Prep U Chapter 8: Communication

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

d. eliminate as many distractions as possible.

A nurse who is preparing to administer an injection to the client states, "This injection will not be painful." The nurse has used which communication technique? a. Giving false reassurance b. Seeking clarification c. Giving information d. Encouraging elaboration

a. Giving false reassurance

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. Direct the client in the other bed to walk in the hallway. b. Ask all visitors to leave the room. c. Pull the curtain dividing the two beds. d. Bring the client into the hallway to discuss the treatment plan.

c. Pull the curtain dividing the two beds.

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: a. aggressive. b. assertive. c. passive. d. nurturing.

a. aggressive.

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. contacting the interprofessional care team to discuss alternative treatment options b. explaining the health consequences of refusing to undergo the prescribed treatment c. asking the client's family to discuss the importance of the prescribed treatment with the client d. recommending assessment of the client's cognitive capacity to make health care decisions

a. contacting the interprofessional care team to discuss alternative treatment options

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? a. "I am so sorry you are going through this. Can we talk?" b. "I know this is hard for you. Is there any way I can help?" c. "Sitting in the dark is not going to cure your cancer. Let's open the curtains." d. "Can you please tell me why you are crying?"

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

Which is an open-ended question? a. "Do you take this medication daily?" b. "Why did the health care provider prescribe this medication for you?" c. "When was the last time you had your prescription refilled?" d. "How many tablets do you take at one time?"

b. "Why did the health care provider prescribe this medication for you?"

A nurse and an older adult client with chronic back pain are beginning to communicate. What activity should the nurse focus on at this point? a. Explaining in detail all of the pain management options available b. Being sensitive to the client's emotional barriers c. Sharing the nurse's own family and personal history of back pain d. Reassuring the client that back surgery will likely alleviate the pain completely

b. Being sensitive to the client's emotional barriers

A 70-year-old client had a cholecystectomy 4 days ago. The client's daughter tells the nurse, "My mother seems confused today." Which question would be best for the nurse to ask to assess the client's orientation? a. "Is your name Evelyn?" b. "Are you in a hospital?" c. "Is today the first day of the month?" d. "What is your name?"

d. "What is your name?"

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

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

A nurse is completing a health history with a client being admitted for a mastectomy. During the interview the client states, "I do not know what to do. I am not sure if I really need this surgery." Which response by the nurse demonstrates active listening? a. "You seem unsure. Tell me your concerns about your surgery." b. "I understand your confused, what do you think you should do?" c. "I understand you are not sure about having the surgery. Why do you think you really do not need the surgery?" d. "You seem unsure, please let me know if you decide to postpone the surgery until you are no longer unsure."

a. "You seem unsure. Tell me your concerns about your surgery."

In which situation would the SBAR technique of communication be most appropriate? a. A nurse is calling a physician to report a client's new onset of chest pain. b. A nurse is facilitating a family meeting to coordinate a client's discharge planning. c. A nurse is explaining the process of bone marrow biopsy to a client who is scheduled for the procedure. d. A nurse is teaching a client about the benefits of smoking cessation and the risks of continuing to smoke.

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

The nurse is caring for a client who is a victim of sexual assault. Which action would the nurse take to develop a trusting rapport with the client? a. Approach the client with empathy and understanding and allow the client to share feelings without being judged. b. Exhibit a professional demeanor while examining the client and obtaining specimens, asking questions that are not intrusive. c. Practice active listening by allowing the client to express fears and concerns then restating in the nurse's own words to demonstrate understanding. d. Use strategic pauses to allow the client to provide information that will be used to help officials in their investigation.

a. Approach the client with empathy and understanding and allow the client to share feelings without being judged.

A nurse is planning care for an adult client with severe hearing impairment who uses sign language and lip reading for communication and who has a new diagnosis of cancer. Which nursing action is most appropriate when establishing the plan of care for this client? a. Arrange for a sign language interpreter when discussing treatment. b. Talk with the client's children to determine needs. c. Consult the oncology nurse specialist. d, Use a text-telephone device (TTD) for daily communication.

a. Arrange for a sign language interpreter when discussing treatment.

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? a. Be silent and allow the client to continue speaking when ready. b. Smile and say, "Don't worry, I am sure the physician is doing a good job." c. Nod and say, "I agree. If I were you, I would get a new doctor." d. Stand and say, "I can see this interview is making you uncomfortable, so we can continue later."

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

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 during this phase of the relationship? a. Reviewing health changes b. Attending to physical health care needs c. Establishing trust and rapport d. Developing solutions that will be enacted

a. Reviewing health changes

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 faces the client, speaks slowly and clearly, and demonstrates the procedure using a needleless syringe. b. The nurse continues with the instructions and makes a mental note to repeat the initial instructions at the end of the training. c. 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. d. The nurse asks the client if he or she is worried about giving oneself an injection.

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

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. Ask the client "What has your health care provider shared with you about stress tests?" c. Provide the client with an educational booklet about stress tests. d. Tell the client about the stress test procedure.

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

Nurses on a hospital burn unit meet as a group to discuss procedures. Which statements accurately describe effective functioning in a group? Select all that apply. a. The group leader alone uses individual talents and interpersonal strengths to assist the group to accomplish goals. b. Group members elicit mutually respectful relationships. c. The group's effectiveness depends on only the group leader's sensitivity to the needs of the group and its individual members. d. The leader or other group members confront any member who dominates or thwarts the group process. e. Group members use power to fix immediate problems without considering the needs of the powerless. f. Group members support, praise, and critique one another.

b. Group members elicit mutually respectful relationships. d. The leader or other group members confront any member who dominates or thwarts the group process. f. Group members support, praise, and critique one another.

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

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

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. "All of the people got themselves out of the car?" d. "Did a police officer take a report at the accident scene?"

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

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

c. "Have you ever thought of laser surgery?"

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

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

The child of a client who just died in a hospice unit arrives and asks, "May I please stay and sit at the bedside? I really wanted to be here so my dad would not die alone." Which statement made by the nurse best demonstrates the use of empathy? a. "You are too late for that, but you may stay for a while if you would like." b. "I tried to contact you earlier, but you did not answer your phone." c. "I will close the door so you can spend some quiet time at the bedside." d. "I understand. I lost my dad last year, and he died alone."

c. "I will close the door so you can spend some quiet time at the bedside."

The client is being discharged, and the nurse observes the client crying. What is the nurse's most appropriate response? a. "Let's discuss your discharge plan." b. "What is your pain level at this time?" c. "Would you like to talk about anything before you go home?" d. "Are you scared because you are going home?"

c. "Would you like to talk about anything before you go home?"

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? a. "Don't worry about labor, I have been through it and it is not so bad." b. "There are many good medications to decrease the pain; it will not be so bad." c. "You're worried about how you will tolerate the pain associated with labor." d. "I would recommend keeping a positive attitude."

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

A client comes into the urgent care center to have sutures removed on an arm. The nurse finds significant crusting along the suture line. The client states not having time to get the sutures removed a week prior, as directed. The nurse soaks the crust and attempts to remove the sutures. As the nurse attempts the suture removal, the client frequently pulls the arm away and tells the nurse, "You are taking too long and it is hurting a little bit. Just pull them out and get it over with." Which statement is an example of appropriate therapeutic response? a. "I am sorry it is taking so long. Tell me how you hurt your arm?" b. "I am sorry it is taking so long and I am hurting you; next time do not wait too long to get sutures removed or the same thing will happen" c. "It will not hurt if you relax and stop pulling your arm away." d. "It is taking longer for me to remove the sutures because the delay allowed the crust to form and adhere to the sutures, making it harder and sometimes painful to remove them."

d. "It is taking longer for me to remove the sutures because the delay allowed the crust to form and adhere to the sutures, making it harder and sometimes painful to remove them."

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. sit at the bedside and allow the client to explain the statement. b. smile at the client and apologize. c. ignore the statement and empty the urinary catheter. d. inform the client that the unit was very busy that day.

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

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

b. Orientation phase

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

c. swaddling the child and gently stroking its head.

A nurse is discharging a client and thus terminating the nurse-client relationship. Which action should the nurse perform in this phase? a. Make formal introductions b. Create a contract regarding the relationship c. Provide assistance to achieve goals d. Examine goals of the relationship to determine whether they were achieved

d. Examine goals of the relationship to determine whether they were achieved

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

a. Assess how the client would like to communicate

The client recently immigrated from Mumbai, India. The client was just admitted to the nurse's unit postoperatively following gallstone removal. The client does not speak the dominant language. When using the hospital's interpretive services, which is most important? a. Speak directly to the client. b. Ensure that family members are present. c. Give all of the discharge instructions at once. d. Have the interpreter write out all of the information listed in the unit brochure.

a. Speak directly to the client.

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? a. "I am sorry to hear you have cancer. I would be upset too, is there anything I can do?" b. "I see you are upset. Would you like to talk?" c. "I see you have been crying. Do you want me to call someone for you?" d. "Don't worry, I have seen lots of people with cancer do fine."

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

To provide effective nursing care, the nurse should engage in what type of communication with the client and significant others? a. Purposive communication b. Intrapersonal communication c. Metacommunication d. Therapeutic communication

d. Therapeutic communication

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

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

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. "I will be by your side throughout the procedure; the procedure will be painless if you don't move." b. "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." c. "The procedure may take only 2 minutes, so you might get through it by mentally counting up to 120." d. "You may feel very uncomfortable when the needle goes in, but you should breathe rhythmically."

b. "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."

The nurse is beginning an assessment on a nonverbal client. The nurse must first: a. speak loudly when interacting with the client. b. use various forms of communication when interacting with the client. c. establish eye contact prior to assessing, touching, and interacting with the client. d. verbalize all steps of the nursing assessment when interacting with the client.

c. establish eye contact prior to assessing, touching, and interacting with the client.