Chapter 8 Communication

The nurse is collecting health data and avoids using closed-ended questions. Which are examples of closed-ended questions? Select all that apply.

"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 discharging a client and thus terminating the nurse-client relationship. Which action should the nurse perform in this phase?

Examine goals of the relationship to determine whether they were achieved

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?"

A client was recently diagnosed with metastatic lung cancer. The nurse finds the client crying in the room. Which statement made by the nurse best demonstrates the use of empathy?

"I see you are upset. Would you like to talk?"

A nurse is caring for a client experiencing biliary colic from uncomplicated cholelithiasis. The client asks, "My doctor says I should have surgery to remove my gallbladder. Do you think it is really necessary?" What is the nurse's best response?

"Share with me the advantages and disadvantages of your options as you see them."

A nurse is educating staff members about the importance of meeting the spiritual needs of clients on the unit. What spiritual needs should be met in the delivery of care? Select all that apply.

-need for meaning and purpose -need for love and relatedness -need for forgiveness

cognitively impaired

A brain disorder in which thinking abilities are mildly impaired.

In which situation would the SBAR technique of communication be most appropriate?

A nurse is calling a health care provider to report a client's new onset of chest pain.

Which is a skill appropriate to use in therapeutic communication?

Control the tone of the voice to avoid hidden messages.

A nurse is caring for a client admitted to the hospital for dehydration. Which physical findings should the nurse acknowledge as nonverbal communication concerning this diagnosis?

Easy wrinkling of the skin and sunken eyes

Metroprolol

Lopressor Beta Blocker It can treat high blood pressure, chest pain (angina), and heart failure. This may lower the risk of death after a heart attack Common side effects: Headaches Feeling tired, dizzy or weak Cold hands or feet Feeling sick (nausea) Stomach pain

The nurse makes a contract with the client during which phase of the nurse-client relationship?

Orientation Phase

The nurse admits a new client to the unit for elective surgery. What would be the best way for the nurse to facilitate the practice of religion for this client? Choose all that apply.

Roman Catholic

A dialysis nurse is educating a client on caring for the dialysis access that was inserted into the client's right arm. The nurse assesses the client's fears and concerns related to dialysis, the dialysis access, and care of the access. This information is taught over several sessions during the course of the client's hospitalization. Which phase of the working relationship is best described in this scenario?

The working phase

To provide effective nursing care, the nurse should engage in what type of communication with the client and significant others?

Therapeutic Communication

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:

aggressive.

Thoracenthesis

insertion of needle into pleural space, to aspirate fluid, blood or air or inject meds effective if dyspnea is lessened

biliary colic

pain in the gallbladder caused by gallstones obstructing bile flow

An appropriate goal for the client with a nursing diagnosis of Spiritual Distress related to intense pain and suffering as verbalized by the client would be that the client will:

participate in supportive spiritual practices.

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 user. To foster effective communication, the nurse should:

remain honest, open, and frank.

A nurse is attempting to calm an infant in the nursery. The nurse responds to the highest developed sense by:

swaddling the child and gently stroking its head.

Which nursing actions would most likely help improve communication with clients and achieve a more effective helping relationship? Select all that apply.

• The nurse controls the tone of his or her voice so that it conveys exactly what is meant. • The nurse makes statements that are as simple as possible, gearing conversation to the patient's level .• The nurse takes advantage of any available opportunities to communicate information to patients in routine caregiving situations.

nurse is conducting a spiritual assessment on a client recently admitted to the hospital unit. Which questions would be appropriate to ask the client about his religious and spiritual practices? Select all that apply.

"Are there any spiritual practices that you would like to continue while hospitalized?" "Does the present situation interfere with any spiritual or religious practice?" "Is religion a significant part of your life?"

A nurse finds that a client has infiltration around the IV line that needs to be removed. What explanation should the nurse give to reduce the client's anxiety?

"I know that you are anxious, but the IV location needs to be changed."

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?

"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."

A client with a cardiac dysrhythmia was recently prescribed metoprolol and is at a follow-up appointment at the cardiologist's office. The client tells the nurse, "I feel depressed, tired, and I have no desire to exercise." To determine a cause-and-effect relationship, the nurse should ask:

"Were you tired and depressed before starting the new medication?"

Which nurse would most likely be the best communicator?

A nurse who easily develops a rapport with clients

A nurse is completing a health history on a client who has a hearing impairment. Which action should the nurse take first to enhance communication?

Assess how the client would like to communicate

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?

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

Mayocardial Infarction

Condition in which damage accuracy to the muscular tissue of the heart, commonly caused by obstructed circulation; also referred to as a heat attack

A client is diagnosed with diabetes. The client's adult child offers to serve as an interpreter, because the client does not speak the dominant language. Which is the best action for the nurse to take?

Contact a professional interpreter.

A client has cancer, but the significant other does not want the client to know the diagnosis. The nurse demonstrates sensitivity to the significant other and works with the couple to achieve desired outcomes. What kind of behavior is the nurse exhibiting?

Empathy

Which quality in a nurse helps the nurse to become effective in providing for a client's needs while remaining compassionately detached?

Empathy

A nurse is attempting to communicate with a client who speaks a different language and is not fluent in the nurse's language. Which nursing action would best facilitate the communication process?

Speak slowly and distinctly, but not loudly.

A nurse has been caring for a client who had a myocardial infarction 2 days ago. During the morning assessment, the nurse asks the client how the client feels. Which scenario warrants further investigation?

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

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

The nurse is communicating with a client who has been newly diagnosed with cancer. Which statement(s) by the nurse is nontherapeutic? Select all that apply.

You will be OK. Your health care provider is an excellent surgeon." "Keep your chin up. People survive this type of cancer all the time." "Why did you not seek help when you first noticed a problem?"

A nurse is on lunch break in the hospital cafeteria and sits at a table near a group of health care providers eating their lunch. One of the health care providers, who is in charge of the nurse's clients, points at the nurse and states, "That guy needs to get fired." The best response by the nurse would be to:

ask to speak to the health care provider in private and address the disrespectful remark.

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 the nurse has not often performed wound care on a complex wound. Using effective intrapersonal communication, this nurse should:

tell oneself to "remain calm" and remember that the nurse was trained to perform this skill.

When the client tells the nurse that she believes God's reality is personal, and that God is the creator of all beings, the nurse determines the client is expressing:

theism.