Adaptive Learning by PrepU: Communication Quiz
A client presents to the urgent care clinic with ear pain. The client reports a medical history of trigeminal neuralgia. The nurse is not familiar with trigeminal neuralgia. When the client asks if the two conditions could be related, the best response by the nurse is: a) "You know more than me, tell me what you think." b) "Absolutely, the ear pain is probably caused by the trigeminal neuralgia." c) "I honestly do not remember specific details regarding trigeminal neuralgia, let me research it." d) "I doubt the two conditions could be related."
"I honestly do not remember specific details regarding trigeminal neuralgia, let me research it." Correct Explanation: The nurse needs to be truthful. A client who is given false information will soon distrust the nurse. If you?re not sure about something, admit you don?t know and seek an answer rather than make a comment that may be an error. The nurse should neither confirm nor deny the two conditions could be related until the nurse has reviewed trigeminal neuralgia. Telling the client that the patient knows more than the nurse may lead to mistrust on the part of the client. (less) Reference: Taylor, C.R. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2015, Chapter 20: Communication p. 466.
A client comes into the urgent care center to have sutures removed on his right arm. The nurse assesses the sutures and finds significant crusting along the suture line. The client indicates he didn't have time to get his sutures removed a week prior as directed. The nurse soaks the crust and attempts to remove the sutures. As the nurse attempts the suture removal, the client frequently pulls his arm away and tells the nurse, "you do not know what you are doing." In response, the nurse should answer: a) "You are the cause of the problem here. I do not have to tolerate this behavior and you are free to leave." b) "How would you know if I know what I am doing or not?" c) "I am sorry this is hurting you but you are hurting my feelings." d) "Sir, I understand this is uncomfortable but I assure you I am experienced with this task and would like to continue."
"Sir, I understand this is uncomfortable but I assure you I am experienced with this task and would like to continue." Explanation: When interacting with clients, family members, other nurses, physicians, and other members of the health care team, nurses should communicate in a way that demonstrates respect for all parties. Assertive behavior is the ability to stand up for oneself and others using open, honest, and direct communication. The focus is on the issue and not the person. Assertive behaviors that are one hallmark of professional nursing relationships, are very different from aggressive (i.e., harsh, injurious, or destructive) behaviors. They also differ greatly from avoidance or acquiescent behaviors. The key to assertiveness is expressing feelings and beliefs in a nondefensive manner. The client in this scenario is acting inappropriately but the nurse needs to be assertive, maintain composure, and handle the situation. The nurse should not use "You" statement, instead "I" statements that relate to the task at hand. Asking the client how he would know if the nurse was performing the task is provocative and inappropriate. Reference: Taylor, C.R. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2015, Chapter 20: Communication, p. 468. Chapter 20: Communicator - Page 468
A female client reports to her primary care physician with aggravated chest pain. The physician orders a stress test. The client tells the nurse that she doesn't want to take the test and feels she should instead continue with the medication a little longer. Understanding that the client is anxious, what is the most appropriate response by the nurse? a) "Most people tolerate the procedure quite well." b) "Tell me more about how you are feeling." c) "Don't you want to improve your health?" d) "Emergency equipment is always kept ready."
"Tell me more about how you are feeling." Explanation: The client may have been anxious due to fear and anxiety related to the stress test. The nurse should try to explore the client's feelings by letting her express her concerns. Asking the client open-ended questions is best because it expresses concern for the client and encourages the client to verbalize her feelings. Stating that emergency equipment is always kept ready evokes more fear and interrupts communication. Questioning whether the client wants to get well or that others have tolerated this procedure quite well is inappropriate. Reference: Taylor, C., et al. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015, Chapter 20: Communicator, p. 463. Chapter 20: Communicator - Page 463
A patient scheduled to have hip replacement surgery states, "I am so scared of the surgery and of the anesthetic." What is the best response by the nurse? a) "Your wife will be in the surgery waiting room the entire time." b) "You really don't have anything to worry about." c) "What will happen if you don't have surgery?" d) "What questions do you have about the surgery?"
"What questions do you have about the surgery?" Explanation: The nurse should allow the client time to express his fears about the anesthesia and the surgery. Telling the client that his wife will be waiting or not to worry, and asking what will happen if he doesn't have the surgery do not address the patient's concerns. Reference: Taylor, C., et al. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015, Chapter 20: Communicator, p. 460. Chapter 20: Communicator - Page 460
During an annual performance review with an employee, the nurse manager does not maintain eye contact and seems concerned about the time and the next appointment. What type of communication is the manager exhibiting? a) Nonverbal b) Consistent c) Clarifying d) Verbal
Nonverbal Explanation: Use of eye contact as a nonverbal form of communication demonstrates attention, presence, and interest. In addition, listening can be hampered by the listener's lack of interest in the topic, premature interpretation of the message, or preoccupation with practice. The nonverbal cues that accompany the message are essential aspects of effective communication. Reference: Taylor, C., et al. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015, Chapter 20: Communicator, p. 449. Chapter 20: Communicator - Page 449
A nurse is caring for a client who suffered a head trauma. The client is in a medically induced coma and on mechanical ventilation. The client's mother is at the bedside in tears. The mother states, "I just want him to know I am here with him." To address the needs of the mother and the client, the nurse should: a) Encourage the mother to bring in pictures of the family that can be displayed in the room. b) Place his hand on the mother's shoulder and reassure the mother that things will be fine. c) Leave the room and allow the mother to grieve. d) Place a chair next to the bed and encourage the mother to hold the son's hand.
Place a chair next to the bed and encourage the mother to hold the son's hand. Explanation: Despite its individuality, touch is viewed as one of the most effective nonverbal ways to express feelings of comfort, love, affection, security, anger, frustration, aggression, excitement, and many others. The nurse may feel it is appropriate to place his hand on the mother's shoulder; however, the nurse should not provide false hope. The nurse should not leave the mother alone to grieve, the nurse should show the mother how to use comforting communication. The client is in a chemically induced come and will not be able to see pictures that are displayed in the room. Reference: Taylor, C.R. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2015, Chapter 20: Communicator, p. 451. Chapter 20: Communicator - Page 451
After English, which language accounts for the largest percentage spoken in the United States? a) Italian b) Greek c) French d) Spanish
Spanish Explanation: Approximately, 150 different languages are spoken in the United States, with Spanish accounting for the largest percentage after English. French, Italian, and Greek do not account for the largest percentage of language after English. Reference: Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th ed. Philadelphia: Lippincott Williams & Wilkins, 2014, Chapter 7: Overview of Transcultural Nursing, p. 98. Chapter 7: Overview of Transcultural Nursing - Page 98
Which of the following factors is most important in the development of rapport between nurse and patient? a) Kindness b) Happiness c) Trust d) Skill
Trust Explanation: Rapport is a feeling of mutual trust between nurse and patient. Other traits and abilities, such as kindness, happiness, and skill, may foster rapport in particular patient interactions, but trust remains the central component of rapport. Reference: Taylor, C., et al. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015, Chapter 20: Communicator, p. 460. Chapter 20: Communicator - Page 460
An experienced nurse is orienting a new nurse to the unit. The experienced nurse tells the new nurse that to be an effective caregiver, the new nurse needs to: a) spend as much time as possible with clients. b) read client medical records thoroughly. c) attempt to obtain a specialty certification. d) develop good communication skills.
develop good communication skills. Explanation: Any nurse who wishes to be an effective caregiver must first learn how to be an effective communicator. Good communication skills enable nurses to get to know their clients and, ultimately, to diagnose and to meet their needs for nursing care. Obtaining a specialty certificate should be encouraged but is not as important as effective communication. Reading a client's chart thoroughly does not necessarily contribute to being an effective caregiver. Nurses should use their judgment in determining how much time to spend with each client. Reference: Taylor, C.R. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2015, Chapter 20: Communicator, p. 447. Chapter 20: Communicator - Page 447
A client has been recently diagnosed with type 1 diabetes mellitus. He is seen in the emergency room every day with high blood sugar. The client apologizes to the nurse for bothering them every day, but he cannot give himself insulin injections. What should the nurse's response be? a) "You should learn to take injections yourself." b) "Ask the doctor to change the medications." c) "Has someone taught you how to take them?" d) "I myself cannot take insulin injections."
"Has someone taught you how to take them?" Explanation: The nurse should assess whether the client has a knowledge deficit regarding self-injection. If there is a knowledge deficit, the nurse should teach the client the correct method to take insulin injections. The first response is a negative reinforcement and is therefore inappropriate. Demanding that the client learn injection administration is also inappropriate. The fourth response, too, is inappropriate, because the nurse cannot offer a change that cannot be carried out. Reference: Taylor, C., et al. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015, p. 457. Chapter 20: Communicator - Page 457
A nurse is calling a physician to communicate a change in the client's condition. According to the I-SBAR-R format for hand-off communication among healthcare personnel, which is the most appropriate way to begin the conversation? a) "I have a client of yours at Jefferson hospital experiencing a change in her condition and needs seen immediately!" b) "Good morning, I am calling about Mrs. Jones who is a client of yours." c) "My name is Sue and I am calling about Mrs. Jones, a client of yours at Jefferson hospital." d) "My name is Sue Smith, RN and I am calling regarding Mrs. Jones in room 356 at Jefferson hospital."
"My name is Sue Smith, RN and I am calling regarding Mrs. Jones in room 356 at Jefferson hospital." Explanation: I-SBAR-R was recently revised by the QSEN institute to include initial identification of yourself and your client. The nurse should identify herself and her role during the initial conversation with the physician. This allows the physician to understand the role of the healthcare provider they are speaking with regarding the client should the physician need to provide orders or instructions regarding the client. The other responses fail to have the nurse identify herself in the beginning of the conversation or fail to recognize identification of the client. Reference: Taylor, C.R. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2015, Chapter 20: communicator, p. 458. Chapter 20: Communicator - Page 458
The nurse must employ appropriate interviewing techniques to elicit accurate and complete health information. Which of the following statements is an example of an open-ended question or comment? a) "Tell me what brought you to the hospital this morning?" b) "You seem upset today. Are you?" c) "Are you having pain right now?" d) "I'll be back in 30 minutes to check on your pain relief."
"Tell me what brought you to the hospital this morning?" Explanation: Using an open-ended question or statement when interviewing a client allows for a wide variety of responses and encourages free verbalization. When determining why a client sought healthcare, this is a valuable way to elicit detailed responses during the assessment process. Asking "Are you having pain right now?" and "You seem upset today. Are you?" require a client to answer with a yes or no response or very little verbiage that will require follow up questions to elicit valuable information. "I'll be back in 30 minutes to check on your pain relief" is an information giving statement by the nurse and does not require a response from the client. Reference: Taylor, C.R. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2015, Chapter 20: Communicator, p. 468. Chapter 20: Communicator - Page 468
A nurse is caring for a client with a diagnosis of metastatic lung cancer. The nurse finds the client sitting in a chair while staring out the window. The nurse conveys caring by saying: a) ?Cheer up. Tomorrow is another day.? b) "Tell me what is on your mind." c) ?Your doctor knows best.? d) "Don?t worry. You will be just fine in another day or two.?
"Tell me what is on your mind." Explanation: Most health care clichés suggest that there is no cause for anxiety or concern, or they offer false assurance. Clients tend to interpret them as a lack of real interest in what they have said. This client is faced with a serious diagnosis and body language would indicate he or she is in deep thought. Cliches such as "don't worry,""cheer up," or "your doctor knows best" do not convey care on the part of the nurse. The simple action of asking what is on the client's mind opens up lines of communication for the client to express his or her feelings. (less) Reference: Taylor, C.R. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2015, Chapter 20: Communication, p. 470. Chapter 20: Communicator - Page 470
The nurse interviews a client during which step of the nursing process? a) Evaluation b) Diagnosing c) Assessment d) Planning
Assessment Explanation: The purpose of the client interview is to obtain accurate and thorough information. In nursing, the interview is a major tool for collecting data during the assessment step of the nursing process. Reference: Taylor, C.R. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2015, Chapter 20: Communication, p. 467. Chapter 20: Communicator - Page 467
A student nurse is attempting to improve her communication skills. Which of the following is an appropriate therapeutic communication skill? a) Avoid the use of periods of silence. b) Control the tone of the voice to avoid hidden messages. c) Use clichs to enhance a patient's understanding of information. d) Be precise and inflexible regarding the intent of the conversation.
Control the tone of the voice to avoid hidden messages. Explanation: Conversation skills involve controlling the tone of one's voice so that exactly what is intended is conveyed and there is no hidden message. Periods of silence have an important role in conversations because they allow for periods of reflection. Clichs should be avoided, and the conversation should be flexible. (less) Reference: Taylor, C., et al. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015, Chapter 20: Communicator, p. 464. Chapter 20: Communicator - Page 464
You are assessing a new patient and their home environment. What is a responsibility that you, as a community-based nurse, have at this initial visit? a) Encourage the patient and their family to use local stores to support their community. b) Encourage the patient and their family to contact appropriate community resources. c) Encourage the patient and their family to contact their church as a resource. d) Encourage the patient and their family to use the internet to find local resources.
Encourage the patient and their family to contact appropriate community resources. Explanation: During initial and subsequent home visits, the nurse helps the patient and family identify these community services and encourages them to contact the appropriate agencies. When appropriate, nurses may make the initial contact. The other answers are incorrect because a home-health nurse would not encourage the patient to support the community; they would not necessarily encourage the patient to use their church as a resource or to use the internet to find their own local resources. They would provide the patient with the applicable local resources. Reference: Taylor, C., et al. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015, Chapter 9: Care Coordination and Continuity in Health Care Settings and the Community, p. 185. Chapter 9: Care Coordination and Continuity in Health Care Settings and the Community - Page 185
A nurse is documenting the effectiveness of a patient's pain management on the patient record. Which documentation is written correctly? a) Mr. Gray is receiving sufficient relief from pain medication. b) Mr. Gray appears comfortable and is resting adequately. c) Mr. Gray appears to have a low tolerance for pain and complains frequently about the intensity of his pain. d) Mr. Gray reports that on a scale of 1 to 10, the pain he is experiencing is a 3.
Mr. Gray reports that on a scale of 1 to 10, the pain he is experiencing is a 3. Explanation: The documentation that records the client's pain on a numeric scale is written correctly. Subjective words such as "sufficient", "appears comfortable", "resting adequately", and "appears to have a low tolerance for pain" should not be used in documentation of a client's pain management. Reference: Taylor, C.R. Fundamentals of Nursing, 8th ed., Philadelphia: Wolters Kluwer Health, 2015, Chapter 16: Documenting, Reporting, Conferring, and Using Informatics, p. 342. Chapter 16: Documenting, Reporting, Conferring, and Using Informatics - Page 342
A nurse is caring for a client in a semi-private room. The nurse is preparing to discuss the medical treatment plan with the client. To best ensure privacy the nurse should do what? a) Pull the curtain dividing the two beds, maintain eye contact, and speak in a low, audible voice. b) Direct the client in the other bed to walk in the hallway. c) Ask all visitors to leave the room. d) Bring the client into the hallway to discuss the treatment plan.
Pull the curtain dividing the two beds, maintain eye contact, and speak in a low, audible voice. Explanation: It might not always be possible to carry on conversations alone with the client in a room, but every effort should be made to provide privacy and to prevent conversations from being overheard by others. Sometimes merely drawing the curtains around the bed in a hospital or long-term care facility or sitting in a corner of the waiting room or lounge can provide the sense of privacy that is so important in most interactions. It is not appropriate to ask the client in the other bed to leave their room. Personal information should not be discussed in public thoroughfares. Reference: Taylor, C.R. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2015, Chapter 20: Communication, p. 451. Chapter 20: Communicator - Page 451
A nurse is caring for a client with myasthenia gravis. The client is having difficulty forming words and his tone is nasal. Which of the following is an effective communication strategy for this client? a) Nod continuously when the client is talking. b) Encourage the client to speak quickly while talking. c) Repeat what the client has said to verify the meaning. d) Engage the client in a lengthy discussion to strengthen his voice.
Repeat what the client has said to verify the meaning. Explanation: The client is having a problem forming words and has a nasal tone due to a nerve involvement that controls speech. For effective communication, the nurse should repeat and verify whatever the client says. The nurse should ask those questions which can be answered in a yes or no form. Lengthy discussions may tire the client. Encouraging the client to speak quickly is inappropriate. Nodding continuously when the client is talking would not facilitate an effective communication strategy. (less) Reference: Taylor, C., et al. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015, p. 474. Chapter 20: Communicator - Page 474
The nurse has entered a patient's room after receiving morning report, rapidly assessed the patient's airway, breathing, and circulation and greeted the patient by saying "good morning." The patient has made no reciprocal response to the nurse. How should the nurse best respond to the patient's silence? a) The nurse should ask the patient if he feels afraid or angry. b) The nurse should document the patient's withdrawal and diminished mood in the nurse's notes. c) The nurse should apologize for bothering the patient, perform necessary assessments efficiently and leave the room. d) The nurse should ask appropriate questions to understand the reasons for the patient's silence.
The nurse should ask appropriate questions to understand the reasons for the patient's silence. Explanation: Silence can have many meanings, and the nurse should attempt to identify the meaning of the patient's silence in a tactful manner. Directly asking if the patient is angry or fearful is likely presumptuous and may harm rapport. The nurse should not make assumptions around the patient's mood nor should the nurse cease to engage with the patient. Reference: Taylor, C., et al. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015, p. 466. Chapter 20: Communicator - Page 466
A client experiencing a manic phase of bipolar disorder sustained cuts on the body from falling through a store window. The nurse is preparing to start an intravenous needle insertion and explains the procedure to the client a) Using clear and simple terms b) Interrupting the client's ravings c) Ignoring the client's statement, "I don't want this" d) Standing next to the bed with arms crossed
Using clear and simple terms Explanation: When communicating with clients who have psychiatric or mental health disabilities, the nurses uses clear and simple communication. The nurse needs to be aware of body language. Standing with arms crossed inhibits communication. The nurse needs to listen to the client and wait for the client to finish speaking. The client makes independent decisions, and the nurse does not ignore the client's refusal. Reference: Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th ed. Philadelphia: Lippincott Williams & Wilkins, 2014, Chapter 9: Chronic Illness and Disability, p. 146. Chapter 9: Chronic Illness and Disability - Page 146
A nurse is at the end of a busy shift on a medical-surgical unit. The nurse enters a client's room to empty his or her urinary catheter and the client says, "I feel like you ignored me today." In response to the statement, the nurse should: a) sit at the bedside and allow the patient to explain the statement. b) ignore the statement and empty the urinary catheter. c) inform the patient that the unit was very busy that day. d) smile at the patient and apologize.
sit at the bedside and allow the patient to explain the statement. Explanation: Clients might or might not feel able to speak freely to the nurse. Often, the signals indicating their readiness to talk are subtle. Don?t miss valuable opportunities for important communication by approaching clients with a closed mind or focusing on your own needs rather than on the client?s needs. Nurses who lack confidence in their own ability to meet the challenges a client presents might become defensive in response to a client?s comments. Nurse defensiveness is a huge barrier to open and trusting communication. Smiling and apologizing and ignoring the client close lines of communication. Although the unit may have been busy, it is best to listen to the client express themselves. (less) Reference: Taylor, C.R. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2015, Chapter 20: Communication, p. 470. Chapter 20: Communicator - Page 470
Choice Multiple question - Select all answer choices that apply. A nurse is assessing a client who has a rash on his chest and upper arms. Which questions should the nurse ask in order to gain more information about the client's rash? Select all that apply. a) "Have you recently traveled outside the country?" b) "Do you smoke cigarettes or drink alcohol?" c) "Are you allergic to any medications, foods, or pollen?" d) "When did the rash start?" e) "How old are you?" f) "What have you been using to treat the rash?"
• "Are you allergic to any medications, foods, or pollen?" • "What have you been using to treat the rash?" • "Have you recently traveled outside the country?" • "When did the rash start?" Explanation: When assessing a client who has a rash, the nurse should first find out when the rash began; this information can identify where the rash is in the disease process and assists with the correct diagnosis. The nurse should also ask about allergies because rashes related to allergies can occur when a person changes medications, eats new foods, or comes into contact with agents in the air, such as pollen. The nurse needs to find out how the client has been treating the rash because treating the rash with topical ointments or taking oral medications may make the rash worse. The nurse should ask about recent travel because travel outside the country exposes the client to foreign foods and environments, which can contribute to the onset of a rash. Although the client's age and smoking and drinking habits can be important to know, this information won't provide further insight to the rash or its cause. Remediation: Health history interview and physical assessment
Choice Multiple question - Select all answer choices that apply. An eight-year-old client who lost his grandmother a week ago asks his mother about his grandmother's absence. Which of the following statements by the mother could lead to a negative self-concept in the client? Select all that apply. a) "Your grandmother is free from any pain now." b) "Your grandmother will come back in a week." c) "You are not supposed to ask such questions." d) "Your grandmother died because she was not getting better." e) "Did you do something wrong to your grandmother?"
• "Did you do something wrong to your grandmother?" • "Your grandmother will come back in a week." • "You are not supposed to ask such questions." Explanation: If questions in childhood are discounted, met with great anxiety, or answered with misinformation, children may develop a negative self-concept or poor body image. The mother is perpetuating the belief that death is a punishment by saying, "Did you do something wrong to your grandmother?" When the mother says, "Your grandmother will come back in a week," she is misinforming the client. By saying, "You are not supposed to ask such questions," she is discounting the question because of the client's age. By answering, "Your grandmother died because she was sick and was not getting better," the mother shows that she is taking the client's question seriously and is fostering a sense of cause and effect. This will promote positive self-concept. By saying "Your grandmother is free from any pain now," the mother is giving the client encouraging information. This will positively influence his coping process and will strengthen his self-concept. Reference: Taylor, C., et al. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015, p. 1564. Chapter 40: Self-Concept - Page 1564
Choice Multiple question - Select all answer choices that apply. A pregnant client is seeking information from the nurse about a home birth with registered midwives. Which of the following statements lets the nurse know that the client has considered the risks and benefits of using a midwife? Select all that apply. a) "I will develop a list of questions to use in interviewing potential midwives." b) "I will look for an obstetrician because it's hard to find a general practitioner who provides maternity services." c) "I am safer having a home birth with a physician." d) "I understand the complications that could occur in a home birth setting." e) "I realize that I may need to be transferred to a hospital if complications develop."
• "I realize that I may need to be transferred to a hospital if complications develop." • "I understand the complications that could occur in a home birth setting." • "I will develop a list of questions to use in interviewing potential midwives." Explanation: Developing a list of questions, understanding the complications that could occur with a home birth, and realizing that a transfer to a hospital might be necessary all demonstrate that the client has researched a home birth and is aware of the positive and negative factors that could occur. These choices show that the client is approaching the situation in a realistic and educated manner. Looking for an obstetrician and stating that a home birth is safer with a physician are not appropriate answers. Remediation: Prenatal Care
