhances communication among healthcare providers and ensures accurate representation of the patient's status.
Choice C rationale:
The nurse posts the obituary of a patient on social media. This action is highly inappropriate and unethical. It breaches patient confidentiality and privacy, violating the Health Insurance Portability and Accountability Act (HIPAA) regulations. Sharing patient information, especially sensitive details like an obituary, on social media platforms is a serious violation of privacy and can lead to legal consequences.
Choice D rationale:
The nurse discards copies of patient information into the regular trash bin. This action is inappropriate and violates patient confidentiality. Proper disposal of patient information is crucial to protect patient privacy and comply with regulations. Patient documents should be shredded or disposed of in designated secure bins to prevent unauthorized access to sensitive information.
Choice E rationale:
The nurse accesses the nurse's own health record via computer. This action is inappropriate unless there is a legitimate reason related to patient care. Accessing one's own health record without a valid purpose is a breach of patient privacy and can lead to disciplinary actions. Healthcare professionals should only access patient records when necessary for providing care and treatment.
Correct Answer is ["C","D"]
Explanation
Choice A rationale:
Asking a patient if their neighbor can visit is not a violation of HIPAA policy as it does not involve sharing sensitive patient information.
Choice B rationale:
Using the facility computer to document patient care is appropriate and not a violation of HIPAA policy, assuming the nurse is following proper security protocols.
Choice C rationale:
Looking at a neighbor's chart to add them to a prayer list at church is a clear violation of HIPAA policy. This action breaches patient confidentiality and compromises their privacy, which is essential under HIPAA regulations.
Choice D rationale:
Failing to log off the computer charting system after documenting patient care is also a violation of HIPAA policy. This can lead to unauthorized access and potential misuse of patient information, putting patient privacy at risk.
Choice E rationale:
Discussing a patient with a coworker in a public place like an elevator violates HIPAA policy. Even though the conversation is with a colleague, it is essential to protect patient information in all circumstances to maintain confidentiality and trust.
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