When a nurse is "talking through" a procedure or assisting the patient to learn, the nurse encourages the patient to:
write down the steps as she performs them.
read the listed steps written on a poster board on the wall.
verbalize each step until the steps are memorized.
close her eyes and envision the process.
The Correct Answer is C
A. write down the steps as she performs them.
Writing down the steps may help the patient review later but does not actively engage the patient in learning during the procedure.
B. read the listed steps written on a poster board on the wall.
Reading steps on a poster board can provide visual support but doesn’t actively involve the patient in recalling or practicing the procedure.
C. verbalize each step until the steps are memorized.
Verbalizing each step is an active form of learning that reinforces memory and helps the patient feel more comfortable with the process, making it an effective teaching strategy.
D. close her eyes and envision the process.
Visualization can help with memory, but it may not be as effective as actively verbalizing each step for practical, hands-on tasks.
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Correct Answer is D
Explanation
A. “Taking fluids poorly, but more than yesterday."
This assessment is vague (“taking fluids poorly”), lacks measurable details, and does not meet the clarity standard required in documentation.
B. "Apparently comfortable all night. Offers no complaints of pain."
“Apparently comfortable” is an assumption rather than an observable, objective statement, which could be legally questionable.
C. "Patient says she is still slightly nauseated, would like to try some toast and tea."
While this is clear, “slightly nauseated” could be more specific, and this does not objectively quantify the patient’s condition.
D. "4 cm reddened area over sacrum. Skin intact, warm, and dry."
This statement is concise, uses precise measurements, and includes objective data, meeting legal documentation guidelines.
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.