ADN240 "COMMUNICATION" [ISB QUIZ]

The nurse is performing an assessment of the patient's sleep patterns. Which question will elicit the best response?

"Do you awaken during the night?" When gathering information about the patient's sleep patterns, the best questions will be to ask if they awaken during the night.

The nurse employed in a mental health clinic is greeted by a neighbor in a local grocery store. The neighbors ask the nurse, "How is Mary doing? She is my best friend and is seen at your clinic every week." Which is the MOST APPROPRIATE nursing response?

"I can not discuss any patient situation with you." The nurse is required to maintain confidentiality regarding the patient and the patient's care. Confidentiality is basic to the therapeutic relationship and is a patient's right. The most appropriate response to the neighbor is the statement of that responsibility in a direct, but polite manner. A blunt statement that does not acknowledge why the nurse cannot reveal patient information may be taken as disrespectful and uncaring.

The unlicensed nursing assistive person (UAP) reports to the nurse that a patient is crying during a comedy show on television. The nurse's best response should be:

"I will go visit her right away and see what is going on." Validating data is making sure that the data are accurate. As patient information is collected, consistency between subjective and objective data must be confirmed. Confirming the validity of collected data often requires verbally checking with the patient to see whether assumptions or conclusions at which the nurse arrived are correct. Crying, a disheveled appearance, and lack of eye contact may be cues of depression. However, conclusions about the underlying cause of the patient's actions cannot be assumed. All cues need to be interpreted and validated to verify the data's accuracy. The nurse has the responsibility to attempt to determine the real reason for the crying episode.

The nurse is caring for a terminally ill patient whose family is insistent that additional chemotherapy be administered even though the patient will most likely die within the next few days. What is the best response of the nurse?

"The focus right now needs to be on keeping your loved one comfortable." The nurse must function as the patient's advocate and encourage what is in the best interest of the patient. Chemotherapy will not extend the patient's life when death is expected within the next few days and will only make the patient suffer needlessly when it is administered. The patient will not get stronger over the next few days, and this criterion for chemotherapy will never be met.

When the community health nurse visits a patient at home, the patient states, "I haven't slept the last couple of nights." Which response by the nurse illustrates a therapeutic communication response to this patient.

"You're having difficulty sleeping?" The correct option uses the therapeutic communication technique of restatement. Although restatement is a technique that has a prompting component to it, it repeats the patients major theme, which assists the nurse to obtain a more specific perception of the problem from the patient. The remaining options are not therapeutic responses since none encourage the patient to expand on the problem. Offering personal experiences moves the focus away from the patient and onto the nurse.

A patient with a diagnosis of major depression who has attempted suicide says to the nurse, "I should have died! I've always been a failure. Nothing ever goes right for me." Which response demonstrates therapeutic communication?

"You've been feeling like a failure for a while?" Responding to the feelings expressed by a patient is an effective therapeutic communication technique. The correct option is an example of the use of restating. The remaining options block communication because they minimize the patient's experience and do not facilitate exploration of the patient's expressed feelings. In addition, use of the word "why" is non-therapeutic.

A patient admitted to a mental health unit for treatment of psychotic behavior spends hours at the locked exit door shouting. "Let me out. There's nothing wrong with me. I don't belong here." What defense mechanism is the patient implementing?

Denial Denial is refusal to admit to a painful reality, which is treated as if it does not exist. In projection, a person unconsciously rejects emotionally unacceptable features and attributes them to other persons, objects, or situations. Regression allows the patient to return to an earlier, more comforting, although less mature, way of behaving. Rationalization is justifying illogical or unreasonable ideas, actions, or feelings by developing acceptable explanations that satisfy the teller and the listener.

The nursing student is writing a report on the use of nonverbal techniques to encourage therapeutic communication. Which examples should be included in the report? (Select all that apply.)

Providing a backrub Avoiding distracting body movements Remaining silent Facing the patient Providing a backrub is considered therapeutic touch; additional examples include holding a patient's hand and gently touching a patient's arm.Facing the patient and avoiding unusual body movements are active listening techniques.Silence refers to being present with a patient without verbal communication.Facing the patient and avoiding unusual body movements are active listening techniques.

The nurse in the mental health unit recognizes which of the following as therapeutic communication techniques? Select all that apply.

Providing acknowledgment and feedback Restating Maintaining neutral responses Listening Therapeutic communication techniques include listening, maintaining silence, maintaining neutral responses, using broad openings and open-ended questions, focusing and refocusing, restating, clarifying and validating, sharing perceptions, reflecting, providing acknowledgment and feedback, giving information, presenting reality, encouraging formulation of a plan of action, providing nonverbal encouragement, and summarizing Asking why is often interpreted as being accusatory by the patient and should also be avoided. Providing advice or giving approval or disapproval are barriers to communication.

A patient complains that several staff members entered the room during the morning bath without knocking. Which component of professional nursing communication has been violated in this scenario?

Respect Respect for the patient includes providing privacy during procedures such as a bath. It is considered respectful to knock on a patient's door prior to entering the room.