Communication with Family and Caregivers

1. Mr. Laroche, 72, is hospitalized for complications related to COPD. His daughter approaches the LPN in the hallway and says, “I want to know everything about my father’s condition. He never tells me anything, and I need to plan his home care.” When the LPN enters the room, Mr. Laroche states clearly that he does not want his daughter informed about his test results or treatment plan. He says, “I just need to think right now. I’m not ready to involve them.” What is the most appropriate action for the LPN? *
2. Mrs. Kaba, 58, will be discharged tomorrow after surgery for a hip fracture. Her sister, who will be her primary caregiver, looks anxious during teaching. She says, “I’m scared to do something wrong. What exactly am I supposed to do at home? I can’t remember everything.” The patient nods and adds, “Yes, she will help me with most of the things once I go home.” The LPN wants to ensure both understand the care plan. What is the best way to promote shared decision-making? *
3. A 39-year-old patient, Mr. Nguyen, is receiving treatment for newly diagnosed type 2 diabetes. His wife accompanies him to all appointments and often answers questions for him. During today’s education session, the wife begins describing his eating habits, but the patient looks uncomfortable and avoids eye contact. When the LPN asks if he wants his wife present, he hesitates and quietly says, “Maybe… maybe I should talk alone first.”
What should the LPN do to ensure privacy while still supporting family involvement? *
4. Mr. Deveau, 81, has moderate dementia and requires assistance for hygiene and feeding. His daughter often visits and expresses a desire to “take care of him the way he took care of me.” She asks the LPN if she can help give him his evening bath. Mr. Deveau is calm, but when the LPN asks if he is comfortable with the idea, he says, “Maybe… but not the private parts.” His daughter responds, “Mom and I bathed him for years, he won’t mind.” What is the most appropriate action? *
5. A 67-year-old woman, Mrs. Séguin, is in the stroke rehabilitation unit. Her husband attends a teaching session about mobility transfers. He appears exhausted, interrupting the teaching several times with statements such as, “I don’t know if I can do all this at home. I barely sleep anymore.” The patient squeezes his hand and says, “He’s trying, but it’s a lot for him.” The LPN notes early signs of caregiver fatigue. What should the LPN do to support both the patient and caregiver? *
6. Mrs. Desbiens, 74, is hospitalized for heart failure stabilization. During the LPN’s teaching about fluid restriction and daily weights, her adult son keeps interrupting, saying things like, “My mother never follows instructions. She’ll forget all of this anyway.” The patient appears embarrassed, keeps her eyes down, and speaks very little. When the son steps out to take a phone call, Mrs. Desbiens sighs and quietly says, “He means well, but I feel useless when he talks over me.” She adds that she wants to participate in her care decisions. What action best supports the patient’s autonomy? *
7. A 51-year-old woman, Ms. Benali, is recovering from abdominal surgery. Her husband tells the LPN, “I’ll handle all decisions from now on. She stresses too easily. Just talk to me about her care.” However, when the LPN speaks with the patient privately, Ms. Benali says, “I don’t want him to make decisions for me. I want him informed, but I want to choose what happens.” She appears nervous about confronting him. What should the LPN do? *
8. Mr. Comtois, 89, has advanced osteoarthritis and limited mobility. During the LPN’s round, his two daughters begin arguing at the bedside. One insists he should start physiotherapy immediately, while the other argues that “he’s too old and tired and rehab will only hurt him.” Mr. Comtois looks distressed and says softly, “I just want everyone to stop fighting.” The disagreement is interfering with care planning. What is the LPN’s best action to support effective family communication? *
9. A 65-year-old man, Mr. Gravel, recently diagnosed with early-stage Parkinson’s disease, arrives with his wife for an assessment. Each time the LPN asks the patient a question, the wife answers first. She says, “He forgets everything. I’ll just tell you what’s going on.” Mr. Gravel gives short, hesitant answers and looks frustrated. He later tells the LPN, “I can speak for myself. I just talk slower now.” What is the most therapeutic intervention? *
10. A teenage girl, 16, is hospitalized for severe anemia. Her mother wants to remain in the room during every part of the assessment. When the LPN prepares to complete a brief abdominal exam, the patient whispers, “Can I do this part alone? I don’t want my mom to worry more.” The mother insists, “I should be here—she’s a minor.” The teen appears visibly anxious. How should the LPN respond? *