Chapter 20 Communicator

The nurse is collecting health data and avoids using closed-ended questions. Which are examples of closed-ended questions? (Select all that apply.) "Is there any chance you might be pregnant?" "Are you ready to get out of bed?" "What sorts of things do you do for fun?" "Do you smoke cigarettes?" "Does it hurt when I touch you here?" "What plans do you have after you are discharged?"

"Are you ready to get out of bed?" "Do you smoke cigarettes?" "Is there any chance you might be pregnant?" "Does it hurt when I touch you here?"

A nurse is discussing cataract treatment with a client. Which statement by the nurse would be most therapeutic? "Have you ever thought of laser surgery?" "My grandfather also benefited from laser surgery." "Why don't you try laser surgery?" "You should try laser surgery."

"Have you ever thought of laser surgery?"

A nurse is asking a colleague about a situation. Which statement demonstrates assertive communication? "Why are you treating me this way?" "I think there is a better way to handle this." "You always act like this." "What is your problem with me?"

"I think there is a better way to handle this."

A nurse has developed strong rapport with the wife of a client who has been receiving rehabilitation following a debilitating stroke. The wife has just been informed that her husband will be unlikely to return home and will require care that can only be provided in a facility with constant nursing care. The client's wife tells the nurse, "I can't believe it's come to this." How should the nurse best respond? "Do you understand that everyone here has your husband's best interest at heart?" "What would help you accept that this is best for both of you?" "This must be very difficult for you to hear. How do you feel right now?" "Why do you think that the care team has made this recommendation?"

"This must be very difficult for you to hear. How do you feel right now?"

A nurse is assessing vital signs on a pregnant client during a routine prenatal visit. The client states, "I know labor will be so painful, it sounds awful. I am sure I will not be able to stand the pain; I really dread going into labor." What is the best response from the nurse? "You're worried about how you will tolerate the pain associated with labor." "I would recommend keeping a positive attitude." "There are many good medications to decrease the pain; it will not be so bad." "Don't worry about labor, I have been through it and it is not so bad."

"You're worried about how you will tolerate the pain associated with labor."

A nurse is completing a health history with a newly admitted client. During the interview, the client presents with an angry affect and states, "If my doctor did a good job, I would not be here right now!" What is the nurse's best response? Nod and say, "I agree. If I were you, I would get a new doctor." Stand and say, "I can see this interview is making you uncomfortable, so we can continue later." Smile and say, "Don't worry, I am sure the physician is doing a good job." Be silent and allow the client to continue speaking when ready.

Be silent and allow the client to continue speaking when ready.

A family has lost a member who was treated for leukemia at a nursing unit. The nurse provides emotional support to the family and counsels them to cope with their loss. Which quality should the nurse use in this situation? Empathy Sympathy Indifference Pity

Empathy

Which qualities in a nurse help the nurse to become effective in providing for a client's needs while remaining compassionately detached? Commiseration Empathy Sympathy Kindness

Empathy

When assessing a client's nonverbal communication, the nurse will assess which characteristic as the most expressive part of the body? Eye contact Posture Facial expressions Hand gestures

Facial expressions

It is important for the nurse to empathize with the client to develop a positive, therapeutic relationship. What is a characteristic of empathy? Identifying with the client's feelings Experiencing feelings similar to that of the client Conveying genuine care to the client Caring for the client without negative judgment

Identifying with the client's feelings

The nurse and the physical therapist discuss the therapy schedule and goals for a client on a rehabilitation unit. What type of communication is occurring between the nurse and the therapist? Interpersonal Intrapersonal Small-group Organizational

Interpersonal

A home care nurse discusses with a client when visits will occur and how long they will last. In what phase of the nurse-client relationship is this type of agreement established? Orientation phase Termination phase Working phase All of the above

Orientation phase

The nurse is reporting to an oncoming nurse about the care of a client using the SBAR format. The nurse informs the oncoming nurse that the client should continue to have neurolgoical checks every 2 hours and the nurse should report any alterations to the health care provider. In which section should this information be relayed? Recommendation Assessment Situation Background

Recommendation

A nurse has been caring for a client who suffered a myocardial infarction 2 days ago. During the morning assessment, the nurse asks the client how he feels. Which scenario warrants further investigation? The client looks at the nurse and states, "I am still not feeling my best." The client smiles at the nurse and states, "I cannot wait to go home." The client stares at the floor and states, "I feel fine." The client is sitting in a chair and states, "I feel a lot better than I did yesterday.

The client stares at the floor and states, "I feel fine."

A nurse who is caring for newborn infants delivers care by utilizing the sense that is most highly developed at birth. Which example of nursing care achieves this goal? The nurse wears colorful clothing to stimulate the infant. The nurse gently strokes the baby's cheek to facilitate breastfeeding. The nurse plays "peek-a-boo" with the infant. The nurse speaks to the infant in a loud voice to get attention.

The nurse gently strokes the baby's cheek to facilitate breastfeeding.

A nurse during orientation notices that the preceptor gives all subcutaneous injections on a 45-degree angle. When the new nurse asks the preceptor the rationale for the practice the preceptors states, "This is how I do it, and this is how you will do it." The new nurse recognizes this behavior to be: nurturing. passive. aggressive. assertive.

aggressive.

A nurse communicating with a client states, "I will be changing your dressing, but we have plenty of time to talk first." She is already wearing sterile gloves and a mask and is busy working with her back to the client. The nurse is conveying: a functional focus. a therapeutic relationship. a congruent relationship. an incongruent relationship.

an incongruent relationship.

When documenting client care, the nurse understands that the most important reason for correct and accurate documentation is: assisting in organization of care. conveying information. noting the client's response to interventions. legal representation to care.

conveying information.

A unit-based infection control task force was developed in an attempt to reduce catheter-acquired infections. The group consists of 10 team members. During the past three meetings, one person dominated the meeting and did not allow other members ample time to speak. The best way to address the team dysfunction is to: have group members issue a written warning to the dominant member. have group members confront the dominant member to promote the needed team work. pick a team leader who is not the dominant member. plan a meeting where the dominant person cannot attend.

have group members confront the dominant member to promote the needed team work.

A nurse who has been caring for a client for the past few days is preparing the client for discharge and termination of the nurse-client relationship. Which activity would the nurse be carrying out? establishing trust and rapport attending to physical health care needs developing solutions that are enacted reviewing health changes

reviewing health changes

Nurses use social media to share ideas, develop professional connections, access educational offerings and forums, receive support, and investigate evidence-based practices. What is an example of the proper use of social media by a nurse? A nurse posts pictures of a client who accomplished a goal of losing 100 pounds and later deletes the photo. A nurse describes a client on Twitter by giving the client's diagnosis rather than the cl'sient's name. A nurse describes a client on Twitter by giving the room number rather than the name of the client. A nurse uses a disclaimer to verify that any views expressed on Facebook are his or hers alone and not the employer's.

A nurse uses a disclaimer to verify that any views expressed on Facebook are his or hers alone and not the employer's.

A nurse is providing care to a 3-year-old child admitted with a diagnosis of infectious diarrhea. The nurse needs to insert an intravenous catheter in order to administer prescribed intravenous fluids. In an attempt to foster communication, the nurse should: involve the child's stuffed animal in the educational session. provide both verbal and written information to the child. ask the child's parents to leave the room while the nurse and child talk. show the child the intravenous catheter and explain how it works.

involve the child's stuffed animal in the educational session.

A 70-year-old female client had a cholecystectomy four days ago. The client's daughter tells the nurse, "My mother seems confused today." Which question would be best for the nurse to ask the client in order to assess the her orientation? "What day of the week is it?" "Is your name Evelyn?" "Are you in a hospital?" "Is today the first day of the month?"

"What day of the week is it?"

The nurse is performing an admission interview with a new client diagnosed with acute coronary syndrome. For the nurse to obtain information and allow the client free verbalization, which question would elicit the most information? "Have you ever had chest pain prior to this admission?" "Did you take any medication when you had the pain?" "I have had chest pain before, and it is really scary!" "Could you tell me more about how you are feeling right now?"

"Could you tell me more about how you are feeling right now?"

During an assessment of a newly admitted client the nurse asks the client many questions. The nurse begins the assessment by asking, "How many times have you been hospitalized this year for your back pain?" This is an example of which type of question? Reflective question Open-ended question Closed question Sequencing question

Closed question

A male client has always prided himself in maintaining good health and is consequently shocked at his recent diagnosis of diabetes. The nurse has asked the client, "How do you think your diabetes is going to affect your lifestyle?" The nurse has utilized which of the following interviewing techniques? Open-ended question Reflective question Closed question Validating question

Open-ended question

A nurse is preparing to provide discharge instructions to a postpartum client regarding infant care. Before beginning the education session, the nurse should: ask the client's partner to leave the room to allow the client to focus. eliminate as many distractions as possible. ask the client if she is able to read. ask all visitors to leave the room.

eliminate as many distractions as possible.

Several nurses on the same hospital unit communicate on the same social networking site. A nurse posts the following statement to the social networking page, "The lady in room 34 with heart failure was a train wreck!" This statement: is unacceptable because the diagnosis of heart failure was listed. is unacceptable and breaches the client's confidentiality rights. is acceptable because the hospital's name was not mentioned. is acceptable because the client's name was not used.

is unacceptable and breaches the client's confidentiality rights.

A nurse is caring for a client admitted to the hospital for dehydration. The physical findings consistent with the diagnosis include: pallor and diaphoresis. slow heart rate and prolonged capillary refill. easy wrinkling of the skin and sunken eyes. cold intolerance and brittle nails.

easy wrinkling of the skin and sunken eyes.

An experienced nurse has been working with a client with heart failure. The client's lungs were clear to auscultation during the morning assessment; however, the afternoon assessment revealed bibasilar crackles and tachypnea. The nurse calls to give SBAR report to the covering health care provider. In the final step of the report the nurse should: recommend 40 mg of furosemide be administered because the client had improvement with past administration. provide detailed findings of the head-to-toe assessment. discuss the client's situation and request a chest x-ray to assess lung function. detail the client's past medical history and active medication orders.

recommend 40 mg of furosemide be administered because the client had improvement with past administration.

A nurse is caring for a client who presents with a skin infection. While obtaining the client's medical history, it is determined that the client is an intravenous drug abuser. To foster effective communication, the nurse should: remain honest, open, and frank. ask the client for a urine specimen for urine drug abuse screening. ask if the client realizes the infection is a direct result of the drug abuse. consult with the social worker regarding inpatient drug rehabilitation.

remain honest, open, and frank.

A nurse enters a client's room to complete an admission history. The nurse will convey interest in the client's story if the nurse: asks all visitors to leave the room. stands at the foot of the bed and maintains constant eye contact. sits at the client's bedside and faces the client. holds the medical record while sitting at the bedside and crossing the legs.

sits at the client's bedside and faces the client.

A nurse is attempting to calm an infant in the nursery. The nurse responds to the highest developed sense by: offering the neonate infant formula. softly humming a song near the neonate. staring into the neonate's eyes and smiling. swaddling the child and gently stroking its head.

swaddling the child and gently stroking its head.

A nurse is caring for a client who is newly diagnosed with terminal cancer. The nurse enters the client's room and finds the client sitting in the dark crying. Which statement conveys empathy by the nurse? "I know this is hard for you. Is there any way I can help?" "Sitting in the dark is not going to cure your cancer. Let's open the curtains." "Can you please tell me why you are crying?" "I am so sorry you are going through this. Can we talk?"

"I know this is hard for you. Is there any way I can help?"

A nurse is obtaining a history from an adult female client. When the nurse asks how many times the client has been pregnant, the client answers, "I have four kids." Which statement, made by the nurse, seeks clarification of the original question? "I understand you have four kids; how many times have you actually been pregnant?" "All right, you have four children, is that correct?" "Were these term births?" "How old are your children?"

"I understand you have four kids; how many times have you actually been pregnant?"

A nurse is caring for a client with depression. The nurse finds that the client is withdrawn and does not communicate with others. What is the most appropriate response by the nurse? "Did you sleep well last night?" "I guess you don't feel like talking today." "Is that a new shirt you're wearing?" "Did you like the dinner yesterday?"

"Is that a new shirt you're wearing?" When the client is not talking, the nurse should use the observation technique of therapeutic communication. The nurse should complement the client to get his attention. Wearing a new shirt is an observation about the client that would draw communication from him. The nurse should avoid direct questions to a client who is experiencing depression.

A nurse is calling a physician to communicate a change in the client's condition. According to the ISBARR format for handoff communication among health care personnel, which is the most appropriate way to begin the conversation? "I have a client of yours at Jefferson hospital experiencing a change in her condition and needs to be seen immediately!" "My name is Sue and I am calling about Mrs. Jones, a client of yours at Jefferson hospital." "My name is Sue Smith, RN and I am calling regarding Mrs. Jones in room 356 at Jefferson hospital." "Good morning, I am calling about Mrs. Jones who is a client of yours."

"My name is Sue Smith, RN and I am calling regarding Mrs. Jones in room 356 at Jefferson hospital."

A client is scheduled for thoracentesis. The nurse assesses that the client appears anxious about the procedure and needs honest support and reassurance. What is the most appropriate response by the nurse to this client? "I will be by your side throughout the procedure; the procedure will be painless if you don't move." "The needle causes discomfort or pain when it goes in, but I will be by your side throughout and will help you hold your position." "You may feel very uncomfortable when the needle goes in, but you should breathe rhythmically." "The procedure may take only 2 minutes, so you might get through it by mentally counting up to 120."

"The needle causes discomfort or pain when it goes in, but I will be by your side throughout and will help you hold your position."

Which of the following nurses most likely is the best communicator? A nurse who is proficient in sign language. A nurse who easily developed a rapport with clients. An advanced practice nurse. A nurse who is bilingual.

A nurse who easily developed a rapport with clients.

A female nurse states the following to another nurse who is constantly forgetting to wash her hands between clients: "It looks like you keep forgetting to wash your hands between clients. It's really not safe for your clients. Let's think of some type of reminder we can use to help you remember." This communication is an example of what type of speech? Therapeutic Assertive Nonassertive Aggressive

Assertive

Nurses on a hospital burn unit meet as a group to discuss procedures. Which statements accurately describe the functions of group dynamics? Select all that apply. Ideally, the group will select a leader who alone uses her talents and interpersonal strengths to assist the group to accomplish goals. The group's ability to function at a high level depends on only the group leader's sensitivity to the needs of the group and its individual members. If a group member dominates or thwarts the group process, the leader or other group members must confront her to promote the needed collegial relationship. In an effective group, power is used to "fix" immediate problems without considering the needs of the powerless. In an effective group, members support, praise, and critique one another. Effective groups possess members who elicit mutually respectful relationships.

Effective groups possess members who elicit mutually respectful relationships. If a group member dominates or thwarts the group process, the leader or other group members must confront her to promote the needed collegial relationship. In an effective group, members support, praise, and critique one another.

A nurse gives a speech on nutrition to a group of pregnant women. What is the speech itself known as? Channel Message Source Stimulus

Message

A nurse enters the client's room and introduces himself stating, "Hello, Mr. Alonso. My name is Anthony Bader. I will be your registered nurse today. I will be providing your nursing care and I will be with you until 3:30 PM. If you need anything, please call me on my phone or put your light on." He then gives the client a printed card with this information. In the helping relationship, what does this represent? Intimate phase Termination phase Working phase Orientation phase

Orientation phase

The nursing instructor is discussing communication with a student. The student identifies that a contract is made with the client during which phase of the nurse-client relationship? Intimate phase Working phase Termination phase Orientation phase

Orientation phase

A nurse is communicating the plan of care to a client who is cognitively impaired. Which nursing actions facilitate this process? Select all that apply. The nurse shows patience with the client and gives the client time to respond. The nurse communicates in a busy environment to hold the client's attention. The nurse gives lengthy explanations of the care that will be given. The nurse maintains eye contact with the client. The nurse keeps communication simple and concrete. If there is no response, the nurse does not repeat what is said and takes a break.

The nurse maintains eye contact with the client. The nurse shows patience with the client and gives the client time to respond. The nurse keeps communication simple and concrete.

An evening shift nurse is caring for a client scheduled for a colon resection in the morning. The client tells the nurse she is afraid of waking up during surgery. The best response by the nurse is to: ask the client why she thinks she will wake up during surgery. ask the surgeon to come to the bedside to reassure the client. look directly at the client and state, "you are afraid of waking up during surgery." state "everyone is afraid of that."

ask the client why she thinks she will wake up during surgery.

A graduate nurse has been working on a telemetry unit for 6 months. The nurse arrives at work in the morning and overhears a night shift nurse talking about the graduate nurse. The night shift nurse is heard saying, "That new nurse is only here to meet a doctor and get married." The best response by the new nurse would be to: approach the night shift nurse and tell her that she is "out of line." ask to speak to the night shift nurse in private and explain how the comment made her feel. ignore the comment and begin her shift. call hospital security and ask them to take a report.

ask to speak to the night shift nurse in private and explain how the comment made her feel.

A pregnant female client presents to the emergency department with vaginal bleeding. A transvaginal ultrasound is performed and the health care provider informs the client that there are normal fetal heart tones noted on the study. When the nurse observes the client's facial expression, she is: gathering information necessary to treat the client. implementing the plan of care. identifying desired outcomes and a plan to meet them. evaluating the client's nonverbal response to the findings.

evaluating the client's nonverbal response to the findings.

A nurse is caring for a client who suffered a spinal cord injury and has paraplegia. The client is frustrated, crying, and tells the nurse, "I just want to die." The nurse best displays empathy when she: says, "I am so sorry this happened to you." says, "I can only imagine how hard this is on you. How can I help you?" places a warm blanket over the client's legs. leaves the room quietly and silently.

says, "I can only imagine how hard this is on you. How can I help you?"

A nurse is preparing to enter a client's room to perform wound care. The shift report revealed that this client has a tunneling wound in the sacral area that cannot be staged. The wound was also documented as having a foul odor. The nurse is nervous because she has not performed wound care on a complex wound in the past. Using effective intrapersonal communication, this nurse should: ask the charge nurse to change her assignment. tell herself to "remain calm" and remember that she was trained to perform this skill. inform the client that several nurses will be needed to care for this wound. tell the unlicensed assistive personnel (UAP) to gather supplies and to prepare to cleanse and dress the wound.

tell herself to "remain calm" and remember that she was trained to perform this skill.