Foundations Exam: Chapter 20 - Communication

During an admission intake assessment, a nurse uses open-ended questions to gather information. An example of an open-ended question is:

"Can you tell me why your physician sent you here to be admitted?"

A client has just been given a diagnosis of cirrhosis of the liver. Which statements by the nurse should be avoided because they could impede communication? Select all that apply. "Your doctor knows best." "Everything will be all right." "Don't worry. You will be just fine in another day or two." "Cheer up. Tomorrow is another day." "That's a lot of information to take in. Would you like to talk about it?"

"Cheer up. Tomorrow is another day." "Your doctor knows best." "Don't worry. You will be just fine in another day or two." "Everything will be all right."

A client who underwent a hysterectomy 4 days ago says to the nurse, "I wonder if I'll still feel like a woman." Which response would most likely encourage the client to expand on this and express her concerns in more specific terms? "Feel like a woman . . ." "Do you want more children?" "Do you feel like you are not a woman?" Remaining silent

"Feel like a woman . . ."

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 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 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?"

When the preoperative client tells the nurse that he cannot sleep because he keeps thinking about the surgery, an appropriate reflection of the statement by the nurse is:

"The thought of having surgery is keeping you awake."

A 70-year-old female client had a cholecystectomy four days ago. The client's daughter tells the nurse, "My mother seems confused today." Which question would be best for the nurse to ask the client in order to assess the her orientation? "Is today the first day of the month?" "What day of the week is it?" "Are you in a hospital?" "Is your name Evelyn?"

"What day of the week is it?"

In which of the following situations would the SBAR technique of communication be most appropriate?

A nurse is calling a physician to report a client's new onset of chest pain.

Nurses use social media to share ideas, develop professional connections, access educational offerings and forums, receive support, and investigate evidence-based practices. What is an example of the proper use of social media by a nurse? A nurse uses a disclaimer to verify that any views expressed on Facebook are his or hers alone and not the employer's. A nurse describes a client on Twitter by giving the client's diagnosis rather than the cl'sient's name. A nurse posts pictures of a client who accomplished a goal of losing 100 pounds and later deletes the photo. A nurse describes a client on Twitter by giving the room number rather than the name of the client.

A nurse uses a disclaimer to verify that any views expressed on Facebook are his or hers alone and not the employer's.

A nursing instructor is discussing differences between nurse-client relationships and social relationships with a group of nursing students. Which statement is a characteristic of a person-centered or helping relationship?

A person-centered or helping relationship is characterized by an unequal sharing of information.

The nursing instructor is discussing communication with a student. The student identifies that a contract is made with the client during which phase of the nurse-client relationship? Working phase Orientation phase Intimate phase Termination phase

Orientation phase

A nurse during orientation notices that the preceptor gives all subcutaneous injections on a 45-degree angle. When the new nurse asks the preceptor the rationale for the practice the preceptors states, "This is how I do it, and this is how you will do it." The new nurse recognizes this behavior to be: aggressive. assertive. nurturing. passive.

aggressive.

Each of the following facilitates a therapeutic nurse-client relationship except: reflection. closed-ended questions. rephrasing. active listening.

closed-ended questions.

A nurse is caring for a client admitted to the hospital for dehydration. The physical findings consistent with the diagnosis include: pallor and diaphoresis. easy wrinkling of the skin and sunken eyes. cold intolerance and brittle nails. slow heart rate and prolonged capillary refill.

easy wrinkling of the skin and sunken eyes.

While communicating with a client who is hearing impaired, the nurse must take into account that the impairment serves as a: filter. receptor. handicap. blocker.

filter.

Which characteristic would indicate a professional relationship? Select all that apply. relationship terminated with goal achievement focus on both parties involved needs reflective of the current situation open self-disclosure by the nurse assessment of needs for enjoyment

needs reflective of the current situation relationship terminated with goal achievement

A nurse has been caring for a client who suffered a myocardial infarction 2 days ago. During the morning assessment, the nurse asks the client how he feels. Which scenario warrants further investigation? 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 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."

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? The client's religious practices The client's accent The client's ethnicity The client's tone of voice

The client's tone of voice

The nurse is attempting to develop therapeutic nurse-client relationship with a newly admitted clientl . What expectations does the nurse have when developing the relationship? a) It is based on the needs of the nurse b) The relationship occurs spontaneously c) The nurse and client will have a social relationship d) The nurse is accountable for the outcome.

The nurse is accountable for the outcome.

Which best describes an element of the nurse-client relationship? conversation for mutual companionship, enjoyment and interaction sharing of life events and activities The nurse self-discloses only what is necessary for the client's benefit. a conversation with the goal of forming a more intimate relationship

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

A nurse is communicating the plan of care to a client who is cognitively impaired. Which nursing actions facilitate this process? Select all that apply. If there is no response, the nurse does not repeat what is said and takes a break. The nurse shows patience with the client and gives the client time to respond. The nurse maintains eye contact with the client. The nurse keeps communication simple and concrete. The nurse gives lengthy explanations of the care that will be given. The nurse communicates in a busy environment to hold the client's attention.

The nurse shows patience with the client and gives the client time to respond. The nurse maintains eye contact with the client. The nurse keeps communication simple and concrete

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 introduction phase The orientation phase The termination phase The working phase

The working phase

In order to provide effective nursing care, the nurse should engage in what type of communication with the client and significant others?

Therapeutic communication

In order to provide effective nursing care, the nurse should engage in what type of communication with the client and significant others? Purposive communication Metacommunication Intrapersonal communication Therapeutic communication

Therapeutic communication

Mrs. Miller is a 60-year-old woman status post a hip replacement. She has had multiple complications following surgery including a skin infection and a blood clot. As a result, she has been a client on the unit for 6 weeks. The nurse has just returned from vacation and this is her first day caring for Mrs. Miller. A colleagues looks at the nurse and describes Mrs. Miller as "quite difficult to deal with." The nurse knows that all of the following can contribute to difficult behaviors except:

a quiet room.

A nurse is preparing to provide discharge instructions to a postpartum client regarding infant care. Before beginning the education session, the nurse should: ask all visitors to leave the room. ask the client if she is able to read. eliminate as many distractions as possible. ask the client's partner to leave the room to allow the client to focus.

eliminate as many distractions as possible.

The client is an 18-month-old in the pediatric intensive care unit. He is scheduled to have a subgaleal shunt placed tomorrow, and his mother is quite nervous about the procedure. The nurse feels for the mother and tells her that the surgeon "has done this a million times. Your son will be fine." This is an example of what type of nontherapeutic communication? giving advice being moralistic false reassurance rescue feelings

false reassurance

A nurse who is preparing to administer an injection to the client states, "This injection will not be painful." The nurse has used which communication technique? seeking clarification encouraging elaboration giving false reassurance giving information

giving false reassurance

The mother of a toddler is deciding if she wants to allow her child to receive the recommended immunizations. The clinic nurse responds, "If you don't immunize your child you are jeopardizing the health of other children." What type of approach does this response indicate? dictatorial or bossing advocacy or enforcing rights authoritarian or belittling guilt inducement or approval/disapproval

guilt inducement or approval/disapproval

A unit-based infection control task force was developed in an attempt to reduce catheter-acquired infections. The group consists of 10 team members. During the past three meetings, one person dominated the meeting and did not allow other members ample time to speak. The best way to address the team dysfunction is to: pick a team leader who is not the dominant member. have group members issue a written warning to the dominant member. have group members confront the dominant member to promote the needed team work. plan a meeting where the dominant person cannot attend.

have group members confront the dominant member to promote the needed team work.

The term metacommunication is best defined as: congruent relationships in the spoken topics. contextual factors that impede communication patterns. interpersonal bridge between verbal and nonverbal communication. documenting a conversation between the client and nurse.

interpersonal bridge between verbal and nonverbal communication.

A nurse is providing care to a 3-year-old child admitted with a diagnosis of infectious diarrhea. The nurse needs to insert an intravenous catheter in order to administer prescribed intravenous fluids. In an attempt to foster communication, the nurse should: ask the child's parents to leave the room while the nurse and child talk. show the child the intravenous catheter and explain how it works. involve the child's stuffed animal in the educational session. provide both verbal and written information to the child.

involve the child's stuffed animal in the educational session.

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 abuser. To foster effective communication, the nurse should: ask the client for a urine specimen for urine drug abuse screening. consult with the social worker regarding inpatient drug rehabilitation. ask if the client realizes the infection is a direct result of the drug abuse. remain honest, open, and frank.

remain honest, open, and frank.

A nurse who has been caring for a client for the past few days is preparing the client for discharge and termination of the nurse-client relationship. Which activity would the nurse be carrying out? establishing trust and rapport reviewing health changes attending to physical health care needs developing solutions that are enacted

reviewing health changes

Paramedics arrive in the emergency department with a victim of a motor vehicle collision. The paramedic reports the driver was restrained, the car was traveling about 30 miles per hour (48 Km/hour) , and the air bags were not deployed. The paramedic continues to report the car was struck from behind and that all individuals in the car were able to self-extricate. Which statement made by the nurse is verifying the report from the paramedic?

"All of the victims got themselves out of the car?"

A family has lost a member who was treated for leukemia at a nursing unit. The nurse provides emotional support to the family and counsels them to cope with their loss. Which quality should the nurse use in this situation? a) Pity b) Sympathy c) Empathy d) Indifference

Empathy

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

an audiologist.

A nurse communicating with a client states, "I will be changing your dressing, but we have plenty of time to talk first." She is already wearing sterile gloves and a mask and is busy working with her back to the client. The nurse is conveying:

an incongruent relationship.

An evening shift nurse is caring for a client scheduled for a colon resection in the morning. The client tells the nurse she is afraid of waking up during surgery. The best response by the nurse is to: look directly at the client and state, "you are afraid of waking up during surgery." ask the surgeon to come to the bedside to reassure the client. ask the client why she thinks she will wake up during surgery. state "everyone is afraid of that."

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

A client arrives at the emergency department after experiencing several black, tarry stools. The nurse will develop a cause and effect by: asking the client to provide a stool specimen for guaiac testing. asking the client if he or she has recently taken ferrous sulfate (iron) or bismuth subsalicylate. insisting the client not eat or drink anything until further instructed. determining if the client has any food or drug allergies.

asking the client if he or she has recently taken ferrous sulfate (iron) or bismuth subsalicylate.

A client reports to the primary health care facility reporting chest pain. After the investigations and initial treatment, the client anxiously inquires if he had a heart attack. What should be the nurse's reply? "Yes, you had a heart attack, but the damage is very minimal." "The physician wants to monitor you and control your pain." "No; we can assure you that you will not have a heart attack." "Yes, you had a heart attack; this is why you are here with us."

"The physician wants to monitor you and control your pain."

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." "I would recommend keeping a positive attitude." "Don't worry about labor, I have been through it and it is not so bad." "There are many good medications to decrease the pain; it will not be so bad."

"You're worried about how you will tolerate the pain associated with labor."

Carl Rogers (1961) studied the process of therapeutic communication. Through his research, the elements of a "helpful" person were described. They include all of the following except which choice? Comfortable sense of self Positive regard Empathy Analysis

Analysis

A female nurse states the following to another nurse who is constantly forgetting to wash her hands between clients: "It looks like you keep forgetting to wash your hands between clients. It's really not safe for your clients. Let's think of some type of reminder we can use to help you remember." This communication is an example of what type of speech? Therapeutic Assertive Aggressive Nonassertive

Assertive

The nurse is visiting a hospice client in his home. He is explaining the difficulties he is having with his home infusion pump. By making statements such as "I see" and "go on" during the conversation, the nurse is utilizing which therapeutic nurse-client communication technique?

Encouraging elaboration

In a helping relationship, the nurse would most likely perform what action? Encourage the client to independently explore goals that allow his or her human needs to be satisfied. Set up a reciprocal relationship in which client and nurse are both helper and person being helped. Establish communication that is continuous and reciprocal. Establish goals for the client that are not set in a specific time frame

Establish communication that is continuous and reciprocal.

The nurse is communicating with a client who begins to cry. The nurse places a hand on the client's arm and sits quietly at the client's beside. What mode of communication is the nurse using to offer caring and comfort for the client? Body Language Kinesthetic Verbal Visual

Kinesthetic

A home care nurse discusses with a client when visits will occur and how long they will last. In what phase of the nurse-client relationship is this type of agreement established? Termination phase Working phase All of the above Orientation phase

Orientation phase

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

Orientation phase

The client recently immigrated from Mumbai, India. The client was just admitted to the nurse's unit postoperatively following gallstone removal. The client does not speak the dominant language. When using the hospital's interpretive services, which is most important? Give all of the discharge instructions at once. Have the interpreter write out all of the information listed in the unit brochure. Speak directly to the client. Ensure that family members are present.

Speak directly to the client.

A nurse working with an experienced licensed practical/vocational nurse (LPN/LVN) delegates the task of administering oral medications to a team of clients. The nurse observes the LPN/LVN document a client's medication administration before entering the client's room. What is the most appropriate action of the nurse? Stop the LPN/LVN immediately and discuss the possible consequences of this action. Check all client's medication records to make sure the appropriate drugs were given. Continue to supervise the LPN/LVN as medications are being administered. Contact the nurse manager to discuss the actions of the LPN/LVN.

Stop the LPN/LVN immediately and discuss the possible consequences of this action