Admission

Paramedics arrive in the emergency department with a client who was in a motor vehicle collision. The paramedic reports that the driver was restrained, the car was traveling about 30 miles per hour (48 km/hr), and the air bags were not deployed. The paramedic continues to report that the car was struck from behind and that all individuals in the car were able to self-extricate. Which statement made by the nurse is verifying the report from the paramedic?

"All of the people got themselves out of the car?"

The nurse is collecting health data and avoids using closed-ended questions. Which are examples of closed-ended questions?

"Are you ready to get out of bed?" "Do you smoke cigarettes?" "Is there any chance you might be pregnant?"

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?

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

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?

"I understand you have four kids; how many times have you actually been pregnant?"

A client reports to a primary care health care provider with aggravated chest pain. The health care provider orders a stress test. The client tells the nurse that the client does not want to take the test and would prefer instead to continue taking medication a little longer. Understanding that the client is anxious, what is the most appropriate response by the nurse?

"Tell me more about how you are feeling."

A nurse is communicating the plan of care to a client who is cognitively impaired. Which nursing actions facilitate this process?

"The nurse maintains eye contact with the client" "The nurse shows patience with the client and and gives the client time to respond."

When the preoperative client tells the nurse that the client cannot sleep because the client keeps thinking about the surgery, an appropriate reflection of the statement by the nurse is:

"The thought of having surgery is keeping you awake." Explanation

The nurse must use appropriate interviewing techniques to elicit accurate and complete health information. Which statement is an example of an open-ended or comment?

"What brought you to the hospital this morning"?

A client scheduled to have hip replacement surgery states "I am so scared of the surgery and of the anesthetic" what is the best response by the nurse?

"What questions do you have about the surgery"

Which is an open-ended question?

"Why did the health care provider prescribe this medication for you?"

The nurse is completing an admission assessment with a client. The client looked down and became tearful when asked about feeling safe at home. How would the nurse respond to the nonverbal communication displayed by the client

"You seem upset. You are safe here and can talk to me confidentially."

Which is a skill appropriate to use in therapeutic communication?

Control the tone of the voice to avoid hidden messages.

The client is an 18-month old in the pediatric intensive care unit. The client is scheduled to have a subgaleal shunt placed tomorrow, and the client's mother is quite nervous about the procedure. The nurse tells the clients mother, "The surgeon has done this a million times. Your son will be fine" This is an example of what type of nontherapeutic communication?

False reassurance

A nurse has been caring for a client who had a myocardial infraction 2 days ago. During the morning assessment, the nurse asks how the client feels. Which scenario warrants further investigation?

The client stares at the floor and states "I feel fine"

When communicating with a client, the nurse uses reflection for which purpose?

To have the client elaborate on thoughts and feelings

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

aggressive

A nurse is on lunch break in the hospital cafeteria and sits at a table near a group of physicians eating their lunch. One of the physicians, who is in charge of the nurse's clients, points at the nurse and states, "That guy needs to get fired." The best response by the nurse would be to:

ask to speak to the physician in private and address the disrespectful remark.

In the provision of care and the establishment of therapeutic relationship, the nurse must first:

be aware of one's own personality.