Fundamental of nursing Chapter 24

Patient C has a speaking disability; although the nurse can use

visual cues to communicate, the patient does not require a picture that mimics the action desire

Soft-toned speech indicates a

welcoming attitude.

Erect posture and brisk walking indicate

well-being and confidence.

The following statements are correct:

"I should be in the personal zone while counseling the patient"; "Speaking at a community forum generally involves the public zone"; and "I should ask for permission before assessing the patient's wrist or feet." While counseling a patient, the nurse should be in the personal zone of 18 inches (46 cm) to 40 inches (102 cm). While speaking at a community forum, the public zone of 12 feet (366 cm) or more is generally maintained. The special zones of touch for which the nurse should ask permission include the wrist or feet. While taking a patient history, the nurse should be in the personal zone of 18 inches (46 cm) to 40 inches (102 cm), not 9 feet (274 cm). While performing a physical assessment, the nurse would enter the intimate zone of 0 to 18 inches (0 to 51 cm), not the social zone. 40%of students nationwide

Which statement by the nurse indicates a correct understanding of personal zones of space and touch? Select all that apply. One, some, or all responses may be correct.

"I should be in the personal zone while counseling the patient." "Speaking at a community forum generally involves the public zone." "I should ask for permission before assessing the patient's wrist or feet.

The charge nurse would intervene if the newly hired nurse said the following:

"I should encourage and help the patient accomplish goals," and "I should achieve a smooth transition for the patient to other caregivers as needed." These indicate the newly hired nurse does not understand what occurs in the orientation phase of the nurse-patient relationship. The nurse should encourage and help the patient accomplish goals in the working phase, not the orientation phase. In the termination phase (not the orientation phase)

Which statement by the newly hired nurse about interacting with a patient in the orientation phase indicates the charge nurse needs to intervene? Select all that apply. One, some, or all responses may be correct

"I should encourage and help the patient accomplish goals." "I should achieve a smooth transition for the patient to other caregivers as needed."

The nurse would have a correct understanding by the following statements:

"I should introduce myself by giving my name and title," "I will avoid referring to patients by diagnosis, room number, or other attributes," and "I should avoid terms such as 'honey,' 'dear,' or 'grandma' while addressing the patients." The nurse should introduce him- or herself by giving his or her name and status, such as nursing student, registered nurse (RN), or licensed practical nurse (LPN). It is important that the nurse avoid referring to patients by diagnosis, room number, or other attributes, because this approach would be demeaning to patients. The nurse should avoid terms of endearment while addressing patients, even with close nurse-patient relationships. Addressing patients by the last name is respectful in most cultures; nurses usually use a patient's last name in an initial interaction and then use the first name if the patient requests it. Using first names is appropriate for infants, young children, and patients who are confused or unconscious, as well as close team members.

The termination phase is the

final stage in the nurse-patient relationship. During this phase, the nurse reminds the patient that termination is near and also evaluates goal achievement.

Giving personal opinions may be indicated by stating,

"I think you should consider terminating treatment," not, "Don't worry; you'll be fine." "How would you describe your relationship with Sue?" is an example of asking a personal question, not "Don't worry; you'll be fine

Which statement by the nurse indicates effective learning about assertive behavior?

"It helps resist intentionally imposed guilt."

Which communicative statement indicates a defensive response?

"No one here would intentionally lie to you.

It is essential that patients understand discharge instructions to

safely care for themselves at home.

The following is a sequence to characterize the nurse-patient relationship:

(1) reviewing the patient for any family history of obesity, (2) assessing the patient by checking body mass index and vital signs, (3) encouraging the patient to self-explore by collecting information on lifestyle changes, (4) instructing the patient to perform daily exercise and note the weight changes, and (5) having the patient review the diet that should be followed after discharge to combat obesity. The first phase of the nurse-patient relationship is the preinteraction phase, which occurs before meeting a patient. This phase involves reviewing available data, including the medical and nursing histories. The second phase is the orientation phase, which involves assessing the health status of the patient such as body mass index and vital signs. The third phase is the working phase, which involves problem solving and accomplishing goals. In this stage, the nurse would encourage the patient to self-explore by collecting information on lifestyle changes. This is followed by instructing the patient to perform daily exercises and noting the weight changes. Both of these steps are involved in working phase. The fourth phase is the termination phase, which occurs before ending the relationship. This involves a brief review of the diet that should be followed after discharge to combat obesity.

The environment is the setting for

sender-receiver interaction

Skills to facilitate attentive listening include the following:

1. sit at an angle facing the patient, 2. maintain intermittent eye contact, and 3. be relaxed and comfortable. It is essential to sit at an angle facing the patient, because this posture conveys the message that the nurse is there to listen to what the patient is saying. The nurse should maintain intermittent eye contact to convey involvement in and willingness to listen to what the patient is saying. It is important to communicate with a sense of being relaxed and comfortable with the patient. It is important to lean toward the patient and not away from the patient, because this position conveys that the nurse is involved and interested. The nurse should sit in an open position by keeping his or her arms and legs uncrossed, because this position suggests that the nurse is "open" to what the patient says. A "closed" position, such as crossing arms, conveys a defensive attitude.

Trust is developed by the following techniques:

1. treat the patient with respect, answer the patient honestly, and display consistent behavior when responding to patients. 2. Trust is a firm belief in the reliability, truth, or ability of someone without doubt or question. 3. Treating the patient with respect fosters trust, as does answering the patient with honesty and responding to patients with consistent behavior. Withholding key information may violate the legal and ethical standards of practice and result in a breach of trust. Leaving the patient immediately after providing care may be perceived as avoiding spending time with the patient and may thereby hinder the development of trust.

Communication channels are means of

sending and receiving messages through visual, auditory, and tactile senses. .

The nurse should not assume the patient is hard of hearing because she is

80, but it is more likely. The patient may have not responded because the nurse was across the room and water was running. The nurse should not jump to conclusions, but instead try again to communicate with patient as with someone who is hard of hearing.

Upon initial assessment, a patient reports a cough for 3 days that is getting worse. The nurse says, "Tell me more about your cough." The patient says, "I wish I could, but that is why I'm here. You tell me what's wrong!" Which response would enhance communication?

After 3 days, your cough has gotten worse. Have you had a fever?

The patient informs the nurse that a diagnosis of terminal breast cancer has completely changed her life and then suddenly becomes silent. How would the nurse respond?

Allow the patient to break the silence

The nurse is asking a patient about pain in the abdomen. When asking a patient about abdominal pain, the nurse would use which method of effective communication? Select all that apply. One, some, or all responses may be correct.

Appropriate intonation Properly paced statements Clear and concise phrasing

. Which action would the nurse perform when communicating with a cognitively impaired patient? Select all that apply. One, some, or all responses may be correct.

Ask one question at a time. Use simple sentences to clarify. Allow time for patient to respond

Which action would the nurse perform for easy communication with a patient who has aphasia?

Ask questions that require "yes" or "no" answers

Which action would the nurse take when communicating with a patient with aphasia? Select all that apply. One, some, or all responses may be correct.

Ask simple questions. Use communication aids. Listen attentively and patiently

Which approach is likely to be effective when communicating with a Spanish-speaking patient who has a hand fracture? Select all that apply. One, some, or all responses may be correct.

Assessing the patient's level of fluency in English Incorporating the patient's communication methods Providing written information in English and the primary language

Which characteristic would the nurse infer from the nonverbal cues of a patient who has a quick and purposeful gait?

The patient is confident.

Which communication strategy would the nurse use when caring for an older patient who is visually impaired? Select all that apply. One, some, or all responses may be correct.

Checking for use of glasses Articulating in a normal tone of voice

The nurse states to a patient, "When you tell me that you're having a hard time living up to expectations, are you talking about your family's expectations?" Which therapeutic communication technique does this illustrate?

Clarifying

Which situation is typical regarding lateral violence?

Colleagues, especially in the workplace, use badmouthing, nasty remarks, or nonverbal expressions of disapproval

Which strategy would the nurse use when communicating with a patient who has difficulty speaking because of injuries caused by facial trauma? Select all that apply. One, some, or all responses may be correct.

Communicate directly to the patient. Review medical records to assess the level of sensory loss. Listen patiently when the patient speaks.

Which critical thinking attitude motivates the nurse to communicate and know more about a patient?

Curiosity

Which action performed by the nurse indicates the working phase of the helping relationship?

Encouraging and helping the patient set goals

Which nursing action is involved in the termination phase of the nurse-patient relationship for a patient with diabetes?

Evaluate whether the patient has achieved the goal of maintaining normal blood sugar levels.

When caring for a patient, the nurse identifies factors that affect the outcomes of the treatment. To which phase of the nursing process does this nursing activity belong?

Evaluation

The nurse summarizes a conversation with a patient to determine whether the patient has understood the nurse. Which element of the communication process does this illustrate?

Feedback

Which nontherapeutic technique would the nurse avoid while communicating with a patient? Select all that apply. One, some, or all responses may be correct.

Giving false reassurance Responding aggressively Asking for explanation

Which statement by the nurse indicates a correct understanding of the elements of professional communication? Select all that apply. One, some, or all responses may be correct.

I should introduce myself by giving my name and title." "I will avoid referring to patients by diagnosis, room number, or other attributes." Correct5 "I should avoid terms such as 'honey,' 'dear,' or 'grandma' while addressing the patients.

Which observation of the patient's speech and behavior would lead the nurse to conclude the patient is having difficulty communicating? Select all that apply. One, some, or all responses may be correct.

Inappropriate verbalization Inability to articulate words Difficulty in comprehending

Which initial step would the nurse take if lateral violence occurs in the workplace?

Informing the manager to obtain suppor

The nurse finds that a patient avoids taking painkillers because of a fear of drug addiction in accordance with the patient's cultural beliefs. Which level of communication would the nurse use for cultural assessment of the patient?

Interpersonal

The nurse explains to a patient that self-talk can improve self-awareness and help build a positive self-concept. To which level of communication does this refer?

Intrapersonal

Which level of communication is exhibited by the nurse performing a mental rehearsal on how to deal effectively in difficult situations with increased confidence?

Intrapersonal

The nurse is planning to conduct an interview of a Portuguese patient who does not speak English. The nurse has arranged for an interpreter, who is currently in the patient's room. The nurse speaks to the interpreter directly and maintains eye contact. The interpreter then translates the information for the patient. What can be said about the communication pattern used by the nurse?

It is inappropriate, because the nurse is not speaking to the patient directly

Which term describes snide remarks or put-downs between colleagues?

Lateral violence

Which type of communication pattern would be exhibited when the nurse observes and acknowledges a patient's verbal and nonverbal indications of stress and prompts the patient to elaborate on these feelings?

Metacommunication

The nurse asks an 80-year-old patient a question while washing hands across the room. The patient does not answer. Which action would the nurse take next?

Move to the patient's bedside, get her attention, and repeat the question while facing the patient.

Which type of communication technique is represented when the nurse asks cancer survivors to share their stories on how they went through treatment and how their family members supported them?

Narrative interaction

Which strategy would be contraindicated while communicating with a patient who has cognitive impairment?

Offer detailed explanations while asking questions to help the patient understand

Which aspect of verbal communication improves effectiveness? Select all that apply. One, some, or all responses may be correct.

Pacing Intonation Vocabular

Which patient would benefit from the use of a picture that mimics the desired action?

Patient D cognitive impairment

Arrange the steps in a sequence of phases that characterize the nurse-patient relationship, beginning with the first phase, for a patient who is obese.

Reviewing the patient for any family history of obesity Assessing the patient by checking body mass index and vital signs Encouraging the patient to self-explore by collecting information on lifestyle changes Instructing the patient to perform daily exercise and note the weight changes Having the patient review the diet that should be followed after discharge to combat obesity

Which communication technique is the nurse using when he or she comments on positive aspects of a patient's behavior and response?

Sharing hope

Which skill would facilitate attentive listening while interacting with the patient? Select all that apply. One, some, or all responses may be correct.

Sit at an angle facing the patient. Maintain intermittent eye contact. Be relaxed and comfortable

Which intervention would help the nurse communicate with patients with varying degrees of hearing loss? Select all that apply. One, some, or all responses may be correct.

Speak clearly and slowly. Check for the patient's hearing aids. Make the patient aware while talking

Which action would the nurse take when caring for a patient facing amputation of the leg during the orientation phase of the relationship?

Talk with the patient about favorite hobbies.

Which phase of the helping relationship is represented when the nurse recalls a funny shared experience with a patient shortly before the patient is transferred to another unit?

Termination

Creativity and perseverance are

attitudes conducive to communication, because they motivate the nurse to identify innovative solutions but do not motivate the nurse to know more about a patient.

at the end of the relationship, the nurse should facilitate a smooth transition for the patient to other caregivers as needed.

The charge nurse does not need to intervene for the other statements because they indicate the newly hired nurse understands what occurs in the orientation phase of the nurse-patient relationship. In the orientation phase, the nurse should begin to make interferences and judgments about patient messages and set the tone for the relationship by adopting a warm, empathetic, and caring manner. The nurse should also closely observe the patient and expect to be closely observed by the patient.

In the communication process, which person is the receiver of the message?

The person who decodes a message

Interpersonal communication is an interaction that occurs within

The spiritual domain of the patient. Therefore the nurse assesses the spiritual and cultural needs of the patient using the transpersonal level of communication.

Which statement describes appropriate uses of focusing as a therapeutic means of communication? Select all that apply. One, some, or all responses may be correct

This method guide the direction of the conversation to important areas. Use focusing when the patient begins a vague conversation. Avoid focusing if it interrupts the patient's important discussion

Which technique would the nurse use to develop trust? Select all that apply. One, some, or all responses may be correct.

Treat the patient with respect. Answer the patient honestly. Display consistent behavior when responding to patients.

Vocabulary is the use of

Vocabulary is the use of words; the ability to understand words forms an important part of verbal communication. Posture is maintaining and moving the body and is part of nonverbal communication, not verbal. Facial expression is the emotion conveyed by the movement of facial structures and is also part of nonverbal communication, not verbal.

Exploring the patient's feelings occurs during the

Working phase

An older-adult patient who is critically ill asks the nurse about assisted suicide. The nurse is ethically opposed to assisted suicide. Which response by the nurse is appropriate?

You have been thinking about it; let us discuss more about how you feel.

The nurse is using metacommunication. Metacommunication is

a broad term that refers to all factors that influence communication. It involves being aware of influencing factors and helping people better understand what is communicated. Therefore by acknowledging the patient's nonverbal and verbal signs of stress and understanding the situation better, the nurse employs metacommunication.

Difficulty in sitting and inability to draw pictures is

a condition unrelated to speech and communication.

small-group communication occurs in

a group.

Interpersonal communication is one-on-one interaction between

a nurse and another person that often occurs face to face; it does not involve teaching a group of nursing students.

Stating that things are bad and nothing can be done is

a passive response, not a defensive response.

Small-group communication occurs when

a small number of people meet in committees and patient care conferences, not when teaching nursing students.

The nurse uses small-group communication while communicating with

a small number of people with a common goal.

Blaming someone for incomplete work indicates

an aggressive response, not a defensive response.

Public communication is interaction with

an audience. This level of communication may involve the registered nurse speaking to a group of nursing students about patient care.

Intrapersonal communication occurs within

an individual and helps express perceptions, feelings, and self-concept. Therefore intrapersonal communication is not involved in the cultural assessment of the patient. .

Substance abuse (not lateral violence) occurs when

an individual ingests alcohol and illicit drugs that are harmful not only to him or herself but also to others.

Sexual violence (not lateral violence) occurs when

an individual touches another individual without consent or forces him or her to take part in sexual activity against his or her will.

Intrapersonal communication is a form of communication that occurs within

an individual. This can also be referred to as self-talk or self-verbalization.

Patients who have limited ability to speak or understand English have a legal right to

an interpreter to ensure understanding of essential information. Using a dictionary is not an effective method to teach a patient with limited English proficiency about new medications. Although the nurse could explain directions to the patient's 14-year-old daughter, the more appropriate method is to obtain an interpreter because the daughter may leave out pertinent information. Using a picture board and visual aids is not as effective as using an interpreter to teach a patient about new medications.

The nurse would ask simple questions that require "yes" or "no" answers because a patient with

aphasia has difficulty speaking. The nurse would encourage the patient to converse and collaborate with a speech therapist as needed; the nurse would not tell the patient to remain silent.

Verbal communication with patients requires

appropriate intonation, because tone makes the intention of the sentence clear and encourages effective communication. Properly paced statements help the patient clearly understand what is communicated, keeping in view the age and health condition of the patient. Verbal communication with patients requires clear and concise phrasing to communicate clearly and focus on the most important aspect. Closed questions do not promote communication and may not yield enough information. Open-ended questions promote communication, and the patient tenders more information. Hurried complex statements can confuse the patient.

Inappropriate verbalization is the inability to use

appropriate verbal expressions in the form of words.

Asking how someone can claim not to have slept when he or she was heard snoring indicates

arguing or challenging, not a defensive response.

Assessment involves

assessing the patient and taking the patient's history. T

The nurse would include the following:

assessing the patient's level of fluency in English, incorporating the patient's communication methods, and providing written information in English and the primary language. It is necessary to assess the patient's primary language and level of fluency in English. Incorporating the patient's communication methods or need into plan of care is an important action. Providing written information in English and in the primary language of the patient is an essential action while communicating with a non-English-speaking patient. While caring for a non-English-speaking patient, a professional interpreter should be provided; a family member should not be used as an interpreter. Nodding or making statements such as "OK" are not necessarily indications of understanding.

The nursing process consists of five phases:

assessment, diagnosis, planning, implementation, and evaluation.

Self-confidence is important

because the nurse who conveys confidence and comfort while communicating can more readily establish an interpersonal caring relationship, but it does not focus on learning more about the patient.

Reviewing the medical record would occur

before the orientation phase of the relationship, during the preinteraction phase.

Therapeutic communication, not confrontation, takes place

between a nurse and patient.

The sender also seeks

both verbal and nonverbal feedback, while the receiver provides feedback to the sender.

Communication strategies for the visually impaired older patient are to

check for the use of glasses and articulate in a normal tone of voice. When the nurse is caring for a visually impaired patient, it is effective to use indirect (not direct) lighting and to avoid glare. It is recommended to use at least a 14-point (not 9-point) font when providing reading material to a visually impaired patient. Do not rely on gestures or nonverbal communication while communicating with visually impaired patients.

The nurse is not sure what the patient means by "living up to expectations" and is

clarifying the patient's concern. The nurse is not providing information, or paraphrasing.

Inability to articulate words, or dysarthria, is the inability to

clearly pronounce words.

The nurse uses public communication while at conferences with

colleagues or during classroom discussions with peers or students, not when performing a cultural assessment

Lateral violence occurs when

colleagues, especially in the workplace, use badmouthing, nasty remarks, or nonverbal expressions of disapproval.

Sharing observations involves .

commenting on observations such as the looks, sounds, or actions of the patient, not commenting on positive aspects of the patient's behavior and response

Curiosity motivates the nurse to

communicate and know more about a patient.

Nontherapeutic communication blocks

communication and involves asking personal questions or giving personal opinions, which discourages further expression of patient's feelings and ideas. Nontherapeutic communication is not the focus of this question.

Nonverbal communication describes

communication without verbal messages; snide remarks or put-downs are verbal messages. Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items with four options. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

In the evaluation phase, the nurse

compares the actual and expected outcomes and identifies the factors affecting outcomes. Based on these, the nurse modifies the nursing care plan.

Asking simple questions that require "yes" or "no" answers makes

comprehension and answering easier for the patient. Using communication aids eases the process and makes the patient feel comfortable. Listening attentively and patiently makes the patient feel comfortable. Visual clues can be used as required to ease the process of communication. The nurse should avoid assuming the patient's answers; rather, let the patient know if something is not understood, because this will encourage effective communication.

Focusing is used to portant areas, not to distract the patient or give suggestions.

concentrate on one area.

Using correct posture shows

confidence, positive attitude, and a sense of well-being.

Offering detailed explanations is

contraindicated. The nurse should use simple sentences and avoid long explanations while communicating with patients who are cognitively impaired. Giving sufficient time for the patient to answer a question is an appropriate strategy in communicating with patients who are cognitively impaired; it is not contraindicated.

Assertive behavior can help nurses deal with

criticism and manipulation by others and learn to say no, set limits, and resist intentionally imposed guilt. Assertive behavior will not necessarily help nurses avoid ethical dilemmas; on the contrary, ethical dilemmas may arise that make assertiveness difficult to implement for fear of retaliation. Assertive messages contain "I," not "you." Effective assertive behavior can help reduce the incidence of lateral violence in the workplace, not make it conducive.

Stating that no one would intentionally lie indicates

defensive behavior.

Nurses use intrapersonal communication to

develop self-awareness and a positive self-esteem that enhances appropriate self-expression; this scenario does not focus on intrapersonal communication.

Intrapersonal communication involves

developing self-awareness and self-esteem that enhances appropriate self-expression. This level of communication is also called self-talk and may involve a mental rehearsal to deal effectively with difficult tasks or situations with increased confidence

Inappropriate verbalization, inability to articulate words, and difficulty in comprehending can make communication

difficult.

In the planning stage, the nurse

documents expected outcomes.

Conversational tone, good vocabulary, and clarity all are elements of

effective verbal communication, not nonverbal communication.

Sharing feelings involves helping patients share

emotions by encouraging openness and modeling healthy self-expression, not commenting on positive aspects.

The sender (not the receiver) is the person who

encodes and delivers a message.

Patient A has hearing impairment; therefore the nurse would speak

facing the patient with the mouth visible and arrange for a sign language interpreter if indicated, not pictures.

Metacommunication is not the term that describes this scenario, but is a broad term that describes

factors influencing communication.

Nonverbal communication involves the

five senses and anything that does not involve the spoken or written word; the patient's facial expression is an example of nonverbal communication. This situation involves more than just nonverbal communication.

Guiding the direction of the conversation to important areas can help

gather required information. When the patient begins a vague conversation, focusing can help gather the missed data. Interrupting the patient's important discussion increases the chances of missing out on valuable information and may seem rude. When the patient provides valuable information, the nurse should carefully consider that information instead of using the technique of focusing. Focusing is used to direct the conversation to unimportant areas, not to distract the patient or give suggestions.

Encouraging the patient to reflect on the initial statement would

help the patient and also help the nurse understand the patient. Telling the patient that the nurse will figure out the problem later relays a negative message to the patient. Saying that the patient "could have almost any disease" might exacerbate the patient's anxiety. Asking where the patient was born is not pertinent at this point.

Commenting on the positive aspects of a patient's behavior and response develops

hope in the patient.

The implementation stage includes

implementation of nursing interventions and delegation of the work.

While counseling a patient, the nurse should be

in the personal zone of 18 inches (46 cm) to 40 inches (102 cm).

Blunt facial expression and avoidance of eye contact indicate

indifference and unwillingness.

The nurse's response should validate the patient's

information, relay empathy, and seek further knowledge.

Communicating directly with the patient helps the nurse assess the patient's ability to

interact and respond to the nurse's stimuli. Reviewing the patient's medical records helps the nurse understand the underlying cause and information related to speech problems. When the nurse listens to the patient without hurrying, the patient feels comfortable and tries to communicate better. Asking the patient to speak fast creates unnecessary pressure and can further affect the speech. When the patient is unable to speak, the nurse should avoid assuming answers but confirm by using other types of communication such as writing or gestures.

Sitting at an angle facing the patient conveys that the nurse is

interested in what the patient is saying. Sitting at an angle facing the patient does not convey uninvolvement with the interaction. When the nurse is relaxed (not sitting at an angle facing the patient), it conveys that the nurse is comfortable with the patient. When the nurse uncrosses legs and arms, not sitting at an angle facing the patient, this conveys the nurse is "open" to what the patient is saying.

When there is a difference of opinion between the nurse and the patient, it is important for the nurse not to force ideas on the patient. Instead of showing disapproval, the nurse should try to

know more about the situation and explore the patient's views. Telling the patient not to think about it would prevent the patient from communicating further. It is an unethical nursing practice for the nurse to tell a patient that the nurse does not want to talk about the topic. Telling the patient that it is a bad idea would offend the patient and prevent the patient from opening up

In a therapeutic relationship, it is helpful to encourage patients to

share personal stories, a process called narrative interaction. Through listening to the patients' stories, the nurse understands the context of patients' lives, their concerns, experiences, and challenges.

Transpersonal refers to communication that occurs within the

spiritual domain,

It is very important to have interpreters present when conducting interviews with patients coming from

non-English-speaking backgrounds. The nurse should speak directly to the patient even if the interpreter is present. This shows that the nurse respects and cares for the patient. The nurse should not speak to the interpreter. The nurse should maintain eye contact with the patient. Conducting the interview in the presence of caregivers would be an invasion of the patient's privacy.

How would the nurse complete the discharge teaching for a patient with limited English proficiency who is to be discharged on a new medication?

obtain an interpreter to facilitate communication of medication information

While speaking at a community forum, the public zone

of 12 feet (366 cm) or more is generally maintained. The special zones of touch for which the nurse should ask permission include the wrist or feet. While taking a patient history, the nurse should be in the personal zone of 18 inches (46 cm) to 40 inches (102 cm), not 9 feet (274 cm). While performing a physical assessment, the nurse would enter the intimate zone of 0 to 18 inches (0 to 51 cm), not the social zone. 40%of students nationwide

. When a patient is seriously ill or distressed, the nurse may be tempted to

offer false hope statements such as, "Don't worry, you'll be fine." Sympathy is concern, sorrow, or pity felt for another person. This is indicated by stating, "I'm so sorry about your condition," not, "Don't worry; you'll be fine." ."

Which nontherapeutic communication technique is the nurse using when saying, "Don't worry; you'll be fine" to a patient?

offering false reassurance

A referent motivates

one person to communicate with another.

Interpersonal communication is

one-on-one interaction between a nurse and another person that often occurs face-to-face; it is not a mental rehearsal.

Asking the patient about blood sugar levels and any foot ulcers is an aspect of checking the health status of the patient, which occurs during the

orientation phase (not the termination phase).

Socializing is used during thee.

orientation phase of a relationship to get acquainted and help establish trust.

Assessing the status of health in the patient occurs during the

orientation phase. The orientation phase includes making inferences about patient messages and behaviors. The nurse anticipates health concerns or issues during the pre-interaction phase.

Which element of nonverbal communication would the nurse consider when establishing a nurse-patient helping relationship? Select all that apply. One, some, or all responses may be correct.

posture Eye contact

Which level of communication is applicable when the registered nurse (RN) is teaching a group of nursing students about the care of patients?

public

feedback is the message the

receiver returns that indicates understanding.

The receiver is the person who

receives and decodes a message.

Patient B has a visual impairment; therefore the nurse would avoid

relying on gestures or nonverbal communication or pictures.

Drooped shoulders and slow walking indicate

sadness, grief, depression, or illness.

The initial step is informing the manager to obtain

support. If a nurse is experiencing lateral violence in the workplace, he or she would inform the manager to obtain support. Complaining about the abusive co-worker in the unit meeting would be inappropriate and could make the situation worse; this is not the initial step. Instead of informing hospital management, the nurse would first approach the manager. The nurse would not try to determine whether other nurses and trainees have also experienced the same thing because this will not solve the issue and may make it worse.

The working phase involves

taking actions to meet the goals set for the patient. The nurse sets the tone for the relationship by adopting a warm, empathetic, caring manner during the orientation phase.

Electronic communication is the use of

technology to create ongoing relationships with patients and their health care teams, not teaching nursing students.

Summarizing previous discussions occurs during the

termination phase of the relationship.

Pacing is

the appropriate rate at which speech is delivered and is important for effective verbal communication.

Using pictures or gestures that resemble

the desired action and involving a family member in conversation while providing counseling are also effective strategies for communicating; they are not contraindicated.

Small-group communication is

the interaction that occurs when a small number of people meet and discuss issues; it does not involve a mental rehearsal.

By summarizing what the patient has said, the nurse can determine whether

the message was received accurately.

Interpersonal communication occurs on a one-on-one basis between

the nurse and the patient.

Which message does the nurse convey to a patient when sitting at an angle facing the patient?

the nurse is interested in what the patient is saying

The nurse should allow the patient to break the silence, because

the patient initiated it. This shows that the nurse is willing to wait for a response when the patient is unable to respond quickly. Use of silence can prove to be therapeutic when a patient is extremely sad or grieving. The nurse should not leave the room, break the silence, or distract the patient.

When the nurse ends the relationship with a patient, it indicates

the termination phase of the helping relationship. This phase may involve the nurse and the patient reminiscing about their relationship and what occurred.

The preinteraction phase involves

the time before the nurse's initial interaction with the patient.

The nurse encourages and helps the patient set goals during

the working phase of the helping relationship.

Encouraging the patient to maintain a checklist of food habits and blood sugar levels would occur in

the working phase, not the termination phase.

Speaking clearly and slowly gives the patient time

to comprehend what the nurse is saying. Patients who have hearing aids are encouraged to use them to improve communication. When patients are aware that the nurse is talking, they are more attentive and try to comprehend better. Speaking quickly will not encourage effective communication; rather, speaking slowly and being patient will help. The nurse should face the patient and make sure the patient can see the nurse's mouth when speaking.

Intonation is the use of

tone that indicates the expression and the emotions of the speaker.

Difficulty in comprehending is the inability to

understand another's expression.

Sharing empathy is the ability to

understand the patient's reality, perceive feelings accurately, and communicate this understanding to the patient, not pointing out positive aspects.

Asking one question at a time gives the patient with cognitive impairment sufficient time to communication.

understand, think, and answer the question. Using simple sentences to clarify helps the patient comprehend without much difficulty and results in effective communication. Because patients with cognitive impairment may be slow in processing information, it is helpful to give them time to respond. Friends and family members are good sources of information and should be included in the discussion on subjects they are familiar with. Avoiding communication is against the duty of the nurse; the nurse should attempt every possible way to communicate with the patient. Providing lengthy explanations is not helpful, because the patient with cognitive impairment may not be able to comprehend, which will lead to ineffective

Clarifying involves checking whether the nurse

understands a message accurately, not asking for stories. The nurse did not use silence; the nurse asked for stories. Although sharing stories can lead to empathy, the nurse did not use empathy when asking for patients' stories. The nurse used narrative interaction.

Giving false reassurance to the patient about the situation is

unethical and may cause the patient to lose trust in the nurse. Responding with aggression, such as by exhibiting anger and frustration, is unprofessional behavior. Asking the patient for explanations might be interpreted by the patient as accusatory and may interfere with communication. Sharing hopes and feelings, listening actively, and clarifying are therapeutic communication techniques.

Pacing, intonation, and vocabulary are aspects of

verbal communication that improve effectiveness.

A quick and purposeful gait indicates

well-being and confidence. Posture and gait convey important clues about a patient's health. A patient who is attentive may lean forward. Fatigue or depression is indicated by a slumped posture and slow, shuffling gait.

Interpersonal violence occurs

when an individual uses power and control over another individual through physical, sexual, or emotional threats; lateral violence occurs among colleagues, there is no power difference.

The nurse would check for the use of contact lenses

when communicating with a visually impaired patient, not with a patient who has aphasia. Avoiding the use of computer-generated speech programs is an inappropriate action for a nurse to use with a patient with aphasia. The nurse would use a computer-generated speech program as a communication aid appropriate for this situation.

. Public communication is interaction with an audience,

which may include speaking to groups of consumers about health-related topics, not a mental rehearsal.

Eye contact suggests a

willingness to listen and shows respect.

Advising the patient to change his or her lifestyle is involved in the

working phase, not the termination phase.

Lateral violence is a term to describe

workplace bullying, such as snide remarks or put-downs between colleagues.