The nurse can best ensure that communication is understood by:
speaking slowly and clearly in the patient's native language.
asking the family members whether the patient understands.
obtaining feedback from the patient that indicates accurate comprehension.
checking for signs of hearing loss or aphasia before communicating.
The Correct Answer is C
A. Speaking slowly and clearly in the patient's native language. While speaking clearly in the patient’s native language is helpful, it does not verify understanding. Feedback from the patient is necessary to confirm comprehension.
B. Asking the family members whether the patient understands. Relying on family members may not be accurate, as they may not fully understand the patient's level of comprehension.
C. Obtaining feedback from the patient that indicates accurate comprehension. Having the patient repeat the information back or summarize it in their own words ensures they have understood the communication.
D. Checking for signs of hearing loss or aphasia before communicating. Assessing for hearing loss or aphasia can be part of the process but does not confirm that communication was understood.
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Correct Answer is B
Explanation
A. Speaking in simple sentences, as if to a child. This is inappropriate and could be perceived as patronizing, which may hinder communication. Older adults should be treated with respect, not as children.
B. Speaking slowly in order to allow the patient to process the message. Older adults may need more time to process information, so speaking slowly can aid understanding without appearing patronizing.
C. Addressing him by his first name to encourage a therapeutic relationship. Addressing older adults by their first names may be seen as disrespectful or overly familiar, unless the patient specifically requests it.
D. Standing in the doorway rather than entering the room to give the older adult patient more privacy. Standing in the doorway may create a physical barrier and distance, which can hinder effective communication and rapport.
Correct Answer is D
Explanation
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.