Deck 16: Strategies for Working With Special Student Situations

Question 1

In working with a challenging student situation the clinical nursing instructor should

A) refer the student to the program coordinator so the instructor can focus her efforts on the other students in the clinical group
B) attempt to diagnose what might be the underlying factors prompting the student's behavior so that these can be addressed
C) disregard the behavior since it probably reflects this student's way of coping with a new situation
D) confront the student during the clinical post-conference by describing her behavior and its effects on the teaching-learning process
E) quietly counsel the student to consider withdrawing from the nursing program since her behavior indicates that she does not want to be there

Answer 1

B
attempt to diagnose what might be the underlying factors prompting the student's behavior so that these can be addressed. Most behavioral problems can be handled by the clinical nursing instructor; referral to the program coordinator should be reserved for behavior that might lead to a student's failure in the clinical component of the course or could be grounds for dismissal from the program. Behavior that interferes with the instructional process needs to be investigated rather than ignored. Communications with the student regarding her behavior should be conducted in private. The instructor should not counsel a student to withdraw from the program nor make assumptions about the meaning of her behavior.

Question 2

Dishonest student behaviors that may be encountered in the course of clinical instruction include

A) using portions of a published nursing care plan without citing the source
B) lying about attending an off-unit experience
C) documenting administration of a treatment when the treatment was not done
D) all of these
E) only b and c

Answer 2

D
all of these.

Question 3

You have assigned Susan to care for a 28-year-old male who was severely burned in a car accident and is undergoing reconstructive surgery. When you enter the patient's room to check on Susan's progress in completing the patient's morning care, Susan is sitting on the patient's bed and kissing him. The patient seems to be actively engaged in the kiss. Which of the following would be your most appropriate response to this situation?

A) Withdraw quietly from the doorway and document the episode in an anecdotal note you will give to Susan the next day.
B) Wait until Susan is out of the patient's room, then confront her in the hallway and send her home for the day.
C) Call Susan out of the room, taking her to a private conference area to discuss the behavior you witnessed and why it was inappropriate.
D) Kick yourself for making this particular assignment and avoid assigning young female students to take care of young male patients in the future.
E) Enter the room, clear your throat loudly, and ask Susan to explain her behavior in front of the patient.

Answer 3

C
Call Susan out of the room, taking her to a private conference area to discuss the behavior you witnessed and why it was inappropriate. Inappropriate behavior needs to be interrupted and dealt with immediately but communications with the student need to be done in private.

Question 4

The clinical nursing instructor should exercise caution when she suspects that a student may have a learning disability. Her best approach is to

A) request that the student be tested and a report on findings be sent to the instructor as well as to the program coordinator
B) say nothing to the student since she is protected under the Americans with Disabilities Act
C) discuss her observations with the student to elicit information concerning any difficulties she encounters in learning so that these can be addressed
D) avoid challenging the student by giving her assignments that are less complex than those of other students in the group
E) increase her supervision of this student as she may pose a risk to patient safety

Question 5

The accommodation most frequently needed by a student with a physical disability is

A) more time to complete assignments
B) a nursing assistant assigned to complete physical work under the disabled student's direction
C) guidance in planning nursing care activities
D) off-unit observational experiences that enable her to develop clinical reasoning skills
E) none of these, as accommodation will always be unique to the individual

Question 6

A student in your clinical group seems very lethargic during pre-conference. You suspect she may have a hangover, since binge drinking has been a big problem on campus this year. When you talk with the student privately she tells you that she has recently been given a prescription for Xanax for her anxiety and depression. What action, if any, should you take regarding the student?

A) Insist that the student produce a copy of the prescription to prove that she has not been drinking.
B) Suspect that the student is lying and call security to escort her off the unit, suggesting to them that her blood alcohol level be evaluated.
C) Allow the student to continue with her clinical assignment since her lethargy is probably a side effect of the prescribed medication.
D) Require the student to remain off the unit until side effects of the medication are better controlled, providing for an alternate assignment.
E) Ask the student to explain the source of her anxiety to justify her need for this medication.

Question 7

A student's defiant or uncivil behavior can quickly move into violence if not managed properly at the outset. Which of the following is the most appropriate response by the clinical nursing instructor?

A) Attempt to defuse the situation with humor, indicating that you do not take the student's behavior seriously.
B) Explain your rationale for your constructive criticisms concerning the student's clinical work, which seem to have triggered her behavior.
C) Refuse to engage the student in a power struggle by ignoring her behavior.
D) Speak assertively to the student in a voice only slightly louder than hers.
E) None of the above.

Question 8

One of the students in your group is a 36 year-old male who is returning to the nursing program after a hiatus of five years due to a family situation. He tells you that he doesn't think he should have to repeat this clinical since he passed this clinical when he was in the program previously. What is the best way to manage this student's assignments?

A) Make assignments that are equivalent to those of other students, holding him to the same standards as others.
B) Make assignments that are equivalent to those of other students, raising the standards used to evaluate his performance.
C) Make assignments that are more difficult than those of other students to prove to him that he has a lot to learn.
D) Make assignments that are easier than those of other students, since this student will take some time to get used to being back in the program.
E) Ask this student to be a peer instructor in order to capitalize on his past experience in the clinical rotation.

Question 9

The student from another culture presents a challenge to the clinical nursing instructor who must

A) provide an interpreter during clinical conferences
B) avoid making assumptions about the meaning of the student's non-verbal behavior
C) expect that the student will develop her own way of successfully completing clinical assignments
D) give this student more time to complete her assignments
E) both b and d

Question 10

Which of the following approaches to teaching in the clinical area is likely to be successful when working with the student for whom English is a second language?

A) encourage the student to use a bilingual medical dictionary as needed
B) enhance contextual cues when presenting difficult-to-understand materials by citing clinical examples
C) give greater weight to this student's written work than to her verbal communications to compensate for her difficulty in using English
D) give greater weight to this student's verbal communications to underline the need for the student to master the English language
E) both a and b