Chapter 8: Communications Prep U

Which guideline should a nurse use when choosing a position (location) in relation to a client during a verbal interaction? a. Choose a position that is no closer than 2 feet, but no farther than 4 feet. b. Assess the client's culture during the initial meeting or assessment. c. The nurse should ask the client where he would like the nurse to position herself and move accordingly. d. Take note of the client's cues when choosing a position and act on these cues.

Take note of the client's cues when choosing a position and act on these cues.

A nurse is caring for a client in a semi-private room. How will the nurse prepare a private environment to discuss the client's plan of treatment? a. Pull the curtain dividing the two beds. b. Direct the client in the other bed to walk in the hallway. c. Bring the client into the hallway to discuss the treatment plan. d. Ask all visitors to leave the room.

Pull the curtain dividing the two beds

The nurse is caring for a client at the end stage of life. The client is crying and states to the nurse, "I just cannot believe I am going to be leaving my children without a parent. I am not ready to go." What response by the nurse demonstrates the expression of empathy to the client? a. "I am so sorry that I am crying with you when you need my support the most." b. "This is so sad and I feel so bad that you are in this situation." c. "This just is not fair at all and I do not understand why this is happening to you." d. "It sounds as though you are most concerned about how your children will feel."

"It sounds as though you are most concerned about how your children will feel."

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? a. "Good morning, I am calling about Mrs. Jones, who is a client of yours." b. "My name is Sue Smith, RN, and I am calling regarding Mrs. Jones in room 356 at Jefferson Hospital." c. "I have a client of yours at Jefferson Hospital who is experiencing a change in condition and needs to be seen immediately!" d. "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."

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? a. "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." b. "I will be by your side throughout the procedure; the procedure will be painless if you don't move." c. "You may feel very uncomfortable when the needle goes in, but you should breathe rhythmically." d. "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."

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: a. "Tell me about the foods you are eating." b. "Have you tried exercising at all in the last week or two?" c. "Were you tired and depressed before starting the new medication?" d. "Do you check your blood pressure and pulse before you take your medication?"

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

During an admission intake assessment, a nurse uses open-ended questions to gather information. An example of an open-ended question is: a. "Do you have an advanced directive or a living will?" b. "What did your health care provider tell you about your need to be admitted?" c. "Are you allergic to any medications?" d. "Can you tell me the medications you take on a daily basis?"

"What did your healthcare provider tell you about your need to be admitted?"

A client reports to a primary health care provider with aggravated chest pain. The health care provider prescribes a stress test. The client tells the nurse about not wanting to take the test and wanting to continue taking medication for now. Understanding that the client is anxious, which action should the nurse take first to provide education needed for this client? a. Instruct the client to find information about the test online. b. Provide the client with an educational booklet about stress tests. c. Tell the client about the stress test procedure. d. Ask the client "What has your health care provider shared with you about stress tests?"

Ask the client, "What has your health care provider shared with you about stress tests?"

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? a. Contact a person skilled in sign language b. Assess how the client would like to communicate c. Provide paper and pencil for written communication d. Use facial and hand gestures

Assess how the client would like to communicate

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? a. Provide paper and pencil for written communication b. Assess how the client would like to communicate c. Use facial and hand gestures d. Contact a person skilled in sign language

Assess how the client would like to communicate.

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? a. Sympathy b. Pity c. Empathy d. Indifference

Empathy

The nurse is visiting a hospice client in the client's home. The client is explaining difficulties with a home infusion pump. By making statements such as "I see" and "go on" during the conversation, the nurse is using which therapeutic nurse-client communication technique? a. Clarification b. Encouraging elaboration c. Restating d. Reflection

Encouraging elaboration

The nurse observing an interaction between a mother and her child appropriately identifies the interaction as which communication zone? a. Intimate b. Public c. Social d. Personal

Intimate

The nurse makes a contract with the client during which phase of the nurse-client relationship? a. Orientation phase b. Intimate phase c. Termination phase d. Working phase

Orientation phase

The nurse makes a contract with the client during which phase of the nurse-client relationship? a. Orientation phase b. Working phase c. Termination phase d. Intimate phase

Orientation phase

When caring for a psychiatric client, a nurse would make a formal contract with the client during which phase of the nurse-client relationship? a. Working phase b. Termination phase c. Intimate phase d. Orientation phase

Orientation phase

The nurse meets with the client to teach self-administration of low molecular weight heparin. During the initial part of the training the client shakes the head and asks the nurse to repeat the instructions. What action demonstrates that the nurse has assessed the client's communication abilities? a. The nurse continues with the instructions and makes a mental note to repeat the initial instructions at the end of the training. b. The nurse stops the instruction and tells the client that a call will be placed to the health care provider to get an order to have a home health nurse administer the medication. c. The nurse faces the client, speaks slowly and clearly, and demonstrates the procedure using a needleless syringe. d. The nurse asks the client if he or she is worried about giving oneself an injection.

The nurse faces the client, speaks slowly and clearly, and demonstrates the procedure using a needleless syringe.

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: a. ask if the client realizes the infection is a direct result of the drug use. b. consult with the social worker regarding inpatient drug rehabilitation. c. ask the client for a urine specimen for urine drug use screening. d. remain honest, open, and frank.

remain honest, open, and frank

A nurse is at the end of a busy shift on a medical-surgical unit. The nurse enters a room to empty the client's urinary catheter and the client says, "I feel like you ignored me today." In response to the statement, the nurse should: a. inform the client that the unit was very busy that day. b. sit at the bedside and allow the client to explain the statement. c. ignore the statement and empty the urinary catheter. d. smile at the client and apologize.

sit at the bedside and allow the client to explain the statement

Paramedics arrive in the emergency department with a client who was in a motor vehicle collision. The paramedic reports that the driver was restrained, the car was traveling about 30 miles per hour (48 km/hr), and the air bags were not deployed. The paramedic continues to report that the car was struck from behind and that all individuals in the car were able to self-extricate. Which statement made by the nurse is verifying the report from the paramedic? a. "Was there any cracking of the windshield?" b. "Were there any fatalities in the other vehicle?" c. "Did a police officer take a report at the accident scene?" d. "All of the people got themselves out of the car?"

"All of the people got themselves out of the car?"

The nurse is caring for a postoperative client who refuses a blood transfusion due to religious beliefs. The nurse is demonstrating trustworthiness when taking which action in response to the client's treatment wishes? a. asking the client's family to discuss the importance of the prescribed treatment with the client b. recommending assessment of the client's cognitive capacity to make health care decisions c. explaining the health consequences of refusing to undergo the prescribed treatment d. contacting the interprofessional care team to discuss alternative treatment options

Contacting the interprofessional care team to discuss alternative treatment options.

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: a. inform the client that several nurses will be needed to care for this wound. b. tell the unlicensed assistive personnel (UAP) to gather supplies and to prepare to cleanse and dress the wound. c. ask the charge nurse to change the assignment. d. tell oneself to "remain calm" and remember that the nurse was trained to perform this skill.

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

A nurse is caring for an older adult client hospitalized following a hip fracture. Which action(s) by the nurse will promote the development of a therapeutic relationship? Select all that apply a. talking with another nurse during a bedside change of shift report b. addressing the client by the client's first name assisting the client with the completion of all activities of daily living c. encouraging the client to talk about the client's life d. asking the client when the client would like to have the bed linens changed

c. Encouraging the client to talk about the client's life d. Asking the client when the client would like to have the bed linens changed.