communication quiz

2. A client tells the nurse that her husband is an alcoholic and hasn't worked for the last 3 months. The nurse's best response would be which of the following? a. "Have you tried Al-Anon meetings?" b. "I'm really sorry to hear that." c. "You sound worried; I think you should talk to the chaplain." d. "What have you done before to cope with his problem?"

d. : Asking what the client has done before focuses the client on solving his or her own problems and helps the nurse assess the client's coping mechanisms. The other options, although empathetic, may block the communication process.

5. Which of the following methods would be most effective for an ambulatory care nurse to use when trying to determine the priority health-related learning needs of a client? a. Carefully review the physician's orders b. Conduct a thorough nursing assessment c. Determine the amount of time required to present the information d. Ask the client what learning needs he or she has about current state of health

d. Learning is more likely to take place when the client's perceived needs are met. The nursing assessment identifies areas for client teaching and the client's ability to learn. The amount of time needed to implement a teaching plan is not associated with establishing priorities.

8. Which of the following statements heard by a nurse during intershift report provides the most useful information related to priority setting for the upcoming shift? a. A client who had catheter removed 8 hours ago has not urinated b. A client who is alert and oriented to person and place c. A client who is 3 days postoperative is experiencing incisional pain d. A client admitted for congestive heart failure has a blood pressure of 138/80

a. A client who has not urinated following catheter removal would require nursing intervention, specifically an assessment of the client's abdominal distention, reviewing intake and output records, and possibly calling the physician for an order to do a straight catheterization. The 2nd priority would be the client who has incisional pain (option 3); however, since the client is 3 days postoperative, this is not as urgent a problem as option 1. The information contained in options 2 and 4 pose no threats to the health status of those clients.

17. Which of the following behaviors by a client indicates to the nurse that learning in the cognitive domain has taken place? a. Explaining the rationale for taking a new medication b. Actively demonstrating the new skill c. Telling the nurse the client has accepted the illness and its effects on lifestyle d. Physically demonstrating insulin injections

a. Learning in the cognitive domain involves the acquisition and use of knowledge mentally or intellectually. Option 3 involves learning in the affective domain, which involves changing feelings and values toward a positive health behavior. Options 2 and 4 involve learning in the psychomotor.

19. What type of information communicated in the end-of-shift report has highest priority in order to provide care to clients? a. Physical assessment data and client response to care b. Client's list of active and resolved problems and associated medical treatments c. Physician visits and new orders d. Intake/output data and vital signs

a. Physical assessment data and client response to care are the most important pieces of information in ensuring that client's healthcare needs are being met. Option 2 is not as relevant to the client's status in real time; options 3 and 4 are useful to a nurse assuming care of a client, but are more limited in the scope of information they provide.

An acute care nurse discharges to home a client who will need services from a home health nurse. What discharge information is most important for the acute care nurse to give to the referral agency nurse? a. Surgical report b. Client's current self-care abilities c. Vital signs on discharge d. Medications last administered

b. Description of the client's self-care abilities provides data to the referral nurse about information needed to continue the client's care. Vital sign information is only one parameter and does not provide enough information about the client's overall status. Medication last administered does not identify all of the medications the client is currently taking. The surgical report does not have direct relevance to the client's home care needs.

11. A nurse observes a client pacing the halls, and it appears that the client has been crying. The most appropriate nursing action is which of the following? a. Consider the behavior as a normal reaction to illness b. Validate perceptions with the client c. Discuss the client's actions with another nurse for verification d. Discuss the morning schedule with the client to decrease apprehension

b. The nurse should validate his or her perceptions with the client to ensure the correct interpretation of the client's nonverbal behavior. Option 3 is inaccurate. The nurse should not make false assumptions (option 1) and should not ignore the client's behavior (option 4).

15. A client needs to learn how to take the pulse before taking prescribed heart medication. Before beginning the client teaching, the nurse needs to evaluate which of the following about the client? a. Cardiac status b. Reading ability c. Psychomotor abilities d. Motivation

c. : Before a client is able to learn a new skill, he or she must possess the physical capacity to perform the skill. In this case, if the client doesn't have the dexterity to palpate a pulse or ability to see a clock's second hand, the client will need assistance with the skill. Options 1 and 2 are unnecessary for the nurse to assess prior to implementing the teaching plan. Motivation to learn is also important, but the nurse must first evaluate the client's ability to perform the skill.

9. The quality assurance nurse reads several nurses' notes from different records that refer to clients' moods. Examples of these notes are "The client is in good spirits today," "The client feels depressed today," and "The client is withdrawn today." Based on the quality assurance nurse's finding, which of the following would be the best action to take? a. Communicate the findings to nursing administration b. Report the findings to the Joint Commission on Accreditation of Healthcare Organizations c. Communicate the findings to the agency's Nursing Staff Development Department d. Do nothing, as this is as acceptable documentation practice

c. The quality assurance nurse's best action is to report the findings to the Nursing Staff Development Department to improve the standards of nursing documentation in the facility.

13. A nurse is preparing to complete an admission assessment on a client that is partially hearing impaired. The best approach would be to do which of the following? a. Request that a family member be present b. Prepare written questions that cover the assessment criteria c. Speak slowly in a low-pitched voice while facing the client d. Perform the physical assessment only at this time

c. For a client who is hearing impaired, speaking slowly in a low-pitched voice and facing the client will promote understanding of the message sent. Options 1 and 2 may be appropriate if the client cannot hear at all. Option 4 will not provide enough information to effectively care for the client.

18. A nurse who has been called in to work to unusually high client census has missed the intershift report. While waiting to get report from another nurse, where can the nurse look to find the most concise and accurate information related to the client care assignment? a. Admission record of each client b. Previous shift's assignment sheet c. Kardex d. Physician progress notes

c. The Kardex should supply the information to provide nursing care to the clients assigned. The other options are not good indicators of client care needs.

4. Using a mannequin, the nurse has demonstrated wound care for a client. To promote client teaching, which of the following would be the best nursing action? a. Complete the wound care on the client, explaining the procedure while performing it b. Watch a video explaining sterile technique that will be used for the client's wound care. c. Have the client perform the wound care with the nurse present to supervise d. Ask the client to review written literature and perform the care at a later time.

c. Clients are more likely to successfully complete a new procedure if they can actively demonstrate the procedure immediately after instructions have been given with the nurse present the first several times. A video and written literature do not allow for active participation; however, they can be used as supplementary learning aids.

3. During the introductory phase of communication with the client, the nurse becomes acquainted with the client and does which of the following? a. Provides the client with advice b. Refers the client to other care providers for follow-up c. Identifies goals and objectives d. Prepares for the interview

c. During the introductory phase of communication the nurse and client identify goals and objectives. Nurses should not offer advice when establishing a therapeutic relationship with a client. Preparing for a client interview is the pre-interview phase of communication

12. Which of the following would be the best approach for the nurse to use when a client conveys anxiety prior to surgery? a. Reassure the client of the surgeon's competency b. Provide information about the surgical experience c. Explore the client's feelings with him or her d. Relate the nurse's personal experience of having a similar surgery

c. Exploring the client's feelings indicates that the client's feelings are important to the nurse. Providing reassurance to the client may dismiss the client's feelings as unimportant. Providing information to a client at this time is inappropriate because it may not be assimilated because of anxiety. Relating a personal experience focuses the attention on the nurse, rather than a client

10. Before going off duty, a nurse is reviewing the notes written for a client. The nurse discovers that there has been an omission of important assessment findings. Which of the following nursing actions is most appropriate at this time? a. Insert the omitted data in the appropriate area b. Recopy the entire section, include the missing data, and throw the original away c. Record the time of the entry, the time of the assessment, and the missing data d. Verbally relay the assessment finding during shift report and leave the record unchanged

c. Recording the time of the entry, the time of the assessment, and the missing data is an acceptable documentation practice. Inserting information in the client record is not an appropriate documentation action. Clients' records should not be recopied. Verbally reporting the omission is not acceptable.

7. An insurance company has requested a copy of the client's chart from the doctor's office in order to compensate the physician for the medical care received by the client. Which of the following is the most appropriate nursing action by the office nurse? a. Tell the doctor of the insurance company's request b. Copy the client's record and send it to the insurance company c. Refer the insurance company to the office manager d. Explain that the client's medical record is confidential

d. All information in the client's record is confidential and access to the record is restricted unless the client has given permission for release. The other responses do not directly advocate for the client's right to confidentiality.

20. Charting by exception is used by a hospital for documentation. Using this format, how would the nurse document routine morning care? a. Morning care completed b. Morning care completed, client tolerated well c. Morning care completed by client d. Not necessary to document morning care if uneventful

d. Charting by exceptions is a form of documentation where notations are made if there was an exception to the rule. All other options are normal and are therefore no necessary to include in documentation using this format

14. A client states "I am so sick, I know I am going to die." Which of the following would be the best way for the nurse to document this data? a. Client is depressed today b. Client thinks he is going to die c. The client is frustrated with being sick d. Client states, "I am so sick, I know I am going to die."

d. Documentation needs to be accurate and complete and should not express the opinions or judgement of the nurse. The other options are unclear, judgmental and/or represent the nurse's interpretation of data.

16. A nurse can best evaluate a client's ability to self-administer insulin by which of the following methods? a. Have the client write the procedure b. Demonstrate the techniques using a mannequin c. Have the client tell the nurse the steps to take when administering the insulin d. Have the client administer his or her own insulin

d. Having the client actively demonstrate the procedure is the best way for the nurse to evaluate the client's level of skill. The other options are less effective ways for the nurse to evaluate the client's learning of the new skill.

1. A nurse enters the room of a female client and asks her how she is doing. The client states, "I'm a little nervous this morning." The nurse's best reply would be which of the following? a. "Why are you feeling nervous?" b. "You certainly look like you're nervous." c. "Can I give you a backrub to calm your nerves?" d. "What do you mean by the word nervous?"

d. Asking the client to describe feelings seeks additional information and indicates to the client that the nurse is attentive. Asking "why" questions (option 1) may force the client to defend himself or herself by indicating there must be a reason for these feelings. Stating that the client looks nervous (option 2) may be interpreted as non-supportive. Providing a backrub (option 3) does not allow the client to express feelings.