NURS 3108 - Chapter 8 Communication Skills EAQs
A nurse finds it difficult to assess pain by observing a person belonging to an Asian culture. What is most likely the reason for this difficulty? The client expresses pain dramatically. The client does not freely express pain. The client is not able to locate the point of pain. The client is not able to quantitatively describe pain.
The client does not freely express pain. Individuals belonging to Asian cultures tend not to express the negative feelings associated with pain and other emotions. Therefore, it is difficult for the nurse to identify the behaviors associated with pain. Extreme dramatic expression of pain may be observed in clients belonging to African and Middle Eastern cultures. It is difficult to observe whether the client is able to locate the point of pain or describe pain quantitatively, because these are subjective assessments of pain.
Which percentage of communication is nonverbal? Up to 30% Up to 50% Up to 70% Up to 90%
Up to 90% Up to 90% of communication is nonverbal. The amounts 30%, 50%, and 70% are too low.
A client diagnosed with paranoid delusions tells the nurse, "Do you see Jesus standing over there? He is right in front of the window." Which response by the nurse would be the most therapeutic? "I do see someone that looks a bit like Jesus by the window." "What makes you think Jesus is standing over by the window?" "That is one of the therapists standing in front of the window, not Jesus." "That is just another one of your delusions, let's find something to distract you."
"That is one of the therapists standing in front of the window, not Jesus." Stating that the person in front of the window is not Jesus is presenting reality, which indicates what is real without arguing or trying to convince the client. Agreeing with the delusion and asking the client what makes them think that Jesus is standing by the window would not address the inaccurate perception. Stating that it is just a delusion does not directly address the inaccurate perception of reality.
The primary care provider has informed the pregnant client of several options for follow-up after the finding of an abnormality on the 5-month ultrasound, which includes genetic testing, amniocentesis, etc. Which approach by the nurse would be most useful? "What do you consider to be options you would be comfortable with?" "I would advise you to complete all of these as soon as possible for your peace of mind." "Amniocentesis could result in loss of the pregnancy; it would not be a risk I would be willing to take if I were you." "Here are some brochures which discuss all of the possible abnormalities and what they mean, please let me know if you have any questions."
"What do you consider to be options you would be comfortable with?" Asking the client what she considers to be possible options supports critical thinking on the part of the client as she attempts to find a solution. Offering advice such as telling her to complete the testing quickly or that she should not take the risk interferes with the client's decision-making process and is not therapeutic. Handing the client brochures implies the nurse does not want to talk about the client's concerns and can create a nontherapeutic barrier.
The nurse is providing a counseling group session for college students who are struggling to be successful and are anxious about potentially failing. Which question posed by the nurse might best help the students in this situation? "Why haven't you invested the amount of time that you should to study for your classes?" "You all seem to spend a great deal of time socializing, you might want to decrease that." "I wouldn't worry too much, students often do poorly at the beginning and then get much better." "What if you could go back and change how you prepared for your exams; what would you do differently?"
"What if you could go back and change how you prepared for your exams; what would you do differently?" "What if" questions can be very useful in helping individuals explore and identify thoughts, feelings and strategies and would be the best response in this situation. "Why" questions put individuals on the defensive and would not be considered therapeutic. Telling the students that they spend too much time socializing is a judgmental statement and would not be helpful in this situation. Indicating that the students should not worry minimizes their feelings and is not therapeutic.
The nursing instructor is speaking with a recent nursing graduate who failed the national licensing exam on the first attempt. The instructor asks the student: "Why didn't you complete a review course like I suggested?" Which alternative question might be more therapeutic? "What strategies did you use to study for the exam?" "How angry are your parents that you failed on the first try?" "Do you really believe that you did all you could to pass the exam?" "Do you feel that the school did not prepare you well enough for the licensing exam?"
"What strategies did you use to study for the exam?" "Why" questions imply criticism. It is better to ask questions such as what strategies the student nurse used to focus more on facilitating problem solving. Asking how angry the students' parents are about the failure, whether the student believes that he or she prepared enough, or if the school prepared the student enough does not focus on problem solving and would not help to focus on solving the current problem.
The nursing student has been assigned to complete the assessment for a client experiencing severe anxiety. The client tells the nursing student: "I am so overwhelmed; I can't deal with the overpowering anxiety." Which response by the student nurse would be the most therapeutic? "Why do you feel so overwhelmed?" "Can you describe the feeling of being overwhelmed a little more?" "Has something recently happened? Did you lose your job or did someone die?" "Have you been attending the support group for people with anxiety that was suggested the last time you were here?"
"Can you describe the feeling of being overwhelmed a little more?" Asking the client to describe the feeling allows exploration of the feeling and would be the most therapeutic. "Why" questions are generally nontherapeutic, because they put the individual on the defensive. Asking excessive questions such as, "Has something recently happened?" "Did someone die?" "Did you lose your job?" may result in confusion on the part of the client. Changing the subject by asking if he or she followed through with the support group may invalidate the client's feelings and is nontherapeutic.
An elderly client recently admitted to the long term care facility for rehabilitation tells the nurse, "No one cares; instead of helping me, they sent me here to die." Which would be the most effective response by the nurse? "Do you feel that no one cares?" "You know that's not true, your family cares." "You will only be here a short time so please don't be this way." "Let's not worry about that right now, let's get you admitted and to therapy."
"Do you feel that no one cares?" Restating the main idea expressed allows the client to clarify if that was not truly the intent. Stating that the client knows this to be untrue minimizes the client's feelings and is not therapeutic. Telling the client that he or she will be in the facility only for a short term is false reassurance and is not therapeutic. Changing the subject by stating, "Let's not worry about that and get you to therapy" is a nontherapeutic response that may invalidate the client's feelings.
A nurse counsels a widow whose husband died five years ago. The widow says, "If I'd done more, he would still be alive." Which is the nurse's most therapeutic response? "I understand how you feel after such a terrible loss." "That was a long time ago. It's time to move on with your life." "You did a good job of caring for him. There was nothing else you could have done." "Your husband was 82 years old with severe chronic obstructive pulmonary disease."
"Your husband was 82 years old with severe chronic obstructive pulmonary disease." Pointing out that the husband was 82 and had severe chronic obstructive pulmonary disease demonstrates the therapeutic technique of presenting reality. The nurse is simply presenting the facts of the situation without judgment or comment. Giving advice, disagreeing, and changing the subject are nontherapeutic communication techniques. Though many people use them in everyday life, they can be problematic when applied to clients.
A student nurse beginning a mental health rotation discusses the fact that the religion he or she practices has a firm belief that mental illness is a punishment from God. What type of factor may affect communication between this student and the clients? Cognitive Emotional Relationship Environmental
Emotional Emotional factors that can affect communication include personal bias, which may occur if the student nurse's belief about mental illness predisposes the student to a certain view of these clients. Cognitive factors include knowledge, problem-solving abilities, and language use. Relationship factors refer to whether participants in the relationship are equal or unequal. Environmental factors can include physical factors or societal determinants which can impact communication.
Mental health issues often go unaddressed due to which factors? Select all that apply. Fear of stigma Problems with transportation Scarcity of health care providers in remote areas Lack of research on mental health disorders Ineffective treatment methods for most mental health disorders
Fear of stigma Problems with transportation Scarcity of health care providers in remote areas Many mental health issues go unaddressed due to fear of stigma, problems with transportation, and a scarcity of health care providers, particularly in rural or remote areas. Although more research can be done on mental health, lack of research does not contribute to mental health issues not being addressed. Effective treatment methods exist for many mental health disorders and are not a reason why mental health issues go unaddressed.
In the communication process, which includes an indication of whether or not the nature of the message sent was correctly interpreted by the receiver? Media Feedback Message Stimulus
Feedback The feedback sent by the receiver often indicates if the message sent by the sender was correctly interpreted.
The home care nurse is making an initial visit to provide support and education to the family of a child with severe asthma. During the assessment, the mother steps out of the room and returns smelling of cigarette smoke. Which would be the most therapeutic way to address this? "You really need to stop smoking if you value the life of your child." "I noticed that you stepped out to smoke, do you see this as an issue with your child's asthma?" "Do you realize that your refusal to stop smoking may result in rehospitalization of your child?" "Why do you continue to smoke when your child has such severe asthma? I can smell it on your clothes."
"I noticed that you stepped out to smoke, do you see this as an issue with your child's asthma?" Stating that the nurse noticed that the individual stepped outside to smoke is making an observation which can call attention to a person's behavior and help them describe thoughts and feelings related to the behavior. Using fear or threats such as stating that "you really need to stop smoking if you value the child's life" or that the behavior will result in rehospitalization is not therapeutic and implies judgment. "Why" questions imply criticism and are not therapeutic.
In an inpatient psychiatric unit, an aggressive client frequently insults a timid client during group sessions. In the group session today, the client spoke out to the bully about the behavior. Which statement by the nurse is most therapeutic to show approval for the client's actions? "You really shouldn't have addressed the bully in the group session today." "I hope that you will be able to defend yourself again when you are bullied." "You did a great job of defending yourself today in group and standing up to the bully." "I noticed you addressed the insulting behavior today in group. How did It feel to be more assertive?"
"I noticed you addressed the insulting behavior today in group. How did It feel to be more assertive?" Asking the client how they felt about being more assertive is correct because it opens the way for finding out if the client was scared or comfortable, wants to work more on assertiveness, or has other issues to discuss. Telling the client they did a great job is incorrect because it is giving approval and stops further communication. Telling the client he or she should not have addressed the bully is incorrect, because it is disapproving. Telling the client he or she will be able to defend him- or herself again when being bullied is incorrect because it does not provide the opportunity for further discussion.
Which statement by the nurse would be the most effective initial statement to an individual brought to the emergency room for evaluation after a violent rape? "I'll stay here and sit with you." "What are you thinking about?" "Could you describe specifically what happened?" "Let's discuss some ways you could prevent this from happening again."
"I'll stay here and sit with you." Offering to sit with the client does not require the client to respond or behave in any certain manner, and would be most therapeutic at this time in the client-provider interaction. Asking the client what he or she is thinking about or to discuss what happened may need to occur but can be done once the client feels safe to do so. Offering to discuss ways to prevent a rape from happening in the future would not be appropriate at this time and may be interpreted as blaming the victim.
A client diagnosed with pancreatic cancer is speaking with the nurse about treatment decisions. The client tells the nurse, "Even though I am scared and unsure, I have decided to participate in the experimental drug trial the physician discussed with me." Which response by the nurse would be considered nontherapeutic? "Tell me more about how you feel about the decision." "You state that you are scared. Would you like to discuss that some more?" "You are unsure about the decision you have made to participate in this trial?" "I'm glad that you decided to do the treatment; it is a drug with great promise."
"I'm glad that you decided to do the treatment; it is a drug with great promise." Giving approval or agreeing with the statement implies that the nurse believes the client is doing the right thing and is thus a nontherapeutic response. Exploring the decision by asking the client to tell the nurse more allows the client to examine the decision and is a therapeutic response. Focusing on the client's statement that he or she is scared is a therapeutic response and allows the client to concentrate on that aspect of the communication. The nurse's response: "You are unsure," is a therapeutic response that restates the client's main idea and encourages them to clarify if necessary.
Which statement demonstrates the nurse's implementation of a therapeutic projective question? "You really should apologize for your behavior today in the group session." "Why did you leave your spouse? Are you going to go back? Why would you leave your children?" "You did a great job about telling that person just what you thought about how badly he or she treated you yesterday." "If you could go back to the time before your divorce and change your behavior, what would your life look like now?
"If you could go back to the time before your divorce and change your behavior, what would your life look like now? Asking the client if the client could go back in time and change behavior is correct because it is a projective question. A projective question is an effective communication tool to help clients articulate, explore, identify thoughts and feelings, and imagine thoughts, feelings, and behaviors they might have in certain situations. Telling the client to apologize for behavior is incorrect because it demonstrates advising, which is a nontherapeutic technique. Asking the client why he or she left his spouse and if the client is going back to the spouse is incorrect because it demonstrates excessive questioning, which is a nontherapeutic technique. Telling the client he or she did a great job telling someone what the client thought about how badly he or she treated the client yesterday is also incorrect because it demonstrates giving approval, which is a nontherapeutic technique.
A single young adult who has had a 10-week pregnancy recently confirmed asks the nurse what she should do because she has no money, no insurance, and the father is not interested in being involved. She tells the nurse that she truly does not want to raise a child. Which response by the nurse would be nontherapeutic? "What are some ways that you think you could deal with this situation?" "If you truly do not want the child, adoption or abortion may be the best alternatives." "You think the father of the baby is not interested in being involved in the pregnancy?" "What did it mean to you when the father of the baby told you that he did not want to be involved?"
"If you truly do not want the child, adoption or abortion may be the best alternatives." Offering advice such as telling the client her choices are abortion or adoption is not helpful and does not allow the client to make their own decision, and is thus nontherapeutic. Encouraging the client to think of other ways she could deal with the situation encourages her to identify alternative actions and is a therapeutic response. Asking if the client thinks the father of the baby is not interested in being involved in the pregnancy uses the technique of reflecting, which can be effective in directing questions back to the client. Asking the client what it meant to her when the father of the baby told them he did not want to be involved is the technique of evaluation, which encourages her to explore the situation from her own perspective.
A nursing student is caring for a client being treated for severe depression who was admitted after being involved in a drinking and driving accident that injured two individuals seriously. The student tells the instructor that he or she is unsure he or she can care for the client, because the client made the choice to drink and drive. Which statement made by the student to the client would concern the instructor? "I am here today to spend time with you." "Could you talk about how you felt after the accident?" "What would you like to talk about during my time here today?" "It is hard for me to understand how you could drink and drive but I will try."
"It is hard for me to understand how you could drink and drive but I will try." Stating that the student cannot understand how the client could drink and drive implies moral judgment and is not an effective communication technique. Stating that one is present to spend time with the client offers self and can offer presence, interest and a desire to understand. Asking the client to talk about how they felt after the accident would be use of the technique of exploring, which can help examine experiences more fully. Asking what the client would like to discuss is a broad opening and can encourage the client to take the lead.
The home care nurse is visiting a client who is managing congestive heart failure at home. The client has gained 3 pounds in the past few days, has 2+ edema of the lower extremities, and is having difficulty breathing. Which statement by the nurse would be considered nontherapeutic as the nurse attempts to determine the factors that have led to the current assessment findings? "I notice that you are having trouble breathing." "When did you first notice the trouble breathing and the weight gain?" "It seems you quit taking your medications, why did you stop taking them?" "Perhaps you and I can work together to determine what has led to these symptoms."
"It seems you quit taking your medications, why did you stop taking them?" The nurse's statement that the client quit taking the medications and asking "why" makes a judgment and may place the client on the defensive; thus this would be a nontherapeutic statement. Asking when the client first noticed the issues helps to place the events in a sequence and can be helpful to determine what may have created the current issues. Suggesting that the nurse and client can work together indicates a desire to collaborate, which is a therapeutic approach to the situation.
A client diagnosed with major depressive disorder says to the nurse, "You're assigned to take care of me, but you keep talking to other clients. You need to spend more time with me." Which is the nurse's most therapeutic response? "It sounds like you're saying you need more attention." "I have other clients whose needs are greater than yours." "My time is equally divided among all clients assigned to me." "Thank you, but I will decide how much time to spend with my clients."
"It sounds like you're saying you need more attention." Telling the client it sounds like he or she is expressing a need for more attention demonstrates the therapeutic technique of reflecting. This encourages the client to accept his or her own feelings. Responses that other clients have greater needs, that the nurse divides time equally, and that the nurse will decide how to spend his or her time might address the nurse's situation, but they are not therapeutic for the client, in that they do not address the client's viewpoint or feelings in a way that encourages growth and understanding.
The nurse is discussing the upcoming transfer of a client to a long term care facility with the client's spouse who is struggling with the decision for long-term care. The spouse asks the nurse if he or she has done the right thing. Which statement would be most therapeutic in this situation? "Yes, you have done all that you can, this nursing home will provide good care." "Tell me more about how you feel about your spouse going into long-term care." "Everything will be all right; your spouse may not need to be there long anyway." "I'm glad you have made this decision; even though it was a hard one, it is the right one."
"Tell me more about how you feel about your spouse going into long-term care." Asking the spouse to talk more about his or her feelings allows reflection and supports decision making. Stating that the spouse has done everything he or she can, made the right decision, or that everything will be all right can minimize the person's feelings and be judgmental on the part of the nurse.
Which statement best reflects the nurse's use of exploring in a conversation? "Tell me more about the accident." "Have you had an accident before?" "Why do you think this accident happened?" "How could you prevent a similar accident in the future?"
"Tell me more about the accident." Encouraging the client to tell the nurse more about the accident encourages exploration of the issue. Asking if the client has had an accident before encourages comparison. Asking how the client could prevent accidents in the future encourages formulation of a plan of action. "Why" questions can put clients on the defensive and are nontherapeutic.
Which should the nurse consider when interpreting nonverbal behaviors? Select all that apply. Age Culture Spiritual norms Voice tone and pitch Environmental factors
Age Culture Spiritual norms Voice tone and pitch Age, culture, spiritual norms, and voice tone and pitch can influence a client's nonverbal behaviors and should be considered by the nurse. Environmental factors may need to be considered, but not in relation to nonverbal behaviors.
A nurse who is comfortable and confident with the interviewing process will effectively use which communication technique? Filling each void in the conversation Allowing for moments of uninterrupted silence Avoiding topics that could possibly be embarrassing Relying on verbal rather than non-verbal communication
Allowing for moments of uninterrupted silence Allowing for uninterrupted silence is correct, because using silence is an effective tool in encouraging clients to open up. Additionally, using silence allows the client to reflect and develop answers to questions. Filling voids in conversations is incorrect, because it is not an effective communication technique in interviewing clients. Avoiding topics that could be embarrassing to the client is incorrect, because it is not an effective communication technique in interviewing clients. Relying on verbal communication is incorrect, because it is not an effective technique in interviewing.
The nurse is documenting assessment data for a newly admitted client. The nurse documents that the client demonstrates a flat affect and does not appear to be in distress despite complaints of abdominal pain. The nurse understands that this behavior is common in which culture? Asian Hispanic Native American African American
Asian In the Asian culture expression of either positive or negative emotions is a private affair; a calm facade may mask severe distress.
The student nurse is analyzing the process recording of an interaction with a depressed client admitted after a suicide attempt. Which aspect of the process recording would the student nurse label as nontherapeutic? Period of silence after introducing self. Asking: "What would you like to discuss?" Stating: "I'll sit with you awhile if you would like to talk." Asking: "Why did you feel so sad that you tried to commit suicide?"
Asking: "Why did you feel so sad that you tried to commit suicide?" "Why" questions such as why did you feel so sad that you tried to commit suicide imply criticism and are nontherapeutic. Periods of silence can be effectively used to encourage the client to share. Asking what the client would like to discuss offers a broad opening and is therapeutic. Offering to sit with the client is a therapeutic technique that enhances communication.
Which is the first thing the nurse should do to prepare for communication with clients from different cultures? Become aware of own cultural identities and biases Learn effective communication techniques for each specific culture. Study the predominant cultures of the clients for whom the nurse will be caring Inform the director of nursing if there are certain cultures with whom the nurse feels uncomfortable working
Become aware of own cultural identities and biases It is important for the nurse to understand his or her own cultural identity and biases to provide effective, respectful care when communicating with clients who have different cultural backgrounds. Learning effective communication techniques for specific cultures is important but not the first thing the nurse needs to do. Studying the predominant cultures of the clients being cared for can be helpful but is not the first thing the nurse should do. If the nurse anticipates difficulties caring for clients from a certain culture, a discussion with the director of nursing may be helpful to work towards resolution but is not the first thing the nurse would do.
Which technique would the nurse be using if he or she states, "I am not sure I understand you, could you repeat what you just told me?" Restating Exploring Clarifying Reflecting
Clarifying When the nurse needs to verify understanding of what the client stated, clarification is an effective communication technique. The nurse may need to restate, explore, or reflect, but this is not an example of that.
A student nurse is working with an elderly Native American client admitted for treatment of diabetes. The student has been asked to complete the assessment. Which behavior by the student could be considered disrespectful according to the Native American culture? A younger nurse asking questions of the client. Exhibiting active listening skills throughout the client assessment. Lightly shaking the hand of the client when initially greeting them. Encouraging the client to maintain direct eye contact throughout the assessment.
Encouraging the client to maintain direct eye contact throughout the assessment. Many Native Americans believe it is disrespectful to engage in direct eye contact, particularly if the speaker is younger. Although Native Americans revere their elders, a younger nurse asking questions is not necessarily considered disrespectful. Native Americans appreciate the use of listening skills during communication interactions. Some Native Americans extend their hand and lightly touch the other's hand rather than a using typical handshake.
Patients from which culture most likely use dramatic body language when discussing emotional problems? Asian Americans African Americans Hispanic Americans British Americans
Hispanic Americans Hispanic Americans may use dramatic body language when describing emotional problems. Asian, African, and British Americans are less likely to use dramatic body language when describing emotional problems.
Which of the nurse's clients would most likely be offended by direct eye contact during communication? Hispanic female being admitted for labor and delivery. A recent Haitian immigrant being assessed for infectious diseases. A German American receiving treatment for complications of diabetes. A Chinese male speaking to the older primary care provider about abdominal pain.
Hispanic female being admitted for labor and delivery. Hispanics generally avoid eye contact with authority figures as a sign of respect. Haitians hold eye contact with everyone but the poor. Americans interpret direct eye contact as an indication of trust or that the person is listening. When speaking to an older adult, the Chinese use direct eye contact and would not be offended. German Americans are comfortable with eye contact during communication.
A Native American adult is hospitalized. The emergency department assessment indicates auditory and visual hallucinations. The client states, "My dead father told me to kill myself to save me from the bad spirits." What would be an appropriate nursing intervention for the nursing care plan? Initiate a consultation between the hospital chaplain and the client. Provide the client with frequent periods alone for meditation and prayer. Assign only Native American staff members to provide this client's care. Consult the family, with the client's consent, for a spiritual healer from the client's tribe.
Initiate a consultation between the hospital chaplain and the client. Culturally competent care is a holistic approach that addresses the mind-body-spiritual aspect of individuals. Consulting with a spiritual leader may help address the client's spiritual concerns. It is unsafe to leave a potentially suicidal client alone. It may not be possible to only assign Native American staff members to care for this client, and all staff members should be culturally respectful and knowledgeable. The client is not mentally well enough to provide consent to allow the nurse to speak to the client's family.
When completing an assessment on a client who presented to the emergency room with extreme anxiety, which assessment finding would the nurse characterize as a nonverbal autonomic physiological response? Is very pale Appears very thin Rarely smiles; limited facial expressions Tapping fingers restlessly on the bedside table
Is very pale Paleness is an observable autonomic physiologic nonverbal behavior. Thin appearance is a physical characteristic. Smiling is considered a nonverbal facial expression behavior. Tapping the fingers is a body movement and thus an aspect of nonverbal body behaviors.
When caring for clients from which cultures would the nurse need to be aware that touch practices are infrequent and may be considered inappropriate or uncomfortable? Select all that apply. Japan Italian British American Chinese American Mexican American
Japan British American Chinese American Patients from Japan, British Americans, and Chinese Americans may not like to be touched and use touch infrequently. This is less of a concern for Italian and Mexican American clients.
While interacting with a client involved in an automobile accident involving injuries, the nurse states: "I know you are upset but it could have been far worse, so let's focus on taking care of you for now." Which nontherapeutic communication did the nurse employ? False reassurance Minimizing feelings Making a value judgment Giving premature advice
Minimizing feelings Stating that the accident could have been far worse minimizes the client's feelings and indicates the nurse does not empathize with the client. False reassurance underrates the client's feelings. Value judgments may cause the client to feel misunderstood. Giving premature advice assumes the nurse knows best.
When assessing clients from the Western tradition, what should a nurse consider about their values related to touch? Touch is considered to be taboo. Moderate touch conveys caring. People frequently touch each other. Touch is considered to be an overt gesture.
Moderate touch conveys caring. In nursing practice, touch is therapeutic and helps to build a trusting relationship between nurse and client. According to the Western tradition, moderate touch conveys caring. In other cultures, however, touch may be considered taboo. People from high-touch cultures frequently touch each other while talking. In low-touch cultures, touch is considered an overt gesture.
Which activities completed by the nurse would support the process of active listening? Select all that apply. Including frequent periods of silence. Monitoring his or her own nonverbal responses. Observing the client's nonverbal behaviors. Learning to quiet oneself to avoid the urge to help. Providing the clients with feedback about themselves of which they may be unaware.
Monitoring his or her own nonverbal responses. Observing the client's nonverbal behaviors. Learning to quiet oneself to avoid the urge to help. Providing the clients with feedback about themselves of which they may be unaware. Active listening requires the nurse to be available psychologically, socially and emotionally. Monitoring one's own nonverbal responses, observing the client's nonverbal behaviors, learning to quiet oneself to avoid the urge to help, and providing the clients with feedback about themselves of which they may be unaware are all activities that support active listening. Silence can be useful during interactions and its use is determined by each specific situation. Using silence frequently does not necessarily support active listening.
Which nursing action demonstrates the ability to engage in active listening during a nurse-client conversation? Noting that the client is wringing his or her hands nervously Restating in different words the content of the client's message Introducing new topics when the conversation reverts to silence Sharing with the client that they seem as if he or she is disappointed
Noting that the client is wringing his or her hands nervously Noting that the client is wringing the hands nervously is correct because the nurse is actively listening by observing nonverbal behavior. Restating in different words the content of the client's message is incorrect because it is paraphrasing, which is a clarifying technique in communication. Introducing new topics during silence is incorrect, because it does not demonstrate active listening. Sharing with the client that he or she seems disappointed is incorrect because it is demonstrating reflecting, which is a clarifying technique.
Which message would be considered a tactile message? Nurse hugs a client needing comfort. Nurse sits at eye level with a client to talk. Nurse sits close to a client who is crying. Nurse silently waits for a crying client to stop.
Nurse hugs a client needing comfort. A hug would be considered a nonverbal tactile message. Sitting at eye level with or close to a client would be nonverbal visual messages. Sitting silently would be a nonverbal silence message.
The nursing student is preparing to document the nonverbal body behaviors of the client being cared for. Which data would the nursing student include as body behaviors? Select all that apply. Patient slouching in the chair Scowling at other clients Appears pale and diaphoretic Shuffling feet as walks down the hall Unshaven, appears to not have bathed for some time
Patient slouching in the chair Shuffling feet as walks down the hall Slouching and shuffling the feet are both examples of nonverbal body behaviors. Scowling is a nonverbal facial expression. Paleness and diaphoresis are examples of observable autonomic physiological responses. Being unshaven and appearing not to have bathed are aspects of personal appearance.
The nurse in a reproductive clinic is completing an assessment on a teen who has presented with possible signs of a sexually transmitted disease (STD). The teen is blushing, not making eye contact, and seems embarrassed by the current situation. Which mode of communication may be most effective initially with this client? Silence Focusing Giving information Verbalizing the implied
Silence In this case, the client may feel embarrassed about having an STD. Silence can be an effective form of communication and may be initially useful to allow the client time to share thoughts and feelings that otherwise may be withheld. Focusing can be useful when a client jumps from topic to topic, which is not occurring in this situation. Giving information is used when a client needs facts or knowledge about care or the role of the nurse, and would not be most effective at the current point in this interaction. Verbalizing what is being implied helps put into concrete terms what the client has implied; in this case the client has not yet spoken so this technique would not be appropriate.
A nurse is assessing a Japanese client. While talking to the client, the nurse maintains direct eye contact. What might the client interpret from the nurse's behavior? The nurse is showing disrespect to the client. The nurse is being attentive to the client. The nurse is showing respect to the client. The nurse does not understand what the client says.
The nurse is showing disrespect to the client. Maintaining direct eye contact is considered to be a sign of rudeness and arrogance in some Asian cultures. On the other hand, in the United States, direct eye contact indicates attentiveness and respect. Although the nurse may intend to communicate attentiveness and respect, the client is unlikely to interpret the eye contact this way. Eye contact is unlikely to communicate a lack of understanding.
Which statements accurately describe the relationship between cultural filters and communication? Select all that apply. The stronger the cultural filters, the higher the likelihood for bias. Cultural filters are developed through the process of socialization. Cultural filters determine what we notice and what we ignore when we interact. Even though cultural filters exist, it is possible to listen to people in an unbiased way. Cultural filters are necessary to provide structure and to help interpret and interact with the world.
The stronger the cultural filters, the higher the likelihood for bias. Cultural filters are developed through the process of socialization. Cultural filters determine what we notice and what we ignore when we interact. Cultural filters are necessary to provide structure and to help interpret and interact with the world. Cultural filters are developed through the process of socialization and determine what one notices or ignores during interactions. They are necessary to provide structure and to help interact with and interpret the world. The stronger the cultural filters, the greater the likelihood of bias. It is impossible to listen to people in an unbiased way, thus this statement does not accurately describe the relationship between cultural filters and communication.
In which nurse-client interaction would it be most appropriate for the nurse to consider using touch? Comforting a tearful client of Japanese heritage Counseling a child who was physically abused by a parent Welcoming a person of Hispanic heritage to a new group session Interacting with a Native American who has a hearing impairment
Welcoming a person of Hispanic heritage to a new group session Therapeutic use of touch is a basic aspect of the nurse-client relationship and often perceived as a gesture of warmth and friendship, but the response to touch is culturally defined. Many Hispanic Americans are accustomed to frequent physical contact and perceive it in a positive way. In Japanese culture, touch is generally limited. A child who has been physically abused may not know how to interpret the nurse's touch, and the facility may even have a "no-touch" policy in such cases. As in Japanese culture, touch in Native American culture is generally limited.
