CELBAN Listening to Patient Dialogues 3 — Questions and Answers
Question 1: A patient undergoing post-surgical recovery says: 'I think I might be running a fever — I feel really hot and my incision site seems redder than yesterday.' What is the priority nursing action after hearing this?
- Reassure the patient that mild redness is expected after surgery
- Take the patient's temperature and assess the incision site for signs of infection (Correct answer)
- Ask the patient to describe the color more specifically before taking action
- Notify the surgeon immediately without further assessment
Correct answer: Take the patient's temperature and assess the incision site for signs of infection
The nurse must first gather objective data — vital signs and wound assessment — before determining whether escalation is needed.
Question 2: During a care conference, a family member states: 'We want everything done — we can't just let him go.' The patient previously told a nurse he did not want aggressive interventions. What should the nurse do?
- Follow the family's wishes since they are the legal decision-makers
- Defer entirely to the attending physician without contributing to the discussion
- Advocate for the patient's expressed wishes and raise the need to clarify goals of care (Correct answer)
- Ask the family to leave the conference so the team can decide independently
Correct answer: Advocate for the patient's expressed wishes and raise the need to clarify goals of care
Nurses are obligated to advocate for the patient's expressed wishes and facilitate a goals-of-care conversation that honors patient autonomy.
Question 3: A patient newly diagnosed with Type 2 diabetes tells her husband during your assessment: 'I guess I just have to give up everything I enjoy eating.' What does this statement suggest to the nurse?
- The patient has already received thorough dietary counseling
- The patient holds a misconception about diabetes management that requires education (Correct answer)
- The patient is in denial and not ready to engage with her care plan
- The patient's cultural food preferences conflict with medical guidelines
Correct answer: The patient holds a misconception about diabetes management that requires education
The patient's all-or-nothing thinking suggests a misconception; a dietitian referral and education about balanced meal planning are indicated.
Question 4: You hear a pediatric patient tell their parent: 'The nurse gave me a needle but I didn't cry because she told me to squeeze your hand.' What does this dialogue reveal about effective nursing technique?
- Distraction and comfort strategies reduce procedural distress in pediatric patients (Correct answer)
- Parental presence during procedures is discouraged in hospital settings
- Children should not be warned before painful procedures to avoid anticipatory anxiety
- The patient's coping was entirely self-directed without nursing input
Correct answer: Distraction and comfort strategies reduce procedural distress in pediatric patients
The nurse's use of a coping instruction (hand-squeezing as distraction) demonstrates evidence-based non-pharmacological pain management in pediatrics.
Question 5: During shift change report, a nurse states: 'Mr. Chen keeps refusing his evening medications — says they make him feel foggy.' What should the oncoming nurse investigate first?
- Whether Mr. Chen has the cognitive capacity to refuse medication
- The specific medications involved and whether cognitive side effects are documented or expected (Correct answer)
- How to administer the medications without the patient's knowledge
- Whether the physician can order the medications in a different form
Correct answer: The specific medications involved and whether cognitive side effects are documented or expected
Identifying which medications cause fogginess allows the nurse and provider to review the regimen for dose timing changes or alternatives before more complex steps.
Question 6: A patient tells an interpreter during a translated consultation: 'I don't want to tell the doctor everything because I'm afraid they will judge me.' The interpreter relays this verbatim. How should the nurse respond?
- Ask the interpreter to encourage the patient to be more open
- Acknowledge the patient's concern and reassure them that disclosures are confidential and non-judgmental (Correct answer)
- Document that the patient is withholding information and flag for psychiatric review
- Proceed with the assessment using only the information the patient volunteers
Correct answer: Acknowledge the patient's concern and reassure them that disclosures are confidential and non-judgmental
Building trust by validating the patient's fear and affirming confidentiality encourages open disclosure and supports accurate assessment.
Question 7: An elderly patient says quietly to a nurse during bathing: 'My daughter-in-law controls all my money and I'm not allowed to call anyone.' What type of concern does this statement raise?
- The patient is experiencing normal family conflict
- This may indicate financial abuse and/or social isolation requiring a safeguarding assessment (Correct answer)
- The patient needs a social work referral for caregiver respite only
- The nurse should encourage the patient to resolve family issues independently
Correct answer: This may indicate financial abuse and/or social isolation requiring a safeguarding assessment
Statements suggesting financial control and restricted communication are red flags for elder abuse that mandate a safeguarding assessment.
CELBAN Listening to Patient Dialogues 3
A patient undergoing post-surgical recovery says: 'I think I might be running a fever — I feel really hot and my incision site seems redder than yesterday.' What is the priority nursing action after hearing this?