PrepU Chapter 8 Communication

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

C. "My name is Sue Smith, RN, and I am calling regarding Mrs. Jones in room 356 at Jefferson Hospital."

Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship? A. Evaluation phase B. Orientation phase C. Termination phase D. Working phase

D. Working phase

Which statement accurately describes the concept of feedback as it pertains to the process of communication? A. The sender's message is translated into a code, using verbal and nonverbal communication. B. The sender and the receiver use one another's reactions to produce further messages. C. The sender sends a clear message that is understood by the receiver. D. The receiver listens to the sender in an unassuming way.

B. The sender and the receiver use one another's reactions to produce further messages.

The nurse observing an interaction between a mother and daughter appropriately identifies the interaction as which communication zone? A. Intimate B. Public C. Social D. Personal

A. Intimate

When communicating with clients, nurses need to be very careful in their approach. This is particularly true when communicating using: A. Written material. B. Medical terminology. C. Demonstration. D. Audio-visual material.

B. Medical terminology.

The nurse makes a contract with the client during which phase of the nurse-client relationship? A. Working phase B. Orientation phase C. Termination phase D. Intimate phase

B. Orientation phase

A home care nurse discusses with a client when visits will occur and how long they will last. In what phase of the nurse-client relationship is this type of agreement established? A. Evaluation phase B. Termination phase C. Working phase D. Orientation phase

D. Orientation phase

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. Attending to physical health care needs B. Developing solutions that will be enacted C. Reviewing health changes D. Establishing trust and rapport

C. Reviewing health changes

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. "Does it hurt when I touch you here?" C. "Is there any chance you might be pregnant?" D. "Do you smoke cigarettes?" E. "What sorts of things do you do for fun?" F. "What plans do you have after you are discharged?"

A. "Are you ready to get out of bed?" B. "Does it hurt when I touch you here?" C. "Is there any chance you might be pregnant?" D. "Do you smoke cigarettes?"

When the preoperative client tells the nurse that the client cannot sleep because the client keeps thinking about the surgery, an appropriate reflection of the statement by the nurse is: A. "The thought of having surgery is keeping you awake." B. "You shouldn't be nervous. We perform this procedure every day." C. "It sounds as if your surgery is a pretty scary procedure." D. "You have a great surgeon. You have nothing to worry about."

A. "The thought of having surgery is keeping you awake."

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. Nod and say, "I agree. If I were you, I would get a new doctor." C. Stand and say, "I can see this interview is making you uncomfortable, so we can continue later." D. Smile and say, "Don't worry, I am sure the physician is doing a good job."

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

The client is an 18-month-old in the pediatric intensive care unit. The client is scheduled to have a subgaleal shunt placed tomorrow, and the client's mother is quite nervous about the procedure. The nurse tells the client's mother, "The surgeon has done this a million times. Your son will be fine." This is an example of what type of nontherapeutic communication? A. False reassurance B. Being moralistic C. Giving advice D. Rescue feelings

A. False reassurance

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 bestdescribed in this scenario? A. The working phase B. The introduction phase C. The termination phase D. The orientation phase

A. The working phase

During an admission intake assessment, a nurse uses open-ended questions to gather information. An example of an open-ended question is: A. "Are you allergic to any medications?" B. "Why did your physician send you here to be admitted?" C. "Can you tell me the medications you take on a daily basis?" D. "Do you have an advanced directive or a living will?"

B. "Why did your physician send you here to be admitted?"

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. Use facial and hand gestures D. Provide paper and pencil for written communication

B. Assess how the client would like to communicate

A nurse is providing care to a 3-year-old child admitted with a diagnosis of infectious diarrhea. The nurse needs to insert an intravenous catheter in order to administer prescribed intravenous fluids. In an attempt to foster communication, the nurse should: A. Provide both verbal and written information to the child. B. Involve the child's stuffed animal in the educational session. C. Ask the child's parents to leave the room while the nurse and child talk. D. Show the child the intravenous catheter and explain how it works.

B. Involve the child's stuffed animal in the educational session.

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. Ensure that family members are present. B. Speak directly to the client. C. Have the interpreter write out all of the information listed in the unit brochure. D. Give all of the discharge instructions at once.

B. Speak directly to the client.

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. A. The nurse communicates in a busy environment to hold the client's attention. B. The nurse keeps communication simple and concrete. C. The nurse gives lengthy explanations of the care that will be given. D. If there is no response, the nurse does not repeat what is said and takes a break. E. The nurse maintains eye contact with the client. F. The nurse shows patience with the client and gives the client time to respond.

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

A unit-based infection control task force was developed in an attempt to reduce catheter-acquired infections. The group consists of 10 team members. During the past three meetings, one person dominated the meeting and did not allow other members ample time to speak. The best way to address the team dysfunction is to: A. Pick a team leader who is not the dominant member. B. Plan a meeting where the dominant person cannot attend. C. Have group members issue a written warning to the dominant member. D. Have group members confront the dominant member to promote the needed team work.

D. Have group members confront the dominant member to promote the needed team work.

A nurse is obtaining a history from an adult female client. When the nurse asks how many times the client has been pregnant, the client answers, "I have four kids." Which statement, made by the nurse, seeks clarification of the original question? A. "Were these term births?" B. "How old are your children?" C. "I understand you have four kids; how many times have you actually been pregnant?" D. "All right, you have four children, is that correct?"

C. "I understand you have four kids; how many times have you actually been pregnant?"

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. "Do you understand that everyone here has your spouse's best interest at heart?" B. "What would help you accept that this is best for both of you?" C. "This must be very difficult for you to hear. How do you feel right now?" D. "Why do you think that the care team has made this recommendation?"

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

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

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

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. Passive. B. Nurturing. C. Aggressive. D. Assertive.

C. Aggressive.

A nurse suspects that a client may have a hearing problem. The nurse should attempt to consult: A. An optometrist. B. A clinical psychologist. C. An audiologist. D. An ophthalmologist.

C. An audiologist.

Each of the following facilitates a therapeutic nurse-client relationship except: A. Rephrasing. B. Reflection. C. Closed-ended questions. D. Active listening.

C. Closed-ended questions.

Which is a skill appropriate to use in therapeutic communication? A. Use cliches to enhance a client's understanding of information. B. Be precise and inflexible regarding the intent of the conversation. C. Control the tone of the voice to avoid hidden messages. D. Avoid the use of periods of silence.

C. Control the tone of the voice to avoid hidden messages.

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 all visitors to leave the room. B. Ask the client's partner to leave the room to allow the client to focus. C. Eliminate as many distractions as possible. D. Ask the client if she is able to read.

C. Eliminate as many distractions as possible.

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. Reflection B. Clarification C. Encouraging elaboration D. Restating

C. Encouraging elaboration

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. Termination phase B. Working phase C. Orientation phase D. Intimate phase

C. Orientation phase

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. "Did a police officer take a report at the accident scene?" B. "Was there any cracking of the windshield?" C. "Were there any fatalities in the other vehicle?" D. "All of the people got themselves out of the car?"

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

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

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

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

D. "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 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. "Is today the first day of the month?" C. "Are you in a hospital?" D. "What day of the week is it?"

D. "What day of the week is it?"

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

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

Nurses use social media to share ideas, develop professional connections, access educational offerings and forums, receive support, and investigate evidence-based practices. Which is an example of the proper use of social media by a nurse? A. A nurse describes a client on Twitter by giving the client's diagnosis rather than the client's name. B. A nurse posts pictures of a client who accomplished a goal of losing 100 lb and later deletes the photo. C. A nurse describes a client on Twitter by giving the room number rather than the name of the client. D. A nurse uses a disclaimer to verify that any views the nurse expresses on Facebook are the nurse's alone and not the employer's.

D. A nurse uses a disclaimer to verify that any views the nurse expresses on Facebook are the nurse's alone and not the employer's.

A nurse is attempting to complete an admission database. While taking the history, the nurse notices the client appears uncomfortable and slightly tachypneic. The nurse should: A. Ask questions as quickly as possible. B. Tell the client to rest and allow a family member to answer. C. Use only open-ended questions. D. Allow the client to set the pace.

D. Allow the client to set the pace.

Which is a characteristic of a person-centered or helping relationship? A. A focus on the needs of the helping person B. The accountability of the person being helped for the outcomes of the relationship C. Spontaneous occurrence with random individuals D. An unequal sharing of information

D. An unequal sharing of information

An evening shift nurse is caring for a client scheduled for a colon resection in the morning. The client tells the nurse that the client is afraid of waking up during surgery. The best response by the nurse is to: A. Ask the surgeon to come to the bedside to reassure the client. B. State "everyone is afraid of that." C. Look directly at the client and state, "You are afraid of waking up during surgery." D. Ask why the client thinks the client will wake up during surgery.

D. Ask why the client thinks the client will wake up during surgery.

A nurse is attempting to calm an infant in the nursery. The nurse responds to the highest developed sense by: A. Softly humming a song near the neonate. B. Staring into the neonate's eyes and smiling. C. Offering the neonate infant formula. D. Swaddling the child and gently stroking its head.

D. Swaddling the child and gently stroking its head.

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? A. The client is sitting in a chair and states, "I feel a lot better than I did yesterday. B. The client looks at the nurse and states, "I am still not feeling my best." C. The client smiles at the nurse and states, "I cannot wait to go home." D. The client stares at the floor and states, "I feel fine."

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