PrepU Concept Communication

A pregnant client presents to the emergency department with vaginal bleeding. A transvaginal ultrasound is performed, and the health care provider informs the client that there are normal fetal heart tones noted. The client begins to tear-up and has a worried appearance. To facilitate therapeutic communication, what statement would the nurse make after observing the client's nonverbal communication?

"Take your time and tell me how you are feeling. I have plenty of time to answer your questions and discuss any thoughts or feelings with you."

A client is discussing the client's problems at the workplace. Which nonverbal cues would indicate that the nurse is attentive to the client? Select all that apply.

1. lean toward the client, 2. Maintain eye contact

When the nurse is administering medication, an older adult client states, "Why does everyone keep asking my name? I've been here for days." How should the nurse respond to the client?

"We ask your name to ensure that we are treating the right client."

A client, 50 years old, is admitted for treatment of a gastric tumor. The client asks the nurse, "Do you think I have cancer?" Which response by the nurse would be most therapeutic?

"You sound concerned about what the physicians will tell you."

The nurse is caring for a 5-year-old child in pain. What is the best method to assess the child's pain?

Ask the child to point to a face drawing that indicates pain intensity.

The home health nurse is conducting the health history interview with a client who does not speak the dominant language. What would be the best action made by the nurse?

Conduct the health history utilizing a telephonic interpreter (over-the-phone translation).

Nurses at a health care facility maintain client records using a method of documentation known as charting by exception (CBE). What is a benefit of this method of documentation?

It provides quick access to abnormal findings.

A nurse identifies a nursing diagnosis of "Anxiety related to hospitalization and uncertainity about diagnostic test results." Which of the following actions by the nurse will be an attempt to decrease client anxiety?

Maintaining eye contact and carefully listening to client responses and concerns

The nurse expects the child with expressive language disorder is likely to present with which nursing assessment finding?

The child has difficulty forming complete sentences.

The nurse has been asked to identify a location to conduct an interview with a psychiatric-mental health client. Which is an essential consideration when choosing a location?

The client's right to privacy

An instructor is preparing for a class discussion on family health and the effects of illness on it. Which of the following would the instructor incorporate into the discussion?

The health of the family often affects the family's ability to function.

A nurse is filing a safety event report for an older adult client who tripped and fell when getting out of bed. Which action exemplifies an accurate step of this process?

The nurse details the client's response and the examination and treatment of the client after the incident.

A woman in active labor suddenly experiences a sharp, excruciating low abdominal pain, which the nurse suspects may be a uterine rupture since the shape of the abdomen has changed. The nurse calls a code, and a cesarean birth is performed stat, but the infant does not survive the trauma. A few hours later, after the woman has stabilized, she asks to hold and touch her infant, and the nurse arranges this. Later, the nurse's documentation should include which outcome statement?

The parents are beginning to demonstrate positive grieving behaviors.

When assessing a toddler's language development, what is the standard against which you measure language in a 2-year-old toddler?

The toddler should speak in two-word sentences ("Me go").

A woman who is from the Philippines becomes upset when the nurse brings in an interpreter, rather than using her cousin as the translator. Which would be the best reason for using an official interpreter in this case?

There may be cultural limitations that change how the information is being interpreted by the family.

The nurse walks into a room and finds the client forcefully expelling stomach contents into a wash basin. When documenting this occurrence, the nurse will use the term:

vomiting

What is ocular muscle imbalance resulting in "lazy eye" called?

amblyopia

A client reports having joint pain that has gotten worse over the last year despite gradually increasing doses of an OTC pain reliever. Which type of pain will the nurse document as the chief complaint?

chronic pain

A nursing student is meeting a client during the pre-interaction phase of the nurse-client relationship. What questions are appropriate for the nusring student to pose during this phase? Select all that apply.

1.What is your name? 2.Can you tell me what brought you to the hospital? 3.What type of house do you live in?

A nurse working in a community clinic is discussing lifestyle modifications with a client. The client has been advised to lose weight because of a BMI greater than 25. Which statement by the nurse would be most therapeutic in helping the client?

"I can offer you some information outlining a variety of ways to lose weight."

The nurse in a medical unit is collecting a client's history and asks the client about the use of complementary and alternative therapies. The client asks why the nurse needs to know about this. What is the nurse's best response?

"It's important that we list all your home care needs for the hospital."

The parents of an infant with a colostomy are concerned that their child's colostomy bag is filling up frequently with gas. What is the most appropriate response by the nurse?

"Open the bag slightly whenever this happens."

A woman's baby is HIV positive at birth. She asks the nurse if this means the baby will develop AIDS. Which statement would be the nurse's best answer?

"The antibodies may be those transferred across the placenta; the baby may not develop AIDS."

A registered nurse (RN) is supervising the work of a licensed practical nurse (LPN) who is caring for a client diagnosed with a terminal illness. Which statement by the LPN would be corrected by the RN?

"The law says you must write a new living will each time you're admitted to the hospital."

The nurse is teaching an 80-year-old client how to instill eye drops for glaucoma. The client's daughter asks, "How do you know that my mother understands what to do?" What is the appropriate nursing response?

"When 15 minutes have passed, I will ask your mother to show me how to instill the drops."

The health care provider is in a hurry to leave the unit and tells the nurse to give morphine 2 mg IV every 4 hours as needed for pain. What action by the nurse is appropriate?

Inform the health care provider that a written order is needed

About which issue should the nurse inform clients who use pain medications on a regular basis?

Inform the primary health care provider about the use of salicylates before any procedure, and avoid over-the-counter analgesics consistently without consulting a physician.

A nurse is using drawing, puppetry, and other forms of play therapy while treating a terminally ill, school-age child. The purpose of these techniques is to help the child:

express feelings that the child can't articulate.

The term metacommunication is best defined as

interpersonal bridge between verbal and nonverbal communication

Which is a disturbance of the normal fluency and time patterning of speech?

stuttering

A client made a formal request to review his or her medical records. With review, the client believes there are errors within the medical record. What is the most appropriate nursing response?

"According to HIPAA legislation, you have a right to request changes to inaccurate information."

The health care provider has requested a urine sample from a female client for urinalysis. Which method should the nurse instruct the client to use to obtain a clean-catch urine?

"Begin to urinate while continuing to hold the labia apart. Allow the first urine to flow into the toilet."

The nurse is providing care for a male client age 69 years who has been admitted to the hospital for the treatment of pneumonia. Auscultation of the client's lungs reveals the presence of discontinuous, popping sounds during inspiration over the lower lung fields. What should the nurse document as being present?

crackles

Which term is used to refer to signals that encourage effective communication?

cues

Which statement by the nurse reflects the nurse's attempt to establish rapport and reduce patient anxiety?

"Good morning, Mr. Jones. The last time you were here you were planning a vacation. Tell me about your trip."

A 12-year-old child tells the school nurse, "I do not understand why my parents will not allow me to go to concerts without chaperones like some of my friends' parents. I feel like a baby compared to my friends." How will the nurse respond?

"Have you given any thought to why they do not let you go without a chaperone?"

The client reports chest pain. The nurse uses which of the following questions to assess the pain further. Select all answers that apply.

"How long have you experienced this pain?" "Please point to where you are experiencing pain." "Rate the pain on a scale of 0 to 10, with 10 being the worst possible pain." "What aggravates your chest pain?"

A hospital employee asks the nurse if another hospital employee is a client on the medical unit. What statements made by the nurse protect client privacy? Select all that apply.

"I am not able to provide that information." "Client privacy is part of the hospital code of conduct."

A nurse is assisting a client with his bed bath. The client states, "I can do it myself." Which is the nurse's best response?

"I will set up your bath for you. I will come back and help you with your bath."

Nursing students are learning about the importance of therapeutic communication in their pediatric course. The nursing instructor identifies a need for further teaching when a student makes which statement?

"It is best to stand when listening to a child to demonstrate knowledge."

The nurse is administering a new medication to an elderly male client and begins instruction about the medication. The client states, "Tell my wife. She takes care of all this kind of stuff." The nurse replies

"When your wife comes in to visit, I will return and provide the information to both of you."

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.

1. The nurse maintains eye contact with the client. 2. The nurse shows patience with the client and gives the client time to respond. 3. The nurse keeps communication simple and concrete.

Therapeutic communication techniques between client and nurse facilitate continuity of care. Which of the following identifies the value of therapeutic communication? Select all that apply.

1.Allows the nurse to display interest in the client and the communication 2.Helps the nurse to assist the client to explore and understand his or her problems

A nurse is preparing to assess the developmental patterns of a toddler using the Denver Developmental Screening Test (DDST II). When using this tool, which area would the nurse assess? Select all that apply.

1.Fine motor skills, 2.Language, 3.Social interaction

A client with schizophrenia has been brought to the hospital in an agitated state. In order for the nurse to perform the initial assessment, which approaches should the nurse use to manage the situation? Select all that apply.

1.Monitor facial expressions, 2.Monitor emotional responses, 3.Ensure availability of assistance

What interventions will best help the client with Huntington disease relieve anxiety and increase communication? Select all that apply.

1.Use biofeedback., 2.Consult with a speech therapist.

The nurse is caring for an 8-year-old with a life-threatening illness. The parents do not speak the native language and want the child discharged so they can pursue alternative therapies that they believe will be less expensive. What is the most important action taken by the nurse to help the family and the child?

Arrange to have a translator present when talking with the parents.

A pregnant woman with sickle cell anemia is very concerned her infant will also develop the disease and questions the nurse about that possibility. Which is the best response from the nurse?

Both parents have to carry the trait.

The nurse is caring for an 88-year-old male admitted 2 days ago for dehydration. The nurse brings the client his breakfast tray and notes that the client appears to be having difficulty understanding what she is saying to him today. Which nursing action is most appropriate?

Check the client's ear canals for cerumen.

The nurse manager for the psychiatric unit sees that there are major conflicts between the day and night shift staff. The nurse manager suggests that each shift put aside their differences for a time and determine a common major goal. Which conflict resolution style does the nurse manager display?

Collaborating

The nurse is in the process of administering medications to clients on the unit and notices one new mother is in the process of attempting to breast-feed her newborn infant. The nurse makes several suggestions to assist this mother. Which action should the nurse prioritize related to this interaction?

Document the care given

The family members of a dying client are finding it difficult to verbalize their feelings for and show tenderness to the client. Which nursing interventions should a nurse perform in such a situation?

Encourage the family members to express their feelings and listen to them in their frank communication.

A nurse is providing care to a client who has limited understanding of the dominant language. Which strategy is best for the nurse to use to ensure that the client obtains the needed health information?

Enlist the services of a qualified language interpreter

When teaching a client, the nurse notices the client tends to lose focus easily. The nurse would adapt client teaching in which way?

Talk with animation and vocal inflection to stimulate the client aurally.

What would be important for the nurse to consider at the beginning of an interview?

Establish rapport with the client and family members

The nurse is caring for a hospitalized toddler who is having a temper tantrum. What is the mostrealistic approach for the nurse to use to manage the child's temper tantrum?

Offer disapproval and then ignore the tantrum.

The nurse is trying to establish a trusting relationship with a client experiencing pain. When the client asks for pain medication, the nurse notes that it is not time to give the medication. What is the best action by the nurse to facilitate a trusting relationship?

Tell the client when the medication is due and return promptly at that time.

The psychiatric nurse correctly identifies the client's form of communication as circumstantiality when the client does what?

Provides long, irrelevant explanations when asked why the client abuses alcohol.

A nurse is conducting an initial assessment of a client. When the client enters the nurse's office, the client finds the nurse sitting with arms folded across the chest and an emotionless facial expression. The nurse is exhibiting which nonverbal communication technique?

closed body position and impassive face

A healthcare provider (HCP) calls the hospital unit and requests to leave a new prescription for a client over the phone as the HCP does not have access to the electronic health record (EHR) at present. What action would the nurse take?

Receive the prescription over the phone and repeat it back to the HCP to verify accuracy.

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?

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

The nurse is caring for a patient who had a total laryngectomy and has drains in place. When does the nurse understand that the drains will most likely be removed?

When the patient has less than 30 mL for 2 consecutive days

The nurse is preparing discharge instructions for several clients after their admission for emergent care of a pregnancy complication. To the client with which condition will the nurse stress the importance of frequent office visits to monitor her progress?

a molar pregnancy

What are the best examples of the role of the nurse as a communicator? Select all that apply.

1.Telling a client their blood pressure 2.Calling a physician about a client's blood pressure 3.Informing the physical therapist that the client's therapy was discontinued 4.Discussing laboratory values with a client

A nurse responds to a client's statement with silence based on the rationale that this technique is used primarily to:

permit the client to gather the client's thoughts.

A client needs to be transferred to the oncology unit for further care. Which information is necessary to include in the transfer report?

current client assessment

When documenting the care of a client, the nurse is aware of the need to use abbreviations conscientiously and safely. This includes:

limiting abbreviations to those approved for use by the institution.

A nurse documents the following in the client chart: Risk for Decreased Cardiac Output related to myocardial ischemia. This is an example of what aspect of client care?

nursing diagnosis

The nurse has received a medication order over the telephone from a provider. What is the nextappropriate nursing action?

read or repeat back the order

The nurse is sharing information about a client at change of shift. The nurse is performing what nursing action?

reporting

The nurse should consider which client aspect as nonverbal communication?

tone of voice

After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/µl. What term should the nurse use to describe this low platelet count?

thrombocytopenia

The nurse is instructing a 4-year-old child about an upcoming procedure. What approach should the nurse employ during teaching?

use simple terms

The nurse is assessing a client for changes in health condition. After listening to the client's lungs for adventitious breath sounds, the nurse also checks the client's latest white blood cell count. The nurse is gathering which type of data when looking up the lab value?

objective

A male client has always prided himself in maintaining good health and is consequently shocked at his recent diagnosis of diabetes. The nurse has asked the client, "How do you think your diabetes is going to affect your lifestyle?" The nurse has utilized which of the following interviewing techniques?

open-ended question

The nurse is interviewing the mother of a child who is at the local clinic. When asked why she brought her toddler in today, she replies that he has been running a fever and coughing a lot since last weekend. This information would be noted in the chart as what data?

the chief complaint