The nurse caring for a patient who is concerned about her 10-pound weight loss relative to her chemotherapy tells the patient. "Lucky you! Every cloud has a silver lining." The nurse's statement is an example of which type of communication block?
Defensive response
Asking probing questions
Using clichés
Changing the subject
The Correct Answer is C
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.
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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.
Correct Answer is B
Explanation
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.