One quiz question I am struggling with

[PennyNickelDime_RN]

Hi,

I am finishing up a OB quiz and am stuck on one question. The question is: A 16-year-old is making her first prenatal visit to the clinic in her fourth month of pregnancy. The nurse's first responsibility would be to:

a. contact the social worker

b. develop a trusting relationship

c. schedule the client for prenatal classes

d. teach the client about proper nutrition

I have ruled out a and c and am trying to decide between b and d. I'm hung up on the phrase FIRST responsibility. It would seem to me that developing trust would be good to help ensure that the teen would follow through with appointments etc, but emphasis on maternal nutrition is also extremely important. It comes down to picking the most correct answer. Any suggestions?

Thank you :monkeydance:

[CTstudent]

I was just reading my Fundamentals book on the chapter "Patient Teaching" and came across this: "Establish rapport and develop trust before beginning teaching and maintain a warm, sincere attitude".

I immediately thought of this question on the board.

[jill48, ASN, RN]

I was just reading my Fundamentals book on the chapter "Patient Teaching" and came across this: "Establish rapport and develop trust before beginning teaching and maintain a warm, sincere attitude".

I immediately thought of this question on the board.

So then, is the answer B?

[Beary-nice]

I say "B" because as others have said you have to develop trust to then teach. I would also think trust would be important because we would want this person to continue coming back and not falling through the cracks.

[jill48, ASN, RN]

I say "B" because as others have said you have to develop trust to then teach. I would also think trust would be important because we would want this person to continue coming back and not falling through the cracks.

Beary-nice, fun with steaks is cracking me up.:rotfl: :rotfl: :rotfl:

[LaceyRN]

I pick answer B.

Just finished 1st semester of school and took therapeutic communication. Both my fundamentals class and TC taught that patient trust comes first before teaching. The establishment of a trusting nurse-client relationship preceeds teaching, not the other way around. If the patient does not have trust in the nurse, any attempt at teaching is futile.

p.s. I think Maslow applies to prioritizing nursing diagnoses, not the nurse-client relationship.

I am reviewing for my cummulative final and came across the answer, I think so anyway! The topic is Nursing Assessment and the order is:

1. gather data

2. establish relationship

3. Identify problems

4. Establish a base (cluster data, nursing diagnosis)

5. Evaluate Outcomes (Interventions)

We are always taught that nurses are to ASSESS first, so based upon this info in my textbook, the next step (nurses 1st priority in our original question) is to establish a relationship, then Identify problems, diagnose, implement (in our case it would be teaching about nutrition.)

Soooo whadda think? Have I made a persuasive case for answer B?

[labman]

Like a lot of others I choose B. If you do not get a trusting relationship you will not get very far with the patient like teaching about nutrition!

[jjjoy, LPN]

double post

[jjjoy, LPN]

I agree that B is the correct answer for previously noted reasons. However, I think this is poorly written question. Answer B straight out states that it's the nurse's first responsibility to develop a trusting relationship... I'd say that it's the nurse's responsibility to attempt to establish a trusting relationship, but the nurse can't control whether or not such a relationship develops. The teen might not be ready to trust no matter how empathetic and trustworthy the nurse may be. It might take several visits for that kind of relationship to develop, if at all. Meanwhile, does this mean that the nurse doesn't attempt to provide the teen with information or health care? Of course not!

[JesL2bRN2007]

I would say B, to esablish a trusting relationship FIRST and THEN D. *shrugs

[jill48, ASN, RN]

:thankya: :thankya: :thankya: That was fun.

[Finally2008]

I feel like I'm standing outside our classroom after an exam....we always debate why OUR answer is the correct one.

Well, will we ever get the correct answer???

[pegbord]

B, establishing trust. Is true that according to Maslow, answer would seem to be D, but Maslow doesn't state "proper nutrition" - just that access to food is more important than psychosocial. So this 16 year old likely has access to food (likely not choosing the food that is best for her and her baby, which is why she needs teaching on this topic). Before the patient is willing to change dietary habits, she has to trust that you have her and her baby's best interest at heart.

That's my rationale. . . . Dying for the OP to post the correct anwer!!!!