In a pediatric setting how should a nurse employ active listening when a child is hesitant to speak about their feelings?

A. She introduced the concept of patient confidentiality: While patient confidentiality is an important nursing principle, Nightingale is not credited with introducing this concept. It was emphasized in later professional nursing codes.

B. She demonstrated that sanitation and hygiene could drastically reduce mortality rates: During the Crimean War, Nightingale implemented strict sanitation measures, improved ventilation, and emphasized hand hygiene. These interventions significantly reduced infection and death rates among wounded soldiers and established hygiene as a cornerstone of nursing practice.

C. She established the first hospital in England: Nightingale did not found the first hospital; she improved care within existing military hospitals and later influenced hospital design and organization.

D. She developed the first nursing licensure examination: Nightingale contributed to nursing education and training standards but did not create a licensure examination. Formal licensure systems were developed later in various countries.

A. Document in the medical record that the client refused to complete an advance directive: While documentation is important, it is not the priority action. The nurse should first provide education and offer support to help the client make an informed decision before noting refusal.

B. Provide the client with written information about advance directives and offer assistance: Educating the client about advance directives respects autonomy and promotes informed decision-making. Providing resources and guidance ensures the client understands their rights and options, making this the priority action.

C. Inform the client that completing an advance directive is mandatory: Advance directives are voluntary; requiring completion violates legal and ethical standards. The nurse’s role is to inform and support, not coerce.

D. Ask the client's family to complete the forms on their behalf: Family involvement may be appropriate only if the client is unable to make decisions. Without the client’s consent, this action undermines autonomy and legal rights. Education and voluntary completion should come first.