Nurs 222 CoursePoint Chapter 8

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) Plan a meeting where the dominant person cannot attend. b) Pick a team leader who is not the dominant member. c) Have group members confront the dominant member to promote the needed team work. d) Have group members issue a written warning to the dominant member.

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

The nurse-client relationship depends on communication. Effective communication between the nurse and the client encompasses which aspects? Select all that apply. a) Spoken words b) Intuition c) Sight d) Telepathy e) Touch f) Observation

a) Spoken words c) Sight e) Touch f) Observation

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: a) Ask the client for a urine specimen for urine drug use screening. b) Consult with the social worker regarding inpatient drug rehabilitation. c) Ask if the client realizes the infection is a direct result of the drug use. d) Remain honest, open, and frank.

d) Remain honest, open, and frank.

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

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

A client has just been given a diagnosis of cirrhosis of the liver. Which statements by the nurse should be avoided because they could impede communication? Select all that apply. a) "Cheer up. Tomorrow is another day." b) "Your doctor knows best." c) "That's a lot of information to take in. Would you like to talk about it?" d) "Don't worry. You will be just fine in another day or two." e) "Everything will be all right."

a) "Cheer up. Tomorrow is another day." b) "Your doctor knows best." d) "Don't worry. You will be just fine in another day or two." e) "Everything will be all right."

The nurse is using nonverbal communication when caring for a group of clients. Which situation(s) reflects nonverbal communication? Select all that apply. a) The nurse is maintaining eye contact when changing a client's dressing. b) The nurse documents on the SBAR form and sends it to the transferring unit. c) The nurse gives a brochure to a client upon discharge. d) The nurse has a smile when being thanked for caring for a family member. e) The nurse assess a client is in pain from a grimace.

a) The nurse is maintaining eye contact when changing a client's dressing. d) The nurse has a smile when being thanked for caring for a family member. e) The nurse assess a client is in pain from a grimace.

cA 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: a) Call the nursing supervisor to address the situation at hand. b) Ask to speak to the physician in private and address the disrespectful remark. c) Return to the nurse's home unit and ask to meet with the charge nurse. d) Write a written account of what transpired and contact an attorney.

b) Ask to speak to the physician in private and address the disrespectful remark.

The nurse is performing an admission interview with a new client diagnosed with acute coronary syndrome. For the nurse to obtain information and allow the client free verbalization, which question would elicit the most information? a) "Have you ever had chest pain prior to this admission?" b) "Could you tell me more about how you are feeling right now?" c) "I have had chest pain before, and it is really scary!" d) "Did you take any medication when you had the pain?"

b) "Could you tell me more about how you are feeling right now?"

Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship? a) Orientation phase b) Working phase c) Termination phase d) Evaluation phase

b) Working phase

A nurse is at the end of a busy shift on a medical-surgical unit. The nurse enters a room to empty the client's urinary catheter and the client says, "I feel like you ignored me today." In response to the statement, the nurse should: a) Smile at the client and apologize. b) Ignore the statement and empty the urinary catheter. c) Sit at the bedside and allow the client to explain the statement. d) Inform the client that the unit was very busy that day.

c) Sit at the bedside and allow the client to explain the statement.

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) Restating b) Clarification c) Reflection d) Encouraging elaboration

d) Encouraging elaboration

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

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

A nurse during orientation notices that the preceptor gives all subcutaneous injections on a 45-degree angle. When the new nurse asks the preceptor the rationale for the practice the preceptors states, "This is how I do it, and this is how you will do it." The new nurse recognizes this behavior to be: a) Aggressive b) Assertive c) Passive d) Nurturing

a) Aggressive

A nurse is completing a health history with a newly admitted client. During the interview, the client presents with an angry affect and states, "If my doctor did a good job, I would not be here right now!" What is the nurse's best response? a) Be silent and allow the client to continue speaking when ready. b) Smile and say, "Don't worry, I am sure the physician is doing a good job." c) Nod and say, "I agree. If I were you, I would get a new doctor." d) Stand and say, "I can see this interview is making you uncomfortable, so we can continue later."

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

A nurse touches the client's hand while discussing the client's diagnosis. This action is: a) A dynamic process b) A translation c) A communication channel d) An auditory channel

c) A communication channel

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? a) Empathy b) Positive regard c) Analysis d) Comfortable sense of self

c) Analysis

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

a) Control the tone of the voice to avoid hidden messages.

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) Orientation phase b) Working phase c) Termination phase d) Evaluation phase

a) Orientation phase

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 best described in this scenario? a) The working phase b) The introduction phase c) The orientation phase d) The termination phase

a) The working phase

A nurse states the following to another nurse who is constantly forgetting to wash hands between clients: "It looks like you keep forgetting to wash your hands between clients. It's really not safe for your clients. Let's think of some type of reminder we can use to help you remember." This communication is an example of what type of speech? a) Aggressive b) Assertive c) Nonassertive d) Therapeutic

b) Assertive

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

b) Being sensitive to the client's emotional barriers.

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

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

A nurse is 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) Use only open-ended questions. c) Tell the client to rest and allow a family member to answer. d) Allow the client to set the pace.

d) Allow the client to set the pace.

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) Look directly at the client and state, "You are afraid of waking up during surgery." b) Ask the surgeon to come to the bedside to reassure the client. c) State "everyone is afraid of that." 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 discharging a client and thus terminating the nurse-client relationship. Which action should the nurse perform in this phase? a) Make formal introductions. b) Create a contract regarding the relationship. c) Provide assistance to achieve goals. d) Examine goals of the relationship to determine whether they were achieved.

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

A nurse is 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) "I understand you have four kids; how many times have you actually been pregnant?" b) "All right, you have four children, is that correct?" c) "How old are your children?" d) "Were these term births?"

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

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

The nurse must use appropriate interviewing techniques to elicit accurate and complete health information. Which statement is an example of an open-ended question or comment? a) "What brought you to the hospital this morning?" b) "Are you having pain right now?" c) "You seem upset today. Are you?" d) "I'll be back in 30 minutes to check on your pain relief."

a) "What brought you to the hospital this morning?"

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

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

A nurse suspects that a client may have a hearing problem. The nurse should attempt to consult: a) An audiologist b) An ophthalmologist c) A clinical psychologist d) An optometrist

a) An audiologist

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

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

A nurse is completing a health history on a client who has a hearing impairment. Which action should the nurse take first to enhance communication? a) Assess how the client would like to communicate. b) Use facial and hand gestures. c) Contact a person skilled in sign language. d) Provide paper and pencil for written communication.

a) Assess how the client would like to communicate.

A nurse is interviewing a client who has come to the clinic for a follow-up visit. The nurse notices the client does not make eye contact and speaks while looking down. How should the nurse respond? a) Assume a position at eye level with the client and continue with the interview. b) Stop the interview and ask, "How are you feeling?" c) Sit silently until the client looks up and makes eye contact. d) Touch the client's hand and say, "You seem upset, is there something bothering you?"

a) Assume a position at eye level with the client and continue with the interview.

A nurse who has been caring for a client for the past few days is preparing the client for discharge and termination of the nurse-client relationship. Which activity would the nurse be carrying out during this phase of the relationship? a) Reviewing health changes b) Attending to physical health care needs c) Establishing trust and rapport d) Developing solutions that will be enacted

a) Reviewing health changes

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

a) Speak directly to the client.

A nurse is caring for a client who is newly diagnosed with terminal cancer. The nurse enters the client's room and finds the client sitting in the dark crying. Which statement conveys empathy by the nurse? a) "I am so sorry you are going through this. Can we talk?" b) "I know this is hard for you. Is there any way I can help?" c) "Sitting in the dark is not going to cure your cancer. Let's open the curtains." d) "Can you please tell me why you are crying?"

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

A nurse enters the client's room and states, "Hello, Mr. Alonso. My name is Anthony Bader. I will be your registered nurse today. I will be providing your nursing care and will be with you until 3:30 PM. If you need anything, please call me on my phone or put your light on." The nurse then gives the client a printed card with this information. In the helping relationship, which phase does this represent? a) Intimate phase b) Orientation phase c) Working phase d) Termination phase

b) 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? a) The nurse did not fail to apply the principles of confidentiality because the client's name was not used. b) Sharing information about a client beyond the area of client care is unacceptable and breaches the client's confidentiality rights. c) The nurse did not fail to apply the principles of confidentiality because the hospital's name was not mentioned. d) Sharing information about the client's diagnosis is unacceptable because it is viewed by the general public and not just other nurses.

b) Sharing information about a client beyond the area of client care is unacceptable and breaches the client's confidentiality rights.

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 stares at the floor and states, "I feel fine." c) The client smiles at the nurse and states, "I cannot wait to go home." d) The client looks at the nurse and states, "I am still not feeling my best."

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

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? a) The client's accent b) The client's tone of voice c) The client's religious practices d) The client's ethnicity

b) The client's tone of voice

A nurse finds that a client has infiltration around the IV line that needs to be removed. What explanation should the nurse give to reduce the client's anxiety? a) "This must have been caused from you moving your arm around." b) "Just be very still; the procedure is very minimal and will be over soon." c) "I know that you are anxious, but the IV location needs to be changed." d) "It will be a painless procedure and there is nothing to worry about; many clients experience this."

c) "I know that you are anxious, but the IV location needs to be changed."

A nurse is assessing vital signs on a pregnant client during a routine prenatal visit. The client states, "I know labor will be so painful, it sounds awful. I am sure I will not be able to stand the pain; I really dread going into labor." What is the best response from the nurse? a) "Don't worry about labor, I have been through it and it is not so bad." b) "There are many good medications to decrease the pain; it will not be so bad." c) "You're worried about how you will tolerate the pain associated with labor." d) "I would recommend keeping a positive attitude."

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

A client is diagnosed with diabetes. The client's adult child offers to serve as an interpreter, because the client does not speak the dominant language. Which is the best action for the nurse to take? a) Allow the client's child to interpret. b) Involve a friend who speaks both the dominant and the client's languages. c) Contact a professional interpreter. d) Ask a fellow nurse who knows some words in the client's language to help.

c) Contact a professional interpreter.

In a helping relationship, the nurse would most likely perform what action? a) Encourage the client to independently explore goals that allow the client's human needs to be satisfied. b) Set up a reciprocal relationship in which both the client and nurse are giving and receiving help. c) Establish communication that is continuous and reciprocal. d) Establish goals for the client that are not set in a specific time frame.

c) Establish communication that is continuous and reciprocal.

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? a) "Close your eyes and take a deep breath. I know you were frightened, but the baby is healthy and everything is going to be okay." b) "This is great news. You don't have anything to worry about and the baby is doing well." c) "I can help you, please talk to me so that I know how I can help you." d) "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."

d) "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."

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) "It sounds as if your surgery is a pretty scary procedure." b) "You have a great surgeon. You have nothing to worry about." c) "You shouldn't be nervous. We perform this procedure every day." d) "The thought of having surgery is keeping you awake."

d) "The thought of having surgery is keeping you awake."

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

d) "What day of the week is it?"

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) "Can you tell me the medications you take on a daily basis?" c) "Do you have an advanced directive or a living will?" d) "What did your health care provider tell you about your need to be admitted?"

d) "What did your health care provider tell you about your need to be admitted?"

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 room number rather than the name of the client. 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 client's diagnosis rather than the client's name. 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.

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

d) Therapeutic communication