chapter 8

What are the four levels of communication?

1. intrapersonal 2. interpersonal 3. small-group 4. organizational

what are the phases of helping relationships?

Orientation phase Working phase Termination phase

small group

a group small enough for everyone to interact directly with all the other members. ex: staff meetings, teaching sessions, support groups

A nurse is engaged in a nurse-client relationship. Which communication techniques would be important for the nurse to avoid? Select all that apply. a. false reassurance b. advice c. silence

a, b. Nontherapeutic communication techniques include false reassurance and giving advice. Exploring, silence and summarizing are therapeutic techniques.

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 why the client thinks the client will wake up during surgery.

b. Asking why the client thinks the client will wake up during surgery opens the lines of communication.

In SBAR, "assessment and recommendation" are based on a. objective data b. subjective data

b. subjective data

interpersonal

between people

social zone

for business transactions and other impersonal relationships (4-12ft)

personal zone

for close friends and those who share special interests (18in-4ft)

organizational

people and groups in an organization communicate

intrapersonal

self talk

working phase

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

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 stares at the floor and states, "I feel fine." b. The client looks at the nurse and states, "I am still not feeling my best."

a. in the scenario in which the client stares at the floor while claiming to feel fine, the nurse should investigate further because of the incongruence between the client's verbal and nonverbal communication.

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. "I understand you are not sure about having the surgery. Why do you think you really do not need the surgery?" b. "You seem unsure. Tell me your concerns about your surgery."

b. The use of active listening facilitates therapeutic interactions. "You seem unsure" demonstrates that the nurse was actively listening and has decoded the content and feelings of the client.

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?"

intimate zone

For a person's closest relationships (0-18in)

termination phase

Therapeutic conclusion of relationship occurs when: Progress has been made toward attainment of the goals. A plan of action for more adaptive coping with future stressful situations has been established. Feelings about termination of the relationship are recognized and explored.

In SBAR, "background" is based on a. objective data b. subjective data

a. objective data

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?

"You're worried about how you will tolerate the pain associated with labor." explanation: Reflecting or paraphrasing confirms that the nurse is following the conversation and demonstrates listening, thus allowing the client to elaborate further.

public zone

For speeches, teachers in classrooms, and passersby (12ft +)

orientation phase

Introduce, Discuss confidentiality, Set goals

what is the purpose of SBAR?

It handles important in the moment information. Message will be focused and precise to the immediate problem. It allows for complete documentation and communication.

Which statement accurately describes the concept of feedback as it pertains to the process of communication?

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

A nurse suspects that a client may have a hearing problem. The nurse should attempt to consult:

an audiologist

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?

assess how the client would like to communicate

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 ethnicity b. The client's tone of voice

b. Nonverbal communication refers to the use of body language, such as gestures, facial expressions, posture, space, appearance, body movement, touch, voice tone and volume, and rate of speech.

Which guideline should a nurse use when choosing a position (location) in relation to a client during a verbal interaction? a. Choose a position that is no closer than 2 feet, but no farther than 4 feet. b. Take note of the client's cues when choosing a position and act on these cues.

b. Preferences regarding space and territoriality vary greatly. A useful strategy to foster good communication is to note, and act on, client cues.

What is the purpose of ISBARR?

decreases anxiety and increases confidence when nursing students use hand-off reports

personal space zones

intimate, personal, social, public