Chapter 7: Prep U

termination phase

occurs at the end of a relationship

A client expresses worry about upcoming surgery. Which response by the nurse is a cliché?

"Do not worry, everything will be fine."

The nurse is having a discussion with a client diagnosed with breast cancer. Which statement would be most effective in promoting communication?

"What are some of your ideas about how to handle this?"

A nurse is completing a health history with a client being admitted for a mastectomy. During the interview the client states, "I do not know what to do. I am not sure if I really need this surgery." Which response by the nurse demonstrates active listening?

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

The client has Alzheimer disease and is a new admission to the nursing home. The client was transferred from the hospital. When first meeting the client, what technique(s) will the nurse use to facilitate communication with this client?

- approach the client from the front of the client - call the client by the client's preferred name - use simple words & short sentences when talking w/ the client

"Do not worry, this is a minor surgery. You will do great!"

False reassurance

"I think you should get a second opinion because your healthcare provider has had a lot of complaints against him."

Nonprofessional involvement

"My ex-boyfriend did not come pick up the kids again & I did not get much sleep last night."

Nonprofessional involvement

The nurse communicates with a newly admitted client. Which nonverbal behavior will the nurse note?

client's gestures

Which is a skill appropriate to use in therapeutic communication?

control the tone of the voice to avoid hidden messages

The parent of a toddler is deciding if they want to allow their child to receive the recommended immunizations. The clinic nurse responds, "If you do not immunize your child you are jeopardizing the health of other children." What type of approach does this response indicate?

guilt inducement or approval/disapproval

A nurse caring for client who is unconscious knows that communication is important even if the client does not respond. Which nonverbal action by the nurse would communicate caring?

holding the client's hand while talking

Which is a component of the termination phase of the nurse-client relationship?

mutual agreement that the client's health problem has improved

Which action by the nurse would facilitate the nurse-client relationship during the orientation phase?

introducing oneself to the client by name

A nurse is conducting an admission assessment of a client who will be receiving treatment for a kidney infection. To foster therapeutic conversation, which action should the nurse take?

remove as many distractions from the interaction as possible

What is an example of positive body language?

tilt of head

The nurse encourages a client to participate in the communication process by using an opening remark based on observations and assessment. Which approach would be most effective for the nurse to use to promote trust?

neutral

A male client has always prided himself in maintaining good health and is consequently shocked at his recent diagnosis of diabetes. The nurse has asked the client, "How do you think your diabetes is going to affect your lifestyle?" The nurse has utilized which of the following interviewing techniques?

open-ended question

The client is able to call the nurse by name and demonstrate how to use the call light.

orientation phase

An experienced nurse is orienting a new nurse to the unit. Which activity demonstrates the nurse is an effective caregiver?

the nurse uses open-ended questions when working w/ a crying client

A nurse is caring for a client experiencing biliary colic from uncomplicated cholelithiasis. The client asks, "My doctor says I should have surgery to remove my gallbladder. Do you think it is really necessary?" What is the nurse's best response?

"Share with me the advantages & disadvantages of your options as you see them."

"Everybody should be allowed to die if they want to."

Being moralistic

"Injecting insulin is nothing for you to worry about. Even children can do it!"

False reassurance

A nurse is completing a health history with a newly admitted client. During the interview, the client presents with an angry affect and states, "If my doctor did a good job, I would not be here right now!" What is the nurse's best response?

be silent & allow the client to continue speaking when ready

"Why did you not use a condom? They are given at the clinic for free."

being moralistic

A client, who was recently diagnosed with diabetes, has been coming to the emergency room every day for hyperglycemia. The client reports not being able to self-administer insulin injections. What strategy would best educate the client and improve the client's ability to self-administer insulin?

demonstrate the proper method & have the client mimic the demonstration

Which communication technique is being utilized when the nurse states, "That's not true, where did you get that idea"?

disagreeing

An RN is discussing the medication regimen with a client. The client is exhibiting negative body language. Which is an example of negative body language?

downcast eyes

A client has cancer, but the significant other does not want the client to know the diagnosis. The nurse demonstrates sensitivity to the significant other and works with the couple to achieve desired outcomes. What kind of behavior is the nurse exhibiting?

empathy

The 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?

encouraging elaboration

When assessing a client's nonverbal communication, the nurse should assess which aspect as being the most expressive?

facial expressions

A nurse on a subacute geriatric ward is working with a male client who has a diagnosis of Alzheimer disease. How can the nurse best enhance therapeutic communication with this client?

give the client plenty of time to make responses to questions that the nurse asks

The nurse is conducting a health interview with an older adult client. During this introductory phase, which action should the nurse take to effectively establish the nurse-client relationship?

greet the client by asking by which name he or she prefers to be addressed

The nurse is providing care to an older adult client who has visual and hearing deficits. What action by the nurse is appropriate to help with communication?

identify oneself by name & title w/ each entry into the client's room

A nurse understands the need for effective communication with clients during assessments. The nurse is completing the admission history for a client admitted to the health care facility. Which can result from the nurse using open-ended questions during the client admission history assessment?

in-depth information

A nurse is caring for a client who presents with a skin infection. While obtaining the client's medical history, it is determined that the client is an intravenous drug user. To foster effective communication, the nurse should:

remain honest, open, and frank

Which guideline should a nurse use when choosing a position (location) in relation to a client during a verbal interaction?

take note of the client's cues when choosing a position & act on these cues

The client verbalizes understanding of what signs indicate infection and when to contact the health care provider.

termination phase

Which situation describes the communication concept of feedback between the nurse and client?

the nurse & the client use one another's reactions to produce further messages

The nurse meets with the client to teach self-administration of low molecular weight heparin. During the initial part of the training the client shakes the head and asks the nurse to repeat the instructions. What action demonstrates that the nurse has assessed the client's communication abilities?

the nurse faces the client, speaks slowly & clearly, & demonstrates the procedure using a needless syringe

Which best describes an element of the nurse-client relationship?

the nurse self-discloses only what is necessary for the client's benefit

The nurse enters a client's room after receiving a morning report. The nurse rapidly assesses the client's airway, breathing, and circulation and greets the client by saying "Good morning." The client makes no reciprocal response to the nurse. How should the nurse best respond to the client's silence?

the nurse should ask appropriate questions to understand the reasons for the client's silence

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?

the working phase

orientation phase

when the nurse and the patient meet and get to know each other

working phase

when the nurse and the patient work together to solve problems and accomplish goals

Which phase of the nurse-client relationship involves the mutual planning of care and putting the plan into action?

working

Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship?

working phase

The client states, "I know I have to get up and moving so I do not get pneumonia."

working phase

The client states, "Using the pillow to splint my abdomen when I cough, really helps."

working phase