A nurse and client have been working together for many months, ...

[fahad]

A nurse and client have been working together for many months, and all goals for their relationship have been met. The nurse notes that the client has cancelled two appointments in a row.
 
  In assessing this situation, which statement by the nurse would gather the most important information?
  a. I see you keep cancelling appointments. Is this time inconvenient?
  b. I'd like to know what you think will happen when you stop seeing me.
  c. Why do you feel uncomfortable talking to me after all this time?
  d. Would you please explain to me why you keep cancelling appointments?

Question 2

A nurse is frustrated because a patient does not make any needed health changes despite ongoing and comprehensive education on the health-related topic. The best action by the nurse would be to
 
  a. ask the patient if he or she really wants to make changes.
  b. assess for barriers to implementing the knowledge.
  c. continue trying to education the patient on the topic.
  d. find out whether the patient learns in a different way.

[cupcake16]

Answer to Question 1

B
The termination phase of a working relationship might cause stress, and clients might exhibit behaviors such as anger or even cancelling appointments. The nurse's role is to help the client understand the meaning behind these actions.
Asking about one rather superficial issue (appointment times) does not show the client that the nurse is really interested in the client. By guessing at the reason for the client's action (assuming the appointment times are inconvenient), the nurse is limiting the chance for a meaningful interaction.
Why questions are generally not a good idea; they tend to put people on the defensive.
Asking for an explanation for cancelled appointments sounds patronizing and authoritarian.

Answer to Question 2

B
If the patient has the knowledge needed to make changes but does not, something is inhibiting the patient's ability or willingness to make the change. The nurse would be wise to assess for things that are keeping the patient from changing.
Asking the patient whether he or she really wants to make changes will most likely sound challenging to the patient and might result in the patient's being defensive.
More education is not the key unless the patient does not have enough information.
Patients do learn in different ways, and tailoring the education to the patient's strengths is a good idea, but in this case, the nurse needs to determine whether something is keeping the patient from making the needed changes.

[fahad]

Gracias!

[patma1981]

TYSM