Communications Quiz and Final

A nurse is caring for a client who had a spontaneous miscarriage at 9 weeks of gestation. The nurse walks into the client's room and finds her crying uncontrollably. Which of the following statements should the nurse make? A. "It is hard to deal with the loss of a pregnancy. Here is the number of a local support group that you can attend." B. "When a pregnancy ends spontaneously, there is often something wrong with the fetus." C. "You are young and will have other children." D. "The best thing for you is to go home and relax."

A. "It is hard to deal with the loss of a pregnancy. Here is the number of a local support group that you can attend." This is a therapeutic response because the nurse is offering empathy and providing information regarding a support network that the client can access.

A nurse is caring for an older adult client who dies during the night while his partner is at his side. The partner says, "I can't believe he's gone." Which of the following responses should the nurse make? A. "It must be hard to accept that this has happened." B. "His suffering is over now and he is in a better place." C. "Would you like to take his personal items home with you?" D. "He lived a long and full life."

A. "It must be hard to accept that this has happened." This is a therapeutic response because the nurse is restating what the client has said, which allows the partner to hear what the nurse has received from her communication.

A nurse is caring for a client who has Type 1 diabetes mellitus and is to receive hemodialysis. The client says, "I don't even know why I'm doing this. There is no cure." Which of the following statements should the nurse make? A. "It sounds as though you have given up." B. "Dialysis will help you live longer." C. "You shouldn't complain. You are fortunate to have this option available to you." D. "Let's talk about what you are going to do after dialysis today."

A. "It sounds as though you have given up." The nurse is using the therapeutic communication technique of restatement to encourage the expression of feelings.

A nurse is caring for a 13-year-old female client who is admitted for an emergency appendectomy. While the nurse is providing the preoperative teaching, the client asks, "Will I have a large scar from the surgery?" Which of the following responses should the nurse make? A. "It will be small enough that it won't show when you're wearing a bathing suit." B. "That isn't our biggest concern right now. You will be fine." C. "You should be happy. You won't be in pain for much longer." D. "What is your favorite class in school?"

A. "It will be small enough that it won't show when you're wearing a bathing suit." This is a therapeutic response because the nurse is providing information specific to the client's concern. The nurse recognizes that body-image is an important issue for adolescents. This response allays fears that the client might be having.

An emergency department nurse takes a telephone call from a client who states, "I have just taken 100 amitriptyline tablets to kill myself." The client is crying and says, "I want to die. I have no reason to live." Which of the following responses should the nurse make? A. "Please stay on the phone with me so we can talk about your feelings." B. "Why do you think you have no reason to live?" C. "How do you feel about what you have just done?" D. "I'm sure things are not as bad as they seem to you now."

A. "Please stay on the phone with me so we can talk about your feelings." This is a therapeutic response because the nurse has given the client opportunity to share his feelings. The nurse is also encouraging the client to stay on the phone so that emergency personnel can get to the client's home.

A nurse is caring for a client who is undergoing a diagnostic evaluation following an episode of chest pain. The client tells the nurse, "I am not sick, and I want go home!" Which of the following responses should the nurse make? A. "Tell me if I am correct in understanding that you feel well?" B. "People aren't admitted to hospitals unless they are sick." C. "Why do you feel this way?" D. "If you're fine, then why is your heart beating irregularly?"

A. "Tell me if I am correct in understanding that you feel well?" The nurse is seeking consensual validation for mutual understanding. The nurse is confirming that the client's words, ideas, and concepts have essentially the same meaning for both participants.

A nurse is caring for a client following a myocardial infarction. The client tells the nurse that she doesn't think she can remain on a low-cholesterol diet. Which of the following responses should the nurse make? A. "What is it about the low-cholesterol diet that concerns you?" B. "If you don't follow the diet, you will probably have another heart attack." C. "I've been on this diet for the last 5 years. You will learn to change your eating habits after a while." D. "I will have the dietitian talk to you, since she is an expert and can be very helpful."

A. "What is it about the low-cholesterol diet that concerns you?" The nurse is seeking clarification. This response lets the client know that her dietary concerns are important. This response can encourage the client to describe these concerns more fully.

A nurse is teaching a client who has a new ileostomy. The client states, "I'd rather be dead than have to live with this all my life." Which of the following responses should the nurse make? A. "You appear upset. Would you like to talk?" B. "I'll ask the provider to prescribe a medication to help you relax." C. "There's no reason to feel like that. Things will get better." D. "I am sorry that you are going through this. I would feel the same way."

A. "You appear upset. Would you like to talk?" The nurse is using restatement and is offering a general lead to communicate understanding in order to let the client know she understands him. The nurse is providing an opportunity for the client to elaborate on his feelings about his ileostomy.

A nurse is caring for a child who has leukemia and is receiving chemotherapy. The child's parent is upset and says, "I just can't believe my child is going to lose her beautiful hair!" Which of the following responses should the nurse make? A. "You are feeling a sense of loss right now." B. "Sometimes the hair thins, but it will grow back." C. "This hair loss means the chemotherapy is working." D. "Kids love to wear the special baseball caps we have."

A. "You are feeling a sense of loss right now." This response offers a general lead to the parent and encourages further discussion.

A nurse is caring for a client who just received news that his grandparents died. The client is crying and has buried his face in a pillow. Which of the following actions should the nurse take? A. Sit quietly with the client for a short time. B. Return in 15 min to see how the client is feeling. C. Reassure the client that he will feel better in the morning. D. Offer the client sympathy because of a similar loss.

A. Sit quietly with the client for a short time. Sitting with the client demonstrates caring and offering of self.

A nurse is caring for a client who is a sexual assault survivor. The client says, "I feel so humiliated. I don't want anyone to know what happened to me." Which of the following responses should the nurse make? A. "You will be just fine. You'll see." B. "Are you saying that you are fearful about what others will think?" C. "This is a normal feeling after what has happened to you." D. "The best thing for you to do is to put this out of your mind and think positive thoughts."

B. "Are you saying that you are fearful about what others will think?" The nurse is using the therapeutic response of clarification. This response helps the client to clarify her own thoughts.

A nurse is caring for a client who has major depressive disorder. The client tells the nurse, "Don't bother me. Find someone else to talk with. I don't have anything worth saying. Go find someone you can help." Which of the following statements should the nurse make? A. "Surely you don't think I don't want to talk to you." B. "I would like to sit quietly with you for a while." C. "I'm assigned to take care of you, so I intend to spend time with you." D. "Let's talk about what you would like for lunch today."

B. "I would like to sit quietly with you for a while." This is a therapeutic response because the nurse is offering self. This response lets the client know that the nurse has the desire to understand.

A nurse is admitting a client who is scheduled for a biopsy of a mass in one of his testicles. The client asks, "Do you think the doctor will find cancer?" Which of the following responses should the nurse make? A. "Most tumors in the testicles are benign." B. "It must be difficult for you not to know what the doctor will find." C. "I think that you should discuss this with your doctor." D. "Why are you worrying about cancer?"

B. "It must be difficult for you not to know what the doctor will find." The nurse is expressing empathy to acknowledge the client's feelings and encourage further communication.

A nurse is caring for a client who has suspected brain tumor and is scheduled for a computerized axial tomography scan (CAT). When the procedure is explained, the client expresses fear about entering the enclosed space of the scanner. Which of the following statements should the nurse make? A. "I think you should request a magnetic resonance image instead." B. "Let me review some breathing exercises with you." C. "It is scary to go into an enclosed space." D. "This is a routine test, so there is no reason to worry."

B. "Let me review some breathing exercises with you." It is not uncommon for a client who has claustrophobia to be fearful of entering the enclosed space of the CT scanner. To help minimize anxiety, the nurse should encourage the use of relaxation techniques, such as breathing exercises, prior to the procedure.

A nurse is caring for a client who has leukemia. The client says, "The doctor told me that my condition is too severe to be treated successfully. I guess I don't have long to live." Which of the following responses should the nurse make? A. "Having a positive attitude can help you." B. "Let's talk about how you are feeling about this information." C. "Have you considered getting a second opinion?" D. "Things get worse before they get better."

B. "Let's talk about how you are feeling about this information." This is a therapeutic response because the nurse is using the exploring technique. This technique allows the client the opportunity to express his feelings regarding the prognosis.

A nurse is caring for a client who has a new diagnosis of breast cancer. The client becomes quiet and withdrawn and says to the nurse, "What do you think people will say about me when I'm gone?" Which of the following responses should the nurse make? A. "What are you worried they will say about you?" B. "The thought of having breast cancer must seem hopeless." C. "Maintaining a positive attitude can influence your recovery." D. "You will be remembered as a very nice person."

B. "The thought of having breast cancer must seem hopeless." The nurse is restating what the client has said in order to focus on her feelings of hopelessness. This allows the client to talk about her emotions related to the diagnosis.

A nurse is caring for a client who has recently found out that she is pregnant. The client says, "I don't think I should tell my partner about the pregnancy." Which of the following responses should the nurse make? A. "Why wouldn't you want to tell your partner?" B. "You seem uncertain about telling your partner." C. "I am sure he will be happy when you tell him." D. "You are in disbelief. You should be thrilled."

B. "You seem uncertain about telling your partner." This is a therapeutic response because the nurse is reflecting on the client's statement.

A nurse is caring for a client who has a new diagnosis of terminal cancer. When the nurse enters the room to set up the bath equipment, the client says, "I'm not an invalid, you know. I can take care of myself. Get our and leave me alone." Which of the following is an appropriate response by the nurse? A. "Did somebody do something to make you angry?" B. "You seem upset. Let's talk about your concerns." C. "I know that you are not an invalid. I was just trying to help." D. "I'll arrange this equipment for you to bathe and will return later."

B. "You seem upset. Let's talk about your concerns." The nurse is seeking consensual validation for mutual understanding and clarification. This response lets the client know that her concerns about self-care are important and encourages the client to provide additional information.

A nurse is admitting an older client who has chronic obstructive pulmonary disease. The client's daughter is present and tells the nurse that her father will become uncooperative if he is not able to follow his usual routines. Which of the following actions should the nurse take? A. Assure the client that his usual routines will be followed. B. Ask the daughter what routines her father follows at home. C. Inform the daughter that the facility has policies that must be followed. D. Tell the daughter to inform the provider about how she wants her father's care organized.

B. Ask the daughter what routines her father follows at home. The nurse is asking relevant questions to seek more information in order to address the daughter's concerns. The nurse is providing general leads to encourage communication.

A nurse is caring for a client who has no family present and is upset by recent news that a current treatment has no been effective. The nurse states, "i'm going to stay with you until your family is able to get here." Which of the following communication techniques is the nurse using? A. Presenting reality B. Offering self C. Seeking clarification D. Planning

B. Offering self The nurse is offering self by remaining with the client until the family arrives. This response shows an interest in the client without making any demands.

A nurse is admitting an older adult client who has pneumonia. The client's daughter, who care for her father at home, says to the nurse, "I'm so glad he is here. You can take much better care of him than I can." Which of the following responses should the nurse make? A. "I am sure you have been taking very good care of your father." B. "We have the equipment to take care of sick clients." C. "It is not easy to care for an older parent." D. "Are you feeling guilty because your father has pneumonia?"

C. "It is not easy to care for an older parent." The nurse is offering empathy. The nurse is letting the daughter know that she understands her situation and will offer help.

A nurse is making morning rounds when a client says, "I almost died last night." Which of the following responses should the nurse make? A. If I were you, I would tell your provider about this." B. "I am sure people get those dreams when they are away from home." C. "That must have been frightening. Tell me more about it." D. "Why would you dream about something like that?"

C. "That must have been frightening. Tell me more about it." This therapeutic response directly addresses the client's concern. The nurse uses the communication tool of empathy in responding to this client's concerns and clarifies the client's feelings.

A client is scheduled for a lumbar puncture to rule out bacterial meningitis. She tells the nurse that she is fearful of becoming paralyzed from the needle being placed into her spinal column. Which of the following responses should the nurse make? A. "Let's not focus on the negative. Let's focus on getting better." B. "Why are you feeling so anxious about this procedure?" C. "The needle is inserted below the third lumbar vertebrae, well below the point at which the spinal cord ends." D. "Your doctor is very skilled in this procedure. Everything will be all right."

C. "The needle is inserted below the third lumbar vertebrae, well below the point at which the spinal cord ends." This is a therapeutic response that provides information that specifically addresses the client's concerns and helps to decrease anxiety and fears.

A nurse is teaching a client how to perform personal ileostomy care prior to discharge. The client says, "I don't think that I am going to be able to take care of this myself." Which of the following responses should the nurse make? A. "In time, you will become better at this than I am." B. "Don't worry about it. Most clients feel like that at first." C. "What part of the ileostomy care are you having trouble with?" D. "I agree. This is a difficult process."

C. "What part of the ileostomy care are you having trouble with?" This is a therapeutic response because the nurse is demonstrating acceptance of the client's feelings and is seeking clarification of the client's concerns.

The adult child of a client has come to take his parent home from the facility following a colon resection. The client's son tells the nurse, "I don't know how I am going to take care of my mom now." Which of the following responses should the nurse make? A. "A home health nurse will be stopping by tomorrow. If you have any questions, you can ask then." B. "Your mother has been taught to care for the colostomy independently." C. "What part of your mother's care are you concerned about?" D. "It is quite simple. I'll make sure that the colostomy bag is clean before your mother leaves."

C. "What part of your mother's care are you concerned about?" This is a therapeutic response because the nurse is using clarification to address the son's immediate concerns about caring for his parent.

A nurse is admitting a client who is to undergo a cardiac catheterization. The client says to the nurse, "My coworker died last week from a heart attack." Which of the following responses should the nurse make? A. Your provider will not let that happen because he knows how to treat your condition." B. "Do you think the same thing might happen to you?" C. "You appear to be feeling anxious." D. "Has anyone in your family had a heart attack?"

C. "You appear to be feeling anxious." The nurse is sharing observations which will encourage the client to be more specific about how he is feeling.

A nurse is caring for a client who states, "There is no one in the world who cares about me." Which of the following responses should the nurse make? A. "But your family visits you often, so they must care." B. "I don't really believe that no one cares about you." C. "You are feeling totally alone and without support?" D. "Why do you feel that way?"

C. "You are feeling totally alone and without support?" The nurse is checking perception or seeking consensual validation of the client's statement. The nurse encourages further discussion by using an open-ended statement that acknowledges the client's feeling.

A nurse is caring for a client who has a reputation for being demanding of the nurse staff. The nurse says to the charge nurse, "I can't believe I have to care for this client again today!" Which of the following responses should the charge nurse make? A. "Someone has to care for him." B. "If you don't like your assignment, call the nurse manager." C. "You are upset about having this client assigned to you today." D. "Why don't you want to take care of this client?"

C. "You are upset about having this client assigned to you today." The charge nurse is using restatement. In making this open-ended comment, the charge nurse acknowledges the nurse's feelings about the assignment while encouraging further professional discussion.

An assistive personnel is bathing a client who is unconscious and is talking to him about current events and the weather. The client's partner says to the nurse, "Why does the assistive personnel talk to my husband? He's unconscious." Which of the following responses should the nurse make? A. "I'll speak to the assistive personnel about it. Your husband should not be stimulated like that." B. "Why do you care if the assistive personnel talks with your husband?" C. "Your husband is unconscious but might still be able to hear." D. "The assistive personnel must not realize that your husband cannot hear."

C. "Your husband is unconscious but might still be able to hear." The client who is unconscious might still be able to hear even if unable to respond. A client who is unconscious also requires an appropriate level of stimulation.

A nurse is caring for a client and asks, "How are you?" The client responds, "My leg still hurts." Which of the following communication techniques should the nurse use first? A. Offer information B. Share hope C. Seek clarification D. Summarize

C. Seek clarification The nurse should apply the nursing process priority-setting framework. The nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with assessment or data collection. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify a provider of a change in the client's status, the nurse must first collect adequate data from the client. Assessing or collecting additional data will provide the nurse with knowledge to make an appropriate decision. The nurse can seek clarification in order to better understand the client's statement. The nurse can restate the message or ask the client to rephrase the message in order to avoid making wrong assumptions. Seeking clarification can assist the client to better describe the situation or problem.

A nurse is caring for a client following a fetal demise. The client is crying and says, "I tried to get pregnant for so long. My partner and I wanted this baby so much. Now what will we do?" Which of the following responses should the nurse make? A. "Why do you think this continues to happen to you?" B. "You can have another baby soon." C. "I think you should look into adoption." D. "Are you feeling overwhelmed?"

D. "Are you feeling overwhelmed?" The nurse is using the technique of clarification to gain a better understanding of the client's thoughts and is expressing understanding with this therapeutic response.

A nurse at a skilled nursing facility is admitting a client who has Alzheimer's disease. While speaking with the nurse, the client's partner begins to cry and says, "I never thought it would come to this. I feel so guilty about bringing my husband here." Which of the following responses should the nurse make? A. "If he understood what was happening, he would forgive you." B. "We will take good care of him here." C. "Admitting your husband was the right decision." D. "This has been a difficult time for you."

D. "This has been a difficult time for you." The nurse is sharing empathy to acknowledge the partner's feelings and encourage further communication.

A nurse is caring for a client who has been recently diagnosed with cancer. The client says, "I would rather be dead than go through the treatment for cancer." Which of the following responses should the nurse make? A. "That wouldn't be fair to your family, would it?" B. "How can you feel that way when you have so much to live for?" C. "Why don't we talk about the success you have in your life?" D. "What is it that concerns you about the cancer treatment?"

D. "What is it that concerns you about the cancer treatment?" This is a therapeutic response because the nurse is asking a broad question that allows the client to explore thoughts and feelings.

A nurse is caring for a client in premature labor who is not responding to tocolytic therapy. The client says to the nurse, "I am so worried about my baby." Which of the following responses should the nurse make? A. The hospital has a newborn intensive care unit." B. "Do you want me to call someone to talk with you?" C. "This happens all the time and the baby is born healthy." D. "You are very frightened for your baby."

D. "You are very frightened for your baby." This statement by the nurse encourages the client to further express feelings through the use of restatement. Restatement helps the nurse to clarify the situation and allows the client to further explain her feelings.

A nursing is caring for a client who is preparing to perform a return demonstration of a subcutaneous injection of medication for the second time. The client hesitates and says, "I'm not sure I can do this." Which of the following responses should the nurse make? A. "Why are you so nervous? Do you need help?" B. "You need to talk to your doctor about prescribing an oral medication." C. "I know it's new. You'll get the hang of it soon." D. "You did great last time. Give it a try."

D. "You did great last time. Give it a try." This response by the nurse encourages the client to complete the procedure and acknowledges the client's effort in learning the new skill.

A nurse is caring for a client when the client's son enters the room and states, "You people can't do anything right. Ever since my father was admitted, it has been one mistake after another. I am taking him out of here." Which of the following responses should the nurse make? A. "Your father hasn't complained about his care. Why do you feel this way?" B. "We have the best intentions for all the clients." C. "Let's not discuss this now. Tell me more about the rest of your family." D. "You feel that your father is not receiving appropriate care?"

D. "You feel that your father is not receiving appropriate care?" This response by the nurse uses clarification to encourage the son to express his concerns.

A nurse is caring for an older adult client who is to undergo surgery for a hip fracture. The client says, "I guess I've lived long enough, and it's my time." Which of the following responses should the nurse make? A. "The doctors and nurses will take good care of you. There's nothing to worry about." B. "This is just a minor setback. You will be on your feet in no time." C. "You are in really good shape for your age." D. "You feel that your life is ending?"

D. "You feel that your life is ending?" This is a therapeutic response because the nurse is using restatement to promote communication. This response addresses the client's immediate concern about not living any longer.

A nurse is caring for an adolescent client who has a positive human chorionic gonadotropin (HCG) test. She tells the nurse, "I don't think I can tell my parents that I am pregnant." Which of the following responses should the nurse make? A. "Do you think you might terminate the pregnancy?" B. "Give them a chance. Your parents will understand." C. "You must tell your parents as soon as possible." D. "You seem frightened to tell your parents."

D. "You seem frightened to tell your parents." This is a therapeutic response because it provides the client with an opportunity to express any concerns or fears.

A nurse is caring for an adolescent client who was recently diagnosed with testicular cancer. When the nurse asks the client a question, he angrily spits in the nurse's face. Which of the following responses should the nurse make? A. "I will come back to change your linens when you are feeling better." B. "Who do you think you are to treat me like that?" C. "Why did you spit in my face?" D. "You seem to be very upset."

D. "You seem to be very upset." This is a therapeutic response because it allows the client to explore his feelings and can de-escalate the situation.

A nurse informs the mother of a premature newborn that the provider will not be discharging them today as he had discussed. The mother states, "I know I shouldn't let it get me down." Which of the following responses should the nurse make? A. "Think positive. Maybe tomorrow." B. "I know just how you feel." C. "This happens very often." D. "You seem upset."

D. "You seem upset." The nurse is restating what the parent has said. The nurse is acknowledging the parent's concerns and encourages the parent to express her feelings.