Answers and Explanations

Sample Questions

  1. The Answer is 4
    1. “You seem upset this morning” is the correct answer choice because the LPN/LVN seeks to verbally validate the client’s behavior rather than simply respond to the behavior. This response promotes the nurse-client relationship by encouraging the client to share his feelings with the LPN/LVN.
    2. “I understand and will leave you alone for now” is not the best approach because it does not promote further communication between the LPN/LVN and the client about how the client is feeling. In order to interpret this client’s behavior, the LPN/LVN must first validate it with the client.
    3. “Why are you angry with me?” is incorrect. The LPN/LVN is drawing a conclusion about the client’s behavior. This type of action is too confrontational. “Why” questions are considered nontherapeutic.
    4. “Are you upset because you do not feel better?” is not the best choice. The LPN/LVN is drawing a conclusion about the client’s behavior without validating it first. This type of response may also belittle the client’s actual concerns.
  2. The Answer is 2
    1. “You seem very anxious. I will stay with you while the cast is removed” is the best response because the LPN/LVN responds to the client’s feelings of fear. This is consistent with therapeutic communication used in American nursing. This response also provides an additional opportunity for the LPN/LVN to remain with the client in a supportive capacity enhancing the nurse-client relationship.
    2. “I know it is unpleasant. Try not to be afraid. I will help you” is not the best response. It is not clear what concerns the client has about this procedure. The LPN/LVN should establish this before responding. The LPN/LVN falsely reassures the client by saying, “I will help you.” Because you do not know the nature of the client’s concerns, you cannot honestly offer help.
    3. “I don’t blame you. I’d be afraid also” is not the correct response because the LPN/LVN shifts the focus of the conversation from the client to the LPN/LVN. This sets up a barrier to further communication. The LPN/LVN concedes the issue too quickly, leaving the source of the client’s fear unknown.
    4. “My aunt just had a cast removed and she’s just fine” is not the best choice. The focus of the conversation is shifted from the client to the LPN/LVN’s aunt, who is of no concern to the client. This response fails to explore the source of the client’s anxiety and sets up a block to further communication.
  3. The Answer is 4
    1. “You seem upset. Let’s talk about how you’re feeling” is the best answer to this question. This promotes the nurse-client relationship and illustrates therapeutic communication used in American nursing. The LPN/LVN responds to the client’s feelings in a nonjudgmental, empathetic way.
    2. “Are you upset because you forgot to use birth control?” is inappropriate because it places blame on the client. The LPN/LVN should not assume that the client “forgot” to do something. This response also fails to respond to the client’s feelings and does not encourage the client to discuss her concerns.
    3. “Why are you so upset? You’re married. There’s no reason not to have the baby” is inappropriate in terms of American therapeutic communication. This response is harsh and presumptive, and assumes that the purpose of every marriage is to have children. This is not always the case in American culture. With this response, the LPN/LVN does not attempt to verify the reason for the client’s tears, thereby discouraging further conversation about what the client is actually experiencing.
    4. “If you’re so upset, why don’t you have the baby and put it up for adoption?” is also inappropriate. This is a value-laden assumption placing positive value on adoption. Again, the LPN/LVN fails to explore with the client the reason for the client’s tears, thereby discouraging further communication. The LPN/LVN is also offering advice.
  4. The Answer is 1
    1. “I cannot say exactly. What are your concerns at this time?” is the most appropriate response because it is unclear why the family member has approached the LPN/LVN at this point. Perhaps the client is in pain and the family member wants to discuss it with the LPN/LVN. This response allows for that possibility. This response is also direct and factually correct.
    2. “I don’t know. I’ll call the doctor” is not the most appropriate response. It shifts the focus of responsibility from the LPN/LVN to the physician, which prevents a nurse–family member relationship from developing.
    3. “This must be a terrible situation for you” is not the most appropriate response. It is a value-laden statement that fails to explore the family member’s reason for approaching the LPN/LVN.
    4. “Don’t worry, it will be very soon” is inappropriate because the LPN/LVN offers the family member false reassurance. It also offers advice by telling the family member not to worry. This statement is demeaning and may sound as if the nurse is too busy to discuss the family member’s concerns.
  5. The Answer is 1
    1. “This is inappropriate behavior. Please close your robe and return to your room” is the correct answer choice. This statement by the LPN/LVN responds to the client’s behavior, sets limits on the behavior, and directs the client toward more appropriate social behavior in the milieu. This statement rejects the client’s behavior, not the client as a person.
    2. “Please dress in your clothes and then join us for lunch in the dining room” is incorrect. It ignores the behavior of the client exposing himself. Instead it directs the client to dress and report to the dining room for lunch as though nothing has happened. This is inappropriate and nontherapeutic.
    3. “I am offended by your behavior and will have to report you” is incorrect. It shifts the focus from the client to the LPN/LVN and the LPN/LVN’s feelings. The LPN/LVN’s personal feelings are irrelevant. Also, the LPN/LVN goes on to threaten the client with reporting him. This is nontherapeutic.
    4. “Do you need some assistance dressing today?” is incorrect. This question fails to respond to the client’s behavior. It is also a yes/no question, which is nontherapeutic.
  6. The Answer is 3
    1. “Can you be more specific about your concerns?” is the correct answer. This is the best answer choice because it seeks to validate the client’s message. It is direct, is not defensive, and allows the client to express her point of view.
    2. “I am young, but I graduated from nursing school” is incorrect. It responds to only part of the message that the client sent to the LPN/LVN. It assumes that the LPN/LVN knows what the client’s concerns are and agrees that there is some problem associated with being too young. Further clarification is necessary in this situation.
    3. “If I don’t bathe you now, you’ll have to wait until I’m finished with my other clients” is a nontherapeutic response. It fails to explore the client’s concerns about the LPN/LVN. It is an uncaring and punitive statement by the LPN/LVN that is inappropriate in a nurse-client relationship.
    4. “Your concerns are unnecessary. I know what I’m doing” is incorrect. The LPN/LVN dismisses the client’s concerns by telling her that she shouldn’t be concerned. The LPN/LVN should not tell a client how he or she should be feeling. It may sound as if the LPN/LVN is trying to reassure the client by telling her that the LPN/LVN knows what he or she is doing; however, the LPN/LVN has yet to validate the concerns that underlie the client’s statement.
  7. The Answer is 2
    1. “Your tests show a mass. It must be hard not knowing what is wrong” is the correct answer choice. This is the best answer choice because it responds to the client’s feelings. It allows the client to continue to identify and express her concerns regarding surgery, hospitalization, and the possibility of having a potentially life-threatening illness. The LPN/LVN validates that the client has appropriate concerns and invites her to elaborate on them.
    2. “Would you like me to call your doctor so that you can discuss your specific concerns?” This response is incorrect because it shifts the focus of responsibility from the LPN/LVN to the doctor, thereby reducing the possibility of developing an ongoing nurse-client relationship.
    3. “It sounds like you are afraid that you are going to die from cancer” is inappropriate. It fails to validate with the client that “dying from cancer” is in fact the issue. The LPN/LVN inappropriately concludes this on the basis of a brief statement made by the client without giving the client a chance to elaborate.
    4. “Don’t worry about it now; I’m sure that you have many healthy years ahead of you” is inappropriate. The LPN/LVN is telling the client how she should feel and then goes on to offer false reassurance. This response fails to address or explore the actual concerns of the client.
  8. The Answer is 4
    1. “Acknowledge the loss and be supportive” is the best answer choice. It promotes the nurse-client relationship and allows for the identification of feelings and the expression of sadness. The client is in an acute stage of grief. This type of response addresses this issue.
    2. “Assure the woman that the loss was ‘for the best’ is incorrect. This statement is insensitive to the client, offers false reassurance, and belittles the client’s most immediate concerns.
    3. “Explain to her that she is young enough to have more children” is inappropriate because it is insensitive to the grief that the client is experiencing. The LPN/LVN offers false reassurance by telling the woman that she can have other children.
    4. “Ask her why she is looking at the babies” is also incorrect. This is inappropriate because it is a “why” question and because the woman may become defensive when answering such a question. This response also fails to respond to the client’s immediate grief.
  9. The Answer is 1
    1. “It is hard to be caught between taking care of your needs and your father’s needs” is the correct response. This is the most therapeutic response as it allows for continued development of a relationship with the family member of the client. This response allows the LPN/LVN to explore and validate the daughter’s feelings about the nursing home placement.
    2. “Would you like me to help you find a nursing home?” is not the best answer choice. It is a yes/no question and doesn’t encourage discussion of the daughter’s feelings.
    3. “Don’t feel guilty. The only solution is to place your father in a nursing home” is not the best therapeutic response. The daughter’s concerns are minimized when the LPN/LVN tells the daughter not to worry. While it may be true that the daughter has done all that she can, this response cuts off an opportunity for further conversation with the LPN/LVN.
    4. “I think I would feel guilty too if I had to place my father in a nursing home” is also incorrect. This statement is value-laden and judgmental, and could block further communication between the LPN/LVN and the client’s daughter. It is not important what the LPN/LVN thinks about the daughter’s decision, nor is it the LPN/LVN’s role to make the daughter feel more guilty about her decision.