Taylor Prep U Ch 8: Communication
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
The client stares at the floor and states, "I feel fine."
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
aggressive.
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
"I see you are upset. Would you like to talk?"
A nurse is asking a colleague about a situation. Which statement demonstrates assertive communication
"I think there is a better way to handle this."
The nurse has arranged to start an IV line for a client with pancreatitis. The nurse notes that the client appears anxious about the procedure. What is the most appropriate response by the nurse to decrease the client's anxiety
"I will start an IV that will add fluids directly to the blood stream."
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
"My name is Sue Smith, RN, and I am calling regarding Mrs. Jones in room 356 at Jefferson Hospital."
A nurse is caring for a client experiencing biliary colic from uncomplicated cholelithiasis. The client asks, "My doctor says I should have surgery to remove my gallbladder. Do you think it is really necessary?" What is the nurse's best response
"Share with me the advantages and disadvantages of your options as you see them."
In which situation would the SBAR technique of communication be most appropriate
A nurse is calling a physician to report a client's new onset of chest pain.
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
Be silent and allow the client to continue speaking when ready.
During an assessment of a newly admitted client the nurse asks the client many questions. The nurse begins the assessment by asking, "How many times have you been hospitalized this year for your back pain?" This is an example of which type of question
Closed question
Which quality in a nurse helps the nurse to become effective in providing for a client's needs while remaining compassionately detached
Empathy
It is important for the nurse to empathize with the client to develop a positive, therapeutic relationship. What is a characteristic of empathy
Identifying with the client's feelings
The nurse and the physical therapist discuss the therapy schedule and goals for a client on a rehabilitation unit. What type of communication is occurring between the nurse and the therapist
Interpersonal
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
Orientation phase
Several nurses on the same hospital unit communicate on the same social networking site. A nurse posts the following statement to the social networking page, "The lady in room 34 with heart failure was a train wreck!" In which manner has the nurse failed to apply the principles of confidentiality
Sharing information about a client beyond the area of client care is unacceptable and breaches the client's confidentiality rights.
When the nurse communicates with a newly admitted client, the nurse must pay particular attention to nonverbal behaviors. The nurse considers which characteristic as nonverbal communication
The client's tone of voice
A nurse is communicating the plan of care for a client who is unconscious. Which nursing actions best facilitate this process? Select all that apply
The nurse is careful what is said in the client's presence because hearing is the last sense to go. The nurse assumes the client can hear and discusses things that would ordinarily be discussed. The nurse speaks with the client before touching the client.
The nurse is using nonverbal communication when caring for a group of clients. Which situation(s) reflects nonverbal communication? Select all that apply
The nurse is maintaining eye contact when changing a client's dressing. The nurse has a smile when being thanked for caring for a family member. The nurse assess a client is in pain from a grimace.
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
The nurse says, "I can only imagine how hard this is on you. How can I help 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
The nurse shows patience with the client and gives the client time to respond. • The nurse maintains eye contact with the client. • The nurse keeps communication simple and concrete.
Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship
Working phase
A nurse is on lunch break in the hospital cafeteria and sits at a table near a group of physicians eating their lunch. One of the physicians, who is in charge of the nurse's clients, points at the nurse and states, "That guy needs to get fired." The best response by the nurse would be to
ask to speak to the physician in private and address the disrespectful remark.
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
ask why the client thinks the client will wake up during surgery.
A nurse is preparing to provide discharge instructions to a postpartum client regarding infant care. Before beginning the education session, the nurse should
eliminate as many distractions as possible.
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
involve the child's stuffed animal in the educational session.
A nurse is caring for a client who presents with a skin infection. While obtaining the client's medical history, it is determined that the client is an intravenous drug user. To foster effective communication, the nurse should
remain honest, open, and frank.
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
sit at the bedside and allow the client to explain the statement
A nurse is attempting to calm an infant in the nursery. The nurse responds to the highest developed sense by
swaddling the child and gently stroking its head.
A nurse is preparing to enter a client's room to perform wound care. The shift report revealed that this client has a tunneling wound in the sacral area that cannot be staged. The wound was also documented as having a foul odor. The nurse is nervous because the nurse has not performed wound care on a complex wound in the past. Using effective intrapersonal communication, this nurse should
tell oneself to "remain calm" and remember that the nurse was trained to perform this skill.
The nurse is collecting health data and avoids using closed-ended questions. Which are examples of closed-ended questions? Select all that apply
• "Is there any chance you might be pregnant?" • "Do you smoke cigarettes?" • "Are you ready to get out of bed?" • "Does it hurt when I touch you here?"
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
Assess how the client would like to communicate
What nursing care behavior by the nurse engenders a client to trust the nurse
A nurse answers the client's questions about an upcoming test in a calm gentle voice while making eye contact with the client.
Which is a skill appropriate to use in therapeutic communication
Control the tone of the voice to avoid hidden messages.
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 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 client presents to the urgent care clinic with ear pain. The client reports a medical history of trigeminal neuralgia. The nurse is not familiar with trigeminal neuralgia. When the client asks whether the two conditions could be related, which response by the nurse is best
"I honestly do not remember specific details regarding trigeminal neuralgia; let me research it."
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
"I know this is hard for you. Is there any way I can help?"
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
"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."
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
"The thought of having surgery is keeping you awake."
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
"This must be very difficult for you to hear. How do you feel right now?"
The nurse is communicating with a client following a routine physical examination. Which statement best demonstrates summarization of the appointment
"We reviewed your plans for your new diet and medications. Do you have any other questions?"
During an admission intake assessment, a nurse uses open-ended questions to gather information. An example of an open-ended question is
"What did your health care provider tell you about your need to be admitted?"
A client scheduled to have hip replacement surgery states, "I am so scared of the surgery and of the anesthetic." What is the best response by the nurse
"What questions do you have about the surgery?"
The client is being discharged, and the nurse observes the client crying. What is the nurse's most appropriate response
"Would you like to talk about anything before you go home?"
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
"You seem unsure. Tell me your concerns about your surgery."
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
"You're worried about how you will tolerate the pain associated with labor."
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
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
Arrange for a sign language interpreter when discussing treatment.
The nurse is reporting to an oncoming nurse about the care of a client using the SBAR format. The nurse informs the oncoming nurse that the client should continue to have neurolgoical checks every 2 hours and the nurse should report any alterations to the health care provider. In which section should this information be relayed
Recommendation
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
Reviewing health changes
A client has cancer, but the significant other does not want the client to know the diagnosis. The nurse demonstrates sensitivity to the significant other and works with the couple to achieve desired outcomes. What kind of behavior is the nurse exhibiting
Empathy
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
False reassurance
The nurse-client relationship depends on communication. Effective communication between the nurse and the client encompasses which aspects? Select all that apply
Observation Sight Spoken words touch
The nurse makes a contract with the client during which phase of the nurse-client relationship
Orientation phase
When caring for a psychiatric client, a nurse would make a formal contract with the client during which phase of the nurse-client relationship
Orientation phase
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
Speak directly to the client.
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
The working phase
Carl Rogers (1961) studied the process of therapeutic communication. Through his research, the elements of a "helpful" person were described. They include all of the following except which choice
analysis
An experienced nurse has been working with a client with heart failure. The client's lungs were clear to auscultation during the morning assessment; however, the afternoon assessment revealed bibasilar crackles and tachypnea. The nurse calls to give SBAR report to the covering health care provider. In the final step of the report the nurse should
recommend 40 mg of furosemide be administered because the client had improvement with past administration.