Comm- EX1

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A nurse manager offers a staff a choice between working 8- or 12-hour shifts. Which statement, if made by the staff nurse, is nonassertive and may result in a frustrated response from the nurse manager? a. "I want to decide the shift for all of the other staff nurses." b. "Do whatever you want. It doesn't really matter to me." c. "Thank you for offering me a choice. I prefer 12-hour shifts." d. "You will never be able to give me what I really want to work."

b. "Do whatever you want. It doesn't really matter to me."

The nurse is providing care to a patient who was admitted with heart failure. The patient has not been following the prescribed diet or taking the prescribed medications. Which type of communication approach is most important for the nurse to use with this patient to facilitate a change in self-care behavior? a. Authoritative, honest and outright communication b. Assertive, responsible and caring communication c. Aggressive, sympathetic and realistic communication d. Positive, expert and focused communication

b. Assertive, responsible and caring communication

According to Swanson's theory, there are five caring processes, one of which is "knowing." What are the other four? a. Communication, assertiveness, responsibility and caring b. Maintaining belief, being with, doing for, and enabling c. Understanding, action, information and comfort d. Maintaining belief, being with, enabling and supporting

b. Maintaining belief, being with, doing for, and enabling

Which are examples of a nurse who is communicating responsibly? (Select all that apply.) a. The nurse uses profanity to respond to a client who is intoxicated and verbally abusive. b. The nurse helps a client talk to family members about discontinuing chemotherapy. c. The nurse uses interpersonal strategies to help a client develop methods of coping. d. The nurse provides a client's health information to a close relative who is visiting. e. The nurse listen carefully to the client's concern about inadequate pain relief.

b. The nurse helps a client talk to family members about discontinuing chemotherapy. c. The nurse uses interpersonal strategies to help a client develop methods of coping. e. The nurse listen carefully to the client's concern about inadequate pain relief.

The nurse manager asks the staff nurse to work an extra shift. Which response by the staff nurse is assertive and based on rational beliefs? a. "I don't want you upset, so I will work extra." b. "Why do I always have to cover extra shifts?" c. "I am not able to work an extra shift." d. "If you can't find anyone else, I will do it."

c. "I am not able to work an extra shift."

The home care nurse visits a mother and her newborn 2 days after discharge from the hospital. The mother states, "My baby cries all the time. I must not be a very good mother." Which response by the nurse is nontherapeutic? A. "It sounds as if you are concerned about your ability to care for your baby." B. The nurse moves closer to the mother and places a hand on her shoulder. C. "You just need to get away for a few hours. Find a babysitter and go to a movie." D. "I am not sure that I understand what you mean. Tell me more about how you feel."

C. "You just need to get away for a few hours. Find a babysitter and go to a movie."

The nurse instructs a client who is diagnosed with hypertension about weight reduction and dietary guidelines. Which action by the nurse would most likely improve the client's willingness to lose weight and eat healthy foods? A. Avoid interacting with the client during meals to prevent embarrassment. B. Ignore the client's requests for foods that are high in fat or calories. C. Give genuine praise to the client for trying to improve dietary habits. D. Warn the client that individuals who are overweight will be treated

C. Give genuine praise to the client for trying to improve dietary habits.

What does maintaining eye contact for 2 to 6 seconds during communication with a patient do? A. Keeps the nurse's attention on the conversation B. Counteracts shyness in the patient C. Indicates continuous focused attention D. Assesses if the patient is involved in the conversation

C. Indicates continuous focused attention

Immediacy is __

a form of self-disclosure that can facilitate the helping relationship

A client has high blood pressure and needs to learn about a low sodium diet. Which question by the client would be an indirect request for information? a. "How should I prepare food without adding salt?" b. "What will I do to make food taste better?" c. " What diet changes are needed to control my blood pressure?" d. "What foods should I avoid that are high in sodium?"

b. "What will I do to make food taste better?"

What therapeutic communication technique requires a great deal of skill and is not used as frequently as other communication techniques? a. Touch b. Silence c. Listening d. Summarizing

b. Silence

A grieving young widow cries out, "Why was my husband killed? Why wasn't me?" What is the nurse's best response? a. Stating, "You need to be strong for your children." b. Silently placing her hand on the widow's arm. c. Asking if there is anyone the widow needs to notified. d. Stating, "You are feeling overwhelmed about your husband's death."

b. Silently placing her hand on the widow's arm.

While admitting a patient to the medical unit, the nurse should take which action? A. Demonstrate human caring by hugging the patient for brief intervals. B. Disclose shared intimate details with other healthcare providers. C. Maintain a physical distance of at least 3 to 4 feet at all times. D. Develop the plan of care and measurable objectives with the patient.

D. Develop the plan of care and measurable objectives with the patient

A nurse examines whether patient interventions have been appropriate and expected outcomes have been met. The nurse is demonstrating which step in the nursing process? A. Assessment B. Planning C. Implementation D. Evaluation

D. Evaluation

The nurse cares for a female patient who is trying to gain understanding of her life and her diagnosis of metastatic breast cancer. Which approach by the nurse would best meet this patient's needs? A. Suggest the patient join a breast cancer support group. B. Provide the patient with reading material on death and dying. C. Contact the patient's spiritual leader to request daily visits. D. Listen to the patient's stories about her past experiences.

D. Listen to the patient's stories about her past experiences.

What is the purpose of Purnell's 12 Domains

The 12 Domains are a model for cultural competence. Provides the cultural assessment with ideas about other cultural components that may need to be addressed.

Define: Ethnocentrism (chapter 5)

(Sumner) universal tendency of people to believe that one's own race or ethnic group is the most important and/or that some or all aspects of its culture are superior to those of other groups.

As an experienced staff nurse, you have been asked to create a teaching guide for nursing orientation on respect. Accessing the list from Ehow about being genuine, you would include all of the following. (Select all that apply.) A. Acting natural around others B. Listening when others are speaking C. Denying your mistakes D. Compliment only when you sincerely mean it E. Lying to make friends F. Skipping invitations to event you wouldn't genuinely enjoy

A. Acting natural around others B. Listening when others are speaking D. Compliment only when you sincerely mean it F. Skipping invitations to event you wouldn't genuinely enjoy

Which defining characteristics support the nursing diagnosis of impaired verbal communication? (Select all that apply.) A. Aphasia B. Geriatric patients C. Profoundly deaf D. Legally blind

A. Aphasia C. Profoundly deaf D. Legally blind

The nurse cares for a client with hypertension, and a nurse-client contract is developed outlining the activities and responsibilities of each. Which would be appropriate to include in this contract? (Select all that apply.) A. The outcomes should be realistic and measurable. B. Progress should be reviewed at regular intervals. C. The contract should be written and signed. D. The nurse should keep the information confidential. E. The nurse and client should mutually evaluate progress.

A. The outcomes should be realistic and measurable. B. Progress should be reviewed at regular intervals. E. The nurse and client should mutually evaluate progress.

According to a study by Robinson (2014), three parts of our true presence (how we connect with patients) are found in being: A. Friendly, kind, and sweet B. Genuine, gifted, and creative C. Humorous, partial, and grateful D. Genuine, attentive, and immersed

D. Genuine, attentive, and immersed

What communication technique should be the nurse when communicating with an unresponsive patient? a. Avoid speaking directly to the patient. b. Assume verbal stimuli are heard. c. Speak in a loud voice. d. Use simple words.

b. Assume verbal stimuli are heard.

A patient states, "I do cocaine when I feel things are out of control." The nurse responds by asking, "What else does cocaine do for you?" What communication skill does this exemplify? a. Summarization b. Restating c. Showing acceptance d. Stating observations

c. Showing acceptance

A nurse must violate the personal space of a patient to perform an invasive procedure. How can the nurse reduce the discomfort of the patient? A. By approaching the interaction in a professional manner B. By distracting the patient with jokes and humor C. By asking another nurse to be present at the bedside D. By assuring the patient that all people dislike invasion of personal space

A. By approaching the interaction in a professional manner

The nurse understands that building a trusting relationship with patients is essential in providing care. Which are examples of the verbal therapeutic communication techniques? (Select all that apply.) A. Clarifying B. Restating C. Conveying acceptance D. Stating observations E. Giving advice

A. Clarifying B. Restating D. Stating observations

Which are true regarding communicating while using eye contact? (Select all that apply.) A. Eye contact is responsible for much communication. B. Eye contact is responsible for much miscommunication. C. Making eye contact generally indicates an intention to interact. D. Eye contact always results in a positive outcome. E. Extended eye contact can imply aggression. F. Extended eye contact can lead to heightened anxiety.

A. Eye contact is responsible for much communication. B. Eye contact is responsible for much miscommunication. C. Making eye contact generally indicates an intention to interact. E. Extended eye contact can imply aggression. F. Extended eye contact can lead to heightened anxiety.

Therapeutic communication is a key to providing the best care possible to your patients. Choose those factors that negatively affect therapeutic communication. (Select all that apply.) A. Language barrier B. Caring environment C. Lack of trust D. Cultural differences E. Use of active listening

A. Language barrier C. Lack of trust D. Cultural differences

The nurse cares for an adult client who is diagnosed with active tuberculosis. Which action, if performed by the nurse during introductions, shows respect for the client? (Select all that apply.) A. Maintain eye contact by looking at the client. D. Avoid touch to reduce transmission of the disease. C. Stay at least 4 to 6 feet away from the client. D. Briefly converse about the weather to break the ice. E. Determine how the client would like to be addressed.

A. Maintain eye contact by looking at the client.

What is true about the use of silence in therapeutic communication? (Select all that apply.) A. Maintaining silence is an effective therapeutic communication technique. B. Maintaining silence is generally overused in therapeutic communication. C. The sender often becomes uncomfortable when using silence. D. The ability to use silence effectively requires skill and timing. E. Prolonged periods of misunderstood silence can cause tension. F. Purposeful use of silence often conveys lack of respect.

A. Maintaining silence is an effective therapeutic communication technique. C. The sender often becomes uncomfortable when using silence. D. The ability to use silence effectively requires skill and timing. E. Prolonged periods of misunderstood silence can cause tension.

What is an example of nonverbal communication? A. Moaning B. Speaking C. Writing D. Reading

A. Moaning

Which are examples of passive listening? (Select all that apply.) A. The nurse nods frequently while the patient speaks. B. The nurse maintains eye contact while listening to the patient. C. The nurse occasionally interjects, "I see," when listening to the patient. D. The nurse gives verbal feedback to the patient.

A. The nurse nods frequently while the patient speaks. B. The nurse maintains eye contact while listening to the patient. C. The nurse occasionally interjects, "I see," when listening to the patient. D. The nurse gives verbal feedback to the patient.

According to the Workplace Bullying Institute, nurses are also exposed to this type of behavior within their professional environment. In teaching the possibility to an incoming graduate nurse, you know that the nurse understands when he or she includes which of the following as abusive conduct? (Select all that apply.) A. Threats B. Humiliation C. Intimidation D. Physical abuse E. Sabotage

A. Threats B. Humiliation C. Intimidation E. Sabotage

When listening to a patient, what action by the nurse demonstrates disinterest and coldness? A. Tightly crossing her arms B. Uncrossing her arms C. Uncrossing her legs D. Facing the patient

A. Tightly crossing her arms

The nurse verbally interprets the meaning of what the patient has said. What is true about the use of touch in therapeutic communication? (Select all that apply.) A. Touch is a form of nonverbal communication. B. Touch is a form of verbal communication. C. Touch should be used with indiscretion. D. Touch can convey warmth and caring. E. Touch can convey support and understanding. F. Touch should be used sincerely and genuinely.

A. Touch is a form of nonverbal communication. D. Touch can convey warmth and caring. E. Touch can convey support and understanding. F. Touch should be used sincerely and genuinely.

You are caring for a patient who has had a CVA (cerebral vascular accident/stroke) and is experiencing aphasia as a result. What would the RN do to promote communication? A. Use visual cues, such as pictures and gestures B. Speak louder so the patient can hear you C. Refer the patient to the speech therapist in order to communicate with your patient D. Ask more questions to get more information

A. Use visual cues, such as pictures and gestures

A patient roughly asks the nurse to bring him some ice cream. What would be considered an assertive response by the nurse? A. "You are hungry and want a snack." B. "I can do that in 10 minutes when I finish my rounds." C. "Maybe I can get one of the aides to bring you something in a while." D. "Call the nursing station and ask them to have the kitchen bring whatever you want."

B. "I can do that in 10 minutes when I finish my rounds."

A nurse openly and genuinely discusses thoughts and feelings about sexually transmitted infections with a group of college students. Which benefit(s) may occur for these college students? (Select all that apply.) A. The college students are reluctant to continue discussions with the nurse. B. The college students develop a trusting relationship with the nurse. C. The college students question the nurse's credibility. D. The college students believe the information is reliable and accurate. E. The college students are able to express important concerns.

B. The college students develop a trusting relationship with the nurse.

The community health nurse is listening to a client talk about a personal problem. Which of these actions by the nurse is most appropriate? A. The nurse should increase the physical distance from the client. B. The nurse should lean toward the client and make eye contact. C. The nurse should periodically interrupt the client to ask questions. D. The nurse should initiate the physical assessment to distract the client.

B. The nurse should lean toward the client and make eye contact.

The nurse cares for an adult client diagnosed with type 1 diabetes mellitus. Which is essential in building mutuality in the nurse-client relationship? A. The nurse controls the relationship by retaining the power to make judgments about diabetes education. B. The nurse teaches diabetes management by involving the client in making decisions about self- care. C. The nurse has expert knowledge of diabetes and formulates appropriate learning outcomes for the client. D. The nurse demonstrates trust and respect by solving problems for the client when issues occur with self-management.

B. The nurse teaches diabetes management by involving the client in making decisions about self- care.

The nurse cares for a client who is scheduled for a breast biopsy. Which is the main purpose of the client-nurse relationship? A. To develop a mutually satisfying experience for the client and nurse. B. To assist the client in achieving and maintaining optimal health. C. To provide excellent client service and improve quality of care. D. To allow the client to receive important health information.

B. To assist the client in achieving and maintaining optimal health.

How can the nurse demonstrate warmth and acceptance when listening to a patient? A. Tightly crossing her arms B. Uncrossing her arms C. Tightly crossing her legs D. Facing away from the patient

B. Uncrossing her arms

When speaking to a person of a different culture, how should the nurse consider modifying his or her communication style? (Select all that apply.) A. Speak slowly and with increased volume B. Use of touch C. Use of eye contact D. Reference of address E. Meaning of gestures

B. Use of touch C. Use of eye contact D. Reference of address E. Meaning of gestures

The home care nurse is assigned to make the first home visit to a new client who has been discharged from the hospital. After initial introductions, the nurse should take which action to convey respect? A. Ask the client to develop a list of needs to discuss at the next visit. B. Wear a name badge that clearly identifies the home care agency. C. Provide contact information for several other clients who can serve as references. D. Tell the client that information obtained will not be shared with others.

B. Wear a name badge that clearly identifies the home care agency.

What are the two "outstanding behaviors" identified of an ideal nurse?

Being genuine and a patient advocate

An experienced nurse is supervising a student nurse in an acute care setting. Which statement, if made by the experienced nurse, would be most appropriate to help the student nurse establish credibility with other nurses on the unit? A. "It is impossible to be credible when you are a student because you lack experience." B. "Try to hide your feelings of inadequacy and portray a sense of confidence." C. "Be honest with the nurses about your strengths and about areas that need improvement." D. "It would help if you bring special treats for the nurses so that they will like you."

C. "Be honest with the nurses about your strengths and about areas that need improvement."

The nurse cares for a client who does not follow dietary recommendations for treatment of heart failure. Which statement, if made by the nurse, demonstrates respect for the client? A. "It doesn't make any difference to me whether you decide to eat healthy or not." B. "You will get more attention from your physician, if you follow diet restrictions." C. "I care about you even if you are not following your dietary restrictions." D. "Have you noticed that patients who eat healthy foods receive better healthcare?"

C. "I care about you even if you are not following your dietary restrictions."

Which question below is open-ended? A. "Are you going to Europe this fall?" B. "Are you sailing to Europe?" C. "What are you most looking forward to in Europe?" D. "Have you been to Europe before?" E. "Where in Europe are you going?"

C. "What are you most looking forward to in Europe?"

The nurse is performing a well-child assessment on a 15-month-old child. The child's mother and father are present. Which action by the nurse will best determine the health beliefs and values of the parents? A. Have the parents independently complete the Myers-Briggs Type Indicator survey. B. Read the documented health histories of the child's parents and grandparents. C. Actively listen to the parents talk about their lives and health concerns. D. Review the traditional health practices of the ethnic group identified by the parents.

C. Actively listen to the parents talk about their lives and health concerns.

The nurse cares for a young adult patient in the emergency room after a sexual assault. Which action by the nurse is appropriate? A. Avoid situations in which the patient will be involved with decision making. B. Tell the patient to join a local support group for sexual assault victims. C. Actively listen to the patient express feelings related to the sexual assault. D. Provide detailed information about evidence collection and invasive procedures.

C. Actively listen to the patient express feelings related to the sexual assault.

The nurse cares for a patient who is scheduled for abdominal surgery. Which action, if taken by the nurse, is most appropriate? A. Mandate the use of a complementary therapy such as guided imagery. B. Administer opioids for pain rated more than 3 (on a 0 to 10 pain scale). C. Ask the patient about expectations for postoperative pain management. D. Provide pain management based on a standardized nursing care plan.

C. Ask the patient about expectations for postoperative pain management.

During a complete assessment, which type of questioning is not usually conducive to fostering communication? A. Open-ended B. Focused C. Closed D. Clarifying

C. Closed

A nurse tells a patient, "This PM you are going for an abdominal A&P, an H&H, as well as an IV pyelogram. Please sign these consent forms." What may this use of medical jargon cause? A. Understanding B. Speed in communication C. Misinterpretation D. Clarity in the message

C. Misinterpretation

The nurse recognizes that a patient experiencing stress feels vulnerable. What would be the most appropriate way for the nurse to intervene? A. Use technical language B. Direct the conversation C. Modify communication methods D. Offer all the information

C. Modify communication methods

The nurse prepares to obtain a health history from a hospitalized patient. Which action by the nurse is appropriate? A. Set time limits for the interview to reduce cost. B. Avoid asking questions that may upset the patient. C. Respect the patient's privacy by closing the door. D. Stand at the foot of the bed to maintain eye contact.

C. Respect the patient's privacy by closing the door.

A nurse frequently looks at her watch when giving a patient a bed bath. What message is most likely conveyed to the patient from the nurse? A. She desires to spend more time with the patient. B. She is anxious to listen to the patient's concerns. C. She is feeling hurried. D. She likes her watch

C. She is feeling hurried.

The nurse cares for a client who has several options for cancer treatment. Which document supports the client's right to have access to information about treatment options? A. The Standards of Clinical Practice B. An Advance Health Care Directive C. The Patient's Bill of Rights D. A Client's Living Will

C. The Patient's Bill of Rights

The nurse discusses smoking cessation with a client. Which action, if taken by the nurse, would most likely result in a behavior change? A. The nurse should advise the client to contact the national telephone quitline. B. The nurse should recommend nicotine replacement and behavioral interventions. C. The nurse should collaborate with the client to develop an individualized plan of action. D. The nurse should implement a strategy that has been validated by research.

C. The nurse should collaborate with the client to develop an individualized plan of action.

Giving a bed bath, assisting a patient on and off the bedpan, or inserting a catheter are all examples of which nonverbal therapeutic communication? A. Listening B. Silence C. Touch D. Conveying acceptance

C. Touch

How is warmth primarily displayed? (chapter 6)

Warmth is primary displayed in a NONverbal manner. Be aware of nonverbal cues.

What does therapeutic communication accomplish? a. Facilitates the information of a positive nurse-patient relationship b. Manipulates the patient c. Assigns the patient a passive role. d. Requires the patient to accept what the nurse says.

a. Facilitates the information of a positive nurse-patient relationship

Which nonverbal action(s) would be consistent with an assertive style of communication? (Select all the apply.) a. Relaxed posture b. Established eye contact c. Hand placed on hips d. Distant, soft voice e. Mask-like facial expression

a. Relaxed posture b. Established eye contact

A nurse is caring for a patient who is experiencing excruciating pain and requires frequent administration of analgesics. What statement would be an example of the nurse demonstrating aggressive communication? A. "Please let me know when you start to have pain." B. "Let's practice some guided imagery." C. "Let's try repositioning you." D. "I will only medicate you every 4 hours."

D. "I will only medicate you every 4 hours."

Which statement is an example of the clarifying communication technique? A. "How do you feel about having surgery tomorrow?" B. "You are concerned that you might have complications from the spinal anesthetic?" C. "Will you please tell me as accurately as you can, what you experienced the last time you were given morphine?" D. "Let me make sure I understand this correctly. The cost of the medication is keeping you from being able to take it each day?"

D. "Let me make sure I understand this correctly. The cost of the medication is keeping you from being able to take it each day?"

While talking with your female patient, you notice that she is frowning. What is the best way to find out her concerns? A. Ask your patient why she is unhappy. B. Tell your patient that everything will be okay. C. Ask your patient if she is angry about the care being given. D. Identify that you notice the patient is frowning.

D. Identify that you notice the patient is frowning.

A nurse is caring for a patient experiencing respiratory distress. The physician places an endotracheal tube. What is the most appropriate nursing diagnosis for this patient? A. Ineffective coping B. Risk for infection C. Altered nutrition: less than body requirements D. Impaired verbal communication

D. Impaired verbal communication

Which demonstrates the nurse's genuine concern for clients? A. Tell a patient who has a terminal illness that everything will be fine. B. Delay notifying the patient about the death of a dependent child. C. Provide a placebo to a patient in severe pain to assess for substance abuse. D. Inform the patient about a medication error along with symptoms to report.

D. Inform the patient about a medication error along with symptoms to report.

The nurse is caring for a client who is diagnosed with type 1 diabetes mellitus. Which nursing action would most likely improve client compliance with the therapeutic regimen? A. Consistently ignore negative statements made by the client. B. Avoid touching the client to reduce tension and uneasiness. C. Focus on the physical aspects of care such as insulin administration. D. Listen attentively to the client's perception of having a chronic illness.

D. Listen attentively to the client's perception of having a chronic illness.

A nurse communicates with a patient by maintaining eye contact and through the use of touch. What type of communication technique is the nurse demonstrating? A. Verbal B. Persuasive C. Directive D. Nonverbal

D. Nonverbal

Define: ethnicity (chapter 5)

refers to the SOCIAL identity and origins of a social group largely because of language, religion, and national origin (ex. the Amish). Sociologists and Psychologists are more likely to use this term.

Cultural Negotiation (chapter 5)

refers to the process of negotiating with the client regarding differences in the lay and professional belief systems concerning appropriate care.

What is "self-disclosure"?

the act of making yourself manifest, showing yourself so others can perceive you. Can use this so that clients and colleagues know you understand them

Cultural Assessment (chapter 5)

the appraisal of a client's health beliefs and behaviors.

Define: Culture (chapter 5)

the learned and shared beliefs, values, and life-ways of a particular group that are generally transmitted inter-generationally and influence one's thinking and actions.

What do patients identify as the barometers of genuineness?

Nurse's tone of voice, manner of approach, honesty, and being human.

What does respect begin as? (chapter 7)

Respect begins as "attitude"

Nurse client situations in which immediacy might be helpful:

1. Tension 2. Trust 3. Diversity 4. Dependency 5. Attraction

As a part of the F.O.C.U.S. model, the "C" stands for A. Communicate B. Connect C. Concern D. Convince

B. Connect

A nurse is communicating with an older adult. How might the nurse enhance communication? A. Speak in a rapid manner to accommodate the patient's short attention span. B. Speak in a lower voice tone to accommodate hearing loss. C. Speak in a simple manner as if speaking to a child. D. Speak in a loud voice directly at ear level.

B. Speak in a lower voice tone to accommodate hearing loss.

The nurse cares for a client with abdominal pain who is scheduled for exploratory surgery. Which statement(s), if made by the nurse, indicates that the client's rights in the helping relationship have been violated? (Select all that apply.) A. "I do not have time right now to help you call your family." B. "I am available to answer questions that you may have about your surgery." C. "You seem frightened. I will stay with you until your family arrives." D. "Your neighbors called, and I told them that you will have surgery." E. "If you do not let me start your IV, I will not give you pain medication."

A. "I do not have time right now to help you call your family." D. "Your neighbors called, and I told them that you will have surgery." E. "If you do not let me start your IV, I will not give you pain medication."

The nurse cares for a patient who has type 2 diabetes mellitus and does not consistently follow the dietary restrictions and exercise recommendations. The patient takes a daily oral hypoglycemic agent as prescribed. Which statement by the nurse is most appropriate? A. "It is great that you take your medicine as prescribed." B. "It wouldn't be that hard to walk a few blocks every other day." C. "You are definitely not one of my good patients." D. "It is a waste of time to help you because you will never change."

A. "It is great that you take your medicine as prescribed."

Which statement by the RN is an example of using assertiveness? A. "It is time for you to go to physical therapy (PT). Do you want to walk part way or do you think you are strong enough to walk all the way?" B. "You need to go to PT sometime today; just let me know when you want to go." C. "It would be best for you to go to PT now, but later is okay also." D. "Going to PT will help you get stronger, so let's go to PT now please."

A. "It is time for you to go to physical therapy (PT). Do you want to walk part way or do you think you are strong enough to walk all the way?"

A nurse is caring for a newly admitted diabetic patient and is performing the initial assessment. What statement made by the nurse demonstrates use of a closed question? A. "What time do you take your insulin?" B. "How do you feel about taking insulin?' C. "Tell me about your support system." D. "How do you feel about having diabetes?"

A. "What time do you take your insulin?"

The nurse cares for a patient with urinary incontinence after a stroke. Which response by the nurse is best? A. "You seem upset about this. We can work together on a bladder retraining program." B. "I don't mind cleaning up your mess. I am used to it because my child does this at night." C. "Don't be embarrassed. A lot of patients have this problem after a stroke." D. "I will bring you some diapers to wear instead of having you wet the bed all the time."

A. "You seem upset about this. We can work together on a bladder retraining program."

The nurse cares for a patient who has just been diagnosed with lung cancer. Which statement by the nurse is therapeutic? A. "You sound really frightened about your diagnosis of cancer." B. "You will get better because the treatment will be started this week." C. "I think you should take a vacation and try to forget about the cancer." D. "An apple a day will keep the doctor away."

A. "You sound really frightened about your diagnosis of cancer."

Every individual has his or her own set of boundaries for personal space. Which example best explains personal space? A. The insertion of a Foley catheter using sterile technique B. Sitting in a chair beside the patient's bed with good eye contact C. Standing at the door and asking the patient what he or she had for breakfast D. Talking to a group of patients from the front of a classroom

B. Sitting in a chair beside the patient's bed with good eye contact

Which individual is displaying thoughts or actions that are genuine? A. A nurse who advocates for clients in order to qualify for a raise in personal hourly pay. B. A nurse who takes action to increase awareness of the need for cultural sensitivity. C. A nurse who supports a change in a project in front of supervisors but complains to staff. D. A nurse who verbally supports a new policy but does not follow the policy in practice.

B. A nurse who takes action to increase awareness of the need for cultural sensitivity.

The home health nurse visits a client with heart failure who has increased dyspnea and peripheral edema and weight gain. The nurse suspects the client is not restricting fluids as prescribed. Which action by the nurse is most appropriate? A. Teach the client about the consequences of not following the fluid restrictions. B. Ask the client to report the amount of fluid intake for the past 24 hours. C. Provide the client with sugarless candy or gum to decrease the thirst sensation. D. Consult with the healthcare provider about increasing the dose of the diuretic

B. Ask the client to report the amount of fluid intake for the past 24 hours.

Which describes characteristics of mutuality in the nurse-client relationship? (Select all that apply.) A. Dependency B. Collaboration C. Paternalism D. Acceptance of differences E. Empathy

B. Collaboration D. Acceptance of differences E. Empathy

The nurse cares for elderly clients in an assisted living center. Which action by the nurse would best show respect for these clients? A. Patronize clients who share ideas or voice concerns. B. Identify healthcare needs by listening to the clients. C. Address the clients formally by their last names. D. Limit the clients' opportunities to express opinions.

B. Identify healthcare needs by listening to the clients.

The nurse makes a home visit to a client with chronic kidney disease. The client asks the nurse to make the decision about whether or not to start dialysis. Which action by the nurse is most appropriate? A. Encourage the client to appoint a durable power of attorney. B. Invite the client to make a decision after reviewing options. C. Direct the client to have the physician make a decision. D. Have the client visit with an individual receiving dialysis.

B. Invite the client to make a decision after reviewing options.

The home health nurse cares for a patient who is diagnosed with chronic obstructive pulmonary disease. Which response(s) and behavior(s) by the nurse would indicate that bonding between nurse and patient has occurred? (Select all that apply.) A. Expects the patient to meet the goals for exercise as determined by the nurse. B. Listens to the patient describe the feelings of anxiety related to severe dyspnea. C. Develops teaching plan based on the learning preferences of the patient. D. Refrains from touching the patient unless performing physical assessment techniques. E. Requests that the patient wait to ask questions until the end of the home visit. F. Learns the names of the patient's family members and close friends and neighbors.

B. Listens to the patient describe the feelings of anxiety related to severe dyspnea. C. Develops teaching plan based on the learning preferences of the patient. F. Learns the names of the patient's family members and close friends and neighbors.

What would be the best method for a literate, English-speaking patient on a ventilator to communicate his or her needs? A. Eye blinking for "yes" and "no" B. Magic slate or paper and pencil C. Computer D. Message board or cards

B. Magic slate or paper and pencil

How may a nurse caring for a pediatric patient best be perceived as nonthreatening? A. Tightly crossing her arms B. Maintaining an open posture C. Maintaining a tense posture D. Standing at the bedside

B. Maintaining an open posture

According to the ANA's Standards of Clinical Nursing Practice, there are several steps within the nursing process that surround patient care. However, one of the most important steps is the one in which the nurse partners with the patient, family, and other caregivers to create an acceptable path that meets the patient's needs and is specific to the disease process. This important step is identified as: A. Evaluation B. Planning C. Implementation D. Nursing diagnosis

B. Planning

Which nonverbal communication technique is very therapeutic and effective but requires a conscious effort by the nurse to practice and acquire skill in the use of this technique? A. Listening B. Silence C. Touch D. Conveying acceptance

B. Silence

A patient states, "My husband has told me how he feels about my having a mastectomy." The nurse nods and says, "Go on." This is an example of: A. clarifying. B. restating. C. focusing. D. minimal encouraging.

D. minimal encouraging.

The nurse plans to delegate a client's personal hygiene to a nursing assistant. Which statement if made by the nurse to the nursing assistant is assertive? a. "Would you mind helping the client with a bath when you have time? If not, I will skip my lunch and do it myself." b. You never get your work done and are always on the phone. You need to help the client right now with a bath, or I will write you up." c. "The client needs help with bathing. I want you to assist the client now, and you can go to lunch when you are finished." d. "I have important work to complete this morning. You will assist the client with a bath. Do not take break until you have finished,"

c. "The client needs help with bathing. I want you to assist the client now, and you can go to lunch when you are finished."

Which statement describes the affective aspect of learning effective communication strategies? a. "The nurse should use clear, direct statements using objective words." b. "The nurse uses body language that is congruent with the verbal message." c. "The nurse believes that positive communication strategies build confidence." d. "The nurse practices assertive and responsible communication strategies."

c. "The nurse believes that positive communication strategies build confidence."

Although the patient denies pain, the nurse observes the patient breathing rapidly with clenched fists and facial grimacing. What is the nurse's best response to these observations? a. "I am glad you are feeling better and have no discomfort." b. "Where do you hurt?" c. "What you are saying and what I am observing don't seen to match." d. "It makes me uncomfortable when you are not honest with me."

c. "What you are saying and what I am observing don't seen to match."

The nurse is sitting in a chair near the patient's bed, leaning forward to her what the patient is saying, and does not interrupt. What is the nurse demonstrating? a. Support b. Caring c. Active listening d. Interest

c. Active listening

If the nurse aggressively says to a patient, "Why couldn't you have asked me to give you your pain medication when I was in here earlier?" What feeling is the patient most likely to demonstrate? a. Anger b. Satisfaction that his needs are met c. Humiliation and worthlessness d. Confidence that his request will be granted

c. Humiliation and worthlessness

What is one of the main characteristics of therapeutic communication? a. It allows the patient a passive role. b. It uses only verbal communication. c. It involves the patient as a person. d. It is directive

c. It involves the patient as a person.

A patient states, "I'm really strung out about this pregnancy." The nurse responds by asking, "What about this pregnancy worries you?" What communication technique is this? a. Closed inquiry b. Restating c. Open-ended question d. Minimal encouraging

c. Open-ended question

A nurse actively avoids the use of one-way communication. What is the major problem with one-way communication? a. The receiver is in control b. Feedback is provided to the sender c. Participation is not equal d. The communication is unstructured

c. Participation is not equal

If in response to the patient statement, "I am upset about all this lab work" the nurse responds, "You're upset?" What is this is an example of? a. An open-ended question b. Reflecting c. Restating d. Paraphrasing

c. Restating

A patient does not speak English; therefore, the nurse cannot use words to provide comfort during a painful procedure. What is another intervention that may provide comfort to this patient? a. Silence b. Listening c. Touch d. Restating

c. Touch

A hospital nurse is concerned about the demands of providing safe care to clients who are seriously ill. The nurse manager should suggest which intervention to effectively help the nurse balance the demanding work in the hospital setting? a. Delegate more tasks to the unlicensed nursing personnel on the unit. b. Request a transfer to another nursing care unit with patients who are stable. c. Write down stories in a journal about how caring makes a difference for patients. d. Use an assertive communication style for every patient-nurse interaction.

c. Write down stories in a journal about how caring makes a difference for patients.

The charge nurse informs a staff nurse that it is turn to float to another unit. Which response by the staff nurse is aggressive? a. " I had such a bad experience last time. Please send another nurse instead of me." b. "I will miss working with you today, but I understand that it is my turn to float." c. "I will not survive on the other unit. The stuff are always too busy to help me." d. "I will float, but you'll be sorry. You cannot handle emergencies without me."

d. "I will float, but you'll be sorry. You cannot handle emergencies without me."

The nurse considers the feelings and needs of a patient by stating, "I know you are concerned about your surgery tomorrow. How can I help you?" What type of communication is this? a. Intrusive b. Aggressive c. Closed d. Assertive

d. Assertive

According to Swanson's theory, there are five caring processes, one of which is "being with." Which of the responses by the nurse portrays an understanding of the concept of "being with" a client? a. The nurse charting in the room to spend more time with the client. b. The nurse wearing locator badge so you can quickly response any time patient would call front desk and ask to page you. c. The nurse requesting one-on-one nurse staffing. d. The nurse being emotionally present to the client.

d. The nurse being emotionally present to the client.


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