Chapter 8 Communication

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? "I am so sorry you are going through this. Can we talk?" "I know this is hard for you. Is there any way I can help?" "Sitting in the dark is not going to cure your cancer. Let's open the curtains." "Can you please tell me why you are crying?"

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

A nurse is caring for a client with depression. The nurse finds that the client is withdrawn and does not communicate with others. What is the most appropriate response by the nurse? "Did you sleep well last night?" "Is that a new shirt you're wearing?" "Did you like the dinner yesterday?" "I guess you don't feel like talking today."

"Is that a new shirt you're wearing?"

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? Allow the client's child to interpret. Involve a friend who speaks both the dominant and the client's languages. Contact a professional interpreter. Ask a fellow nurse who knows some words in the client's language to help.

Contact a professional interpreter.

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 client's mother, "The surgeon has done this a million times. Your son will be fine." This is an example of what type of nontherapeutic communication? Rescue feelings False reassurance Giving advice Being moralistic

False reassurance

When caring for a psychiatric client, a nurse would make a formal contract with the client during which phase of the nurse-client relationship? Intimate phase Orientation phase Working phase Termination phase

Orientation phase

The nurse makes a contract with the client during which phase of the nurse-client relationship? Intimate phase Orientation phase Working phase Termination phase

Orientation phase The orientation phase of the relationship represents the first phase of therapeutic work and involves signing of formal contracts. Formal contracts in this setting are a therapeutic tool to help a client develop more insight and control over the client's own behavior. The working phase is when the nurse assists clients in this process by helping them to describe and clarify their experiences, to plan courses of action and try out the plans, and to begin to evaluate the effectiveness of their new behavior. The termination phase is the final phase and the period when a client's goals are assessed and the relationship comes to an end. There is no intimate phase.

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? The client is sitting in a chair and states, "I feel a lot better than I did yesterday. The client stares at the floor and states, "I feel fine." The client smiles at the nurse and states, "I cannot wait to go home." The client looks at the nurse and states, "I am still not feeling my best."

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

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: ask questions as quickly as possible. use only open-ended questions. tell the client to rest and allow a family member to answer. allow the client to set the pace.

allow the client to set the pace.

A client arrives at the emergency department after experiencing several black, tarry stools. The nurse should assess for the cause of the client's complaint by: asking the client to provide a stool specimen for guaiac testing. asking the client whether the client has recently taken ferrous sulfate (iron) or bismuth subsalicylate. determining whether the client has any food or drug allergies. insisting that the client not eat or drink anything until further instructed.

asking the client whether the client has recently taken ferrous sulfate (iron) or bismuth subsalicylate.

When communicating with clients, nurses need to be very careful in their approach. This is particularly true when communicating using: written material. audio-visual material. demonstration. medical terminology.

medical terminology.

What nursing care behavior by the nurse engenders a client to trust the nurse? A nurse tells the client, "Don't worry about the test, I have never cared for anyone that had problems with it." A nurse answers the client's questions about an upcoming test while completing documentation in the EHR. A nurse answers the client's questions about an upcoming test in a calm gentle voice while making eye contact with the client. A nurse tells the client, "My shift will be over in 45 minutes, I will let the oncoming nurse know you have questions about tomorrow's test."

A nurse answers the client's questions about an upcoming test in a calm gentle voice while making eye contact with the client.

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? Approach the client with empathy and understanding and allow the client to share feelings without being judged. Exhibit a professional demeanor while examining the client and obtaining specimens, asking questions that are not intrusive. Practice active listening by allowing the client to express fears and concerns then restating in the nurse's own words to demonstrate understanding. Use strategic pauses to allow the client to provide information that will be used to help officials in their investigation.

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