PP RNSG 1137 Communications Mastery Quiz

The client is balancing the disease with cold foods.

A diabetic patient is reviewing the hospital menu to order lunch. The client asks the nurse suggestions for "cold" foods to order. What is the nurse's understanding of why the client asking about suggestions for "cold" foods?

Pulse amplitude +1 bilateral lower extremities

A nurse is assessing a client's pulse and notices a weak and thready pulse in both lower extremities. How should the nurse document this finding?

Enlist the help of a hospital interpreter; ask the son to translate if none is readily available.

The nurse is admitting a hospital client who does not speak English and who is accompanied by the client's school-aged child. The client appears to be in pain, but the nurse is unable to assess the character or history of the client's pain. How should the nurse best communicate with the client?

"I will ask the surgeon to come speak to you about the procedure."

A nurse has been asked to obtain a client's signature on an operative consent form. When the nurse approaches the client, who is scheduled for a cholycystectomy later in the day, the client asks the nurse why the procedure is needed. Which of the following is the appropriate response by the nurse?

preadmission nurse

A 60-year-old client is admitted for an arthroscopy of the right shoulder through same-day surgery. Which nurse is responsible for starting the client's discharge planning?

Talk with the staff nurse about the assignment and the concerns voiced.

A charge nurse is making shift assignments when a staff nurse requests to not be assigned to a particular child because of the quantity of time the child requires. The charge nurse knows that the child and family have bonded with the staff nurse. What should the charge nurse do next?

"The diagnosis won't be based on the findings of a single test but by combining all data found."

A client suspected of having systemic lupus erythematosus (SLE) is being scheduled for testing. She asks which of the tests ordered will determine if she is positive for the disorder. Which statement by the nurse is most accurate?

Checking vital signs and assessing for nonverbal indications of pain

A client who recently immigrated from Korea to the U.S. or Canada is hospitalized with second- and third-degree burns. He speaks little English and has been lying quietly in bed. Ten hours after the client's admission, the nurse conducts a serial assessment and asks him whether he's in pain. He smiles and shakes his head vigorously back and forth. Which nursing action is most appropriate at this time?

It may be necessary to remove a small amount of hair from the infant's scalp.

An IV infusion is to be administered through a scalp vein on an infant's head. What should the nurse tell the parents to prepare them for the procedure?

Reposition the client, elevate the head of the bed, and provide a cool compress.

An adult is dying from metastatic lung cancer, and all treatments have been discontinued. The client's breathing pattern is labored, with gurgling sounds. The client's spouse asks the nurse, "Can you do something to help with the breathing?" Which is the nurse's best response in this situation?

The emotional responses may be similar to those of other crime victims.

Despite education and role-play practice of restraint procedures, a staff member is injured when actually restraining a client. When helping the uninjured staff deal with the incident, the nurse should address which factor?

Assessment

The nurse uses which part of the SBAR acronym when stating, "I think the client is dry."

"It's so hard to predict when this scar will disappear."

A 24-year-old client with diabetes mellitus sustains a large laceration that requires suturing. Which of the following statements indicates that the client understands wound healing?

Insist that the officers stay in the room at all times.

An inmate from a correctional facility is admitted to the hospital wearing handcuffs. The nurse caring for the client needs to provide morning care and notices the two correctional officers socializing with the nursing staff at the desk. What is the best action by the nurse in this situation?

Concerns regarding the cancer and how the surgery will affect the client

Communication is very important when preparing a client for a mastectomy. What are primary issues for the nurse to discuss?

Call the health care provider (HCP) for specific prescriptions based on the glucose level.

On the day of surgery, a client with diabetes who takes insulin on a sliding scale is to have nothing by mouth and all medications withheld. The client's 0600 glucose level is 300 mg/dL (16.7 mmol/L). What should the nurse do?

Communication barriers between the mother and staff

The nurse is caring for a child whose mother is deaf and untrusting of staff. She frequently cries at the bedside, but refuses intervention from social work or the chaplain. Which issue is most important for the nurse to address with the mother to promote a trusting relationship?

"Encourage your wife to rest in between contractions." "Continue to praise your wife and give her encouragement." "Stay by your wife's side. It is important that she know you are there to support her."

The nurse is caring for a client who is in the transitional stage of labor. The client's partner is concerned and asks, "What else can I do for my wife? She is so irritable." Which of the following interventions would the nurse suggest? Select all that apply.

"They are very sensitive to criticism."

The nurse providing health promotion education to the parents of a 6-year-old child should include which of the following statements about 6-year-old children in the education?

When communicating a change in a client's condition to his or her physician.

The nurse should utilize SBAR communication (Situation, Background, Assessment, Recommendation) during which of the following clinical situations?

"cc" "QOD" "MgSO4"

The student nurse is administering medications to the clients. The nurse educator asks the student, "Which of the medication orders have the potential to cause a medication error?" What is the best response by the student? Select all that apply.

"What does the pain feel like?"

A client states, "I have abdominal pain." Which assessment question would best determine the client's need for pain medication?

Digoxin 0.125 mg given at 1400 instead of prescribed dose of 0.25 mg.

A nurse administers digoxin 0.125 mg to a client at 1400 instead of the prescribed dose of digoxin 0.25 mg. Which of the following statements should the nurse record in the medical record?

Charting by exception.

A nurse working in a new orthopedic unit is asked to initiate the practice of an abbreviated form of documentation, which requires less nursing time and readily detects changes in client status. Which of the following documentation methods should the nurse suggest?

Blood pressure 130/90 mm Hg; pulse 100 bpm; respirations 14 breaths/min

A client is admitted to the preoperative clinic for a breast biopsy. Which information would the nurse enter into the medical record as objective data?

Inform the other nurse that the viewed screen resulted in a breach of confidentiality.

A visitor to the surgical unit asks the nurse about another client on the unit. The visitor viewed the client's name on the computer screen of another nurse at the nurses' station and recognized the client as a relative. What is the first action of the nurse in relation to this situation?

Ask the client about his reactions to this situation.

A young man makes an appointment to see the psychiatric nurse at the Employee Assistance Program of a large corporation beacuse his boss is sending him provocative e-mails and making seductive remarks on his voice mail at home. The nurse informs him about corporate workplace violence guidelines, and he agrees to work with corporate security on the issue. What should the nurse do next?

"When did the rash start?" "Are you allergic to any medications, foods, or pollen?" "What have you been using to treat the rash?" "Have you recently traveled outside the country?"

A nurse is assessing a client who has a rash on the chest and upper arms. Which questions would the nurse ask in order to gain further information about the client's rash? Select all that apply.

"Let me check with the hospital policy regarding making a video."

A nurse is discussing wound care with a client. The client insists on taking a short video of the instruction by using the client's smart phone. What is the nurse's best response to the client?

Progress note.

A nurse is maintaining a problem-oriented medical record for a client. Which of the following components of the record describes the client's responses to what has been done and revisions to the initial plan?

"All visitors should wash their hands before they leave or enter the room."

A parent of a 9-year-old child who is scheduled to have surgery expresses concern about the potential for a postoperative infection. Which of the following information would be most important for the nurse to tell the parent?

triage priority. identifying information when possible (such as name, age, and address). medications and treatments administered.

An airplane crash results in mass casualties. The nurse is directing personnel to tag all victims. Which information should be placed on the tag? Select all that apply.

"I understand your concern. I'll call the physician to review the results with you."

An anxious client asks the nurse for the results of recent blood work and wants to know what the results mean. Which of the following responses by the nurse is the most appropriate?

Document the adolescent's choice and offer to discuss feelings about the medication.

The nurse is caring for an adolescent with cancer who is well informed about the medical condition and treatment. The adolescent refused the morning medications and states intentions of refusing all future medications. What is the best action by the nurse?

Seek input from all groups and strive for consensus on what would benefit most or all of these people.

The nurse is meeting with a community group to discuss the changes that need to be made to meet their health needs after a community assessment has been done. One cultural group is insisting their views need to be implemented because they are in the majority in that community. What is the best action by the nurse?

Ask the client's health care provider (HCP) to take a sample of the sister's blood.

The young sister of a young adult client with leukemia asks, "Can you check my blood? When my sister got pneumonia, so did I. And I think I have this, too." Which of the following by the nurse would be inappropriate?

Sharing assessment information and information on the client's capability and level of participation in meeting activities of daily living

What are important nursing responsibilities when a referral to other health team members has been made for a client?

talking with the nurse

Which activity should the nurse recommend to the client on an inpatient unit when thoughts of suicide occur?

Ask the physician to prescribe a specific laxative.

A client has not had a bowel movement for 2 days and is feeling uncomfortable. The physician writes an order that states, "laxative of choice." How should the nurse proceed with this order?

"Prostate cancer at this stage is very slow growing."

A 65-year-old client has been told by the health care provider (HCP) that his prostate cancer was graded at stage IIB. The client inquires if this means he is going to die soon. What is the best response by the nurse?

Document the client's choice and reassess the pain in 1 hour.

A client has been prescribed a narcotic analgesic to be given around the clock for cancer-related pain. The client is competent and has actively been involved in decisions regarding care. What should the nurse do when the client refuses the next dose of pain medication?

Identifying risks and ensuring future safety for clients.

A nurse on a night shift entered an elderly client's room during a scheduled check and discovered the client on the floor beside her bed after falling when trying to ambulate to the washroom. After assessing and assisting the client back to bed, the nurse has completed an incident report. What is the primary purpose of this particular type of documentation?

"This is in response to your hormones and will stop within a week of life."

While changing her newborn's diaper, a mother states: "there is some bleeding from the vagina." Which of the following is the nurse's appropriate response?

"You are concerned that the client is receiving too much narcotic medication?"

While providing palliative care to a client in the home setting, the client's family expresses concern that the client is receiving "too much narcotic medication." Which of the following statements is the most therapeutic response by the nurse?

directing the conversation to realistic concerns

A client recovering from a drug overdose is interacting with the nurse and recounting her exploits at numerous parties she has attended. Which action is most therapeutic?

Identify personal goals. Gain insight into feelings. Assess for suicidal ideation.

A client who has been chronically unemployed with a history of explosive anger and depression is now experiencing significant hopelessness. What would be most appropriate for the nurse to include in the client's treatment plan? Select all that apply.

"You need to continue the lorazepam as prescribed to ensure a slow and safe withdrawal."

A client with a of anxiolytic withdrawal is prescribed lorazepam in daily decreasing dosages for 2 weeks. The client has been taking 60 mg diazepam daily for 8 month, but now has been taking lorazepam for 3 days. The client states she feels shaky, is having problems sleeping, and does not want to continue with lorazepam. She asks the nurse if she can stop taking the lorazepam now. The nurse's best response is:

"This will stop my daughter-in-law from putting me in a home."

A nurse is admitting a client to the palliative unit and discussing advanced directives. Which of the following statements made by the client leads the nurse to believe the client requires clarification around advanced directives?

Contact the previous nurse requesting that the nurse correct the error

A nurse notes that another nurse on the previous shift made an entry on the wrong client's health record. What are the most appropriate steps for the first nurse to take?

Narrative notes.

The nurse managers of a home healthcare office wish to maximize nurses' freedom to characterize and record client conditions and situations in the nurses' own terms. Which of the following documentation formats is most likely to promote this goal?

"I believe that the client has something to offer to the treatment plan."

A cancer client talked to the nurse about wanting to go home and die. The nurse spent a long time clarifying and understanding where the client was coming from. The health care team came by and decided that they would change the treatment regime to a more aggressive approach. The nurse observed the client and witnessed the client's attempt to address the team with the client's desire to stop treatment. Which statement reflects patient advocacy?

Inform the spouse that the client will be going to the recovery room after the operation, and that someone will notify the unit when the client is ready to come back.

A client's spouse has arrived prior to surgery. When the client is transferred to the operating room, what would be appropriate for the nurse to tell the spouse?

Talk quietly to the infant while he is awake.

A parent tells the nurse that their 8-month-old infant is anxious. Which suggestion by the nurse is most appropriate to help the parent lessen anxiety in the infant?

Temperature of 102° F

Which finding is an example of a variance in the critical pathway of a client 3 days after an above-the-knee amputation?

Equal sharing of time for discussion of problems so there is mutuality in the relationship

Which of the following is an example of social interaction, rather than a therapeutic professional nursing interaction, between a nurse and a client?