Fundamentals Ch 8

A client is scheduled for thoracentesis. The nurse assesses that the client appears anxious about the procedure and needs honest support and reassurance. What is the most appropriate response by the nurse to this client? "I will be by your side throughout the procedure; the procedure will be painless if you don't move." "You may feel very uncomfortable when the needle goes in, but you should breathe rhythmically." "The needle causes discomfort or pain when it goes in, but I will be by your side throughout and will help you hold your position." "The procedure may take only 2 minutes, so you might get through it by mentally counting up to 120."

"The needle causes discomfort or pain when it goes in, but I will be by your side throughout and will help you hold your position."

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? "I understand your confused, what do you think you should do?" "I understand you are not sure about having the surgery. Why do you think you really do not need the surgery?" "You seem unsure. Tell me your concerns about your surgery." "You seem unsure, please let me know if you decide to postpone the surgery until you are no longer unsure."

"You seem unsure. Tell me your concerns about your surgery."

A nurse is discussing cataract treatment with a client. Which statement by the nurse would be most therapeutic? "You should try laser surgery." "Have you ever thought of laser surgery?" "Why don't you try laser surgery?" "My grandfather also benefited from laser surgery."

"Have you ever thought of laser surgery?"

Which is a skill appropriate to use in therapeutic communication? Control the tone of the voice to avoid hidden messages. Avoid the use of periods of silence. Be precise and inflexible regarding the intent of the conversation. Use cliches to enhance a client's understanding of information.

Control the tone of the voice to avoid hidden messages.

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. 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. If there is no response, the nurse does not repeat what is said and takes a break. The nurse keeps communication simple and concrete. The nurse gives lengthy explanations of the care that will be given. The nurse maintains eye contact with the client.

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

It is important for the nurse to empathize with the client to develop a positive, therapeutic relationship. What is a characteristic of empathy? Conveying genuine care to the client Identifying with the client's feelings Caring for the client without negative judgment Experiencing feelings similar to those of the client

Identifying with the client's feelings

The nurse cares for a client who is sharing a personal health story. Which behavior(s) demonstrates active listening? Select all that apply. The nurse makes eye contact while the client is sharing a personal story. The nurse shares a personal story about experiences with hospitalization. The nurse paraphrases what the client has stated before generating a response. The nurse observes the nonverbal behavior of the client as the client speaks. The nurse offers multiple solutions while the client is sharing a personal story.

The nurse makes eye contact while the client is sharing a personal story. The nurse paraphrases what the client has stated before generating a response. The nurse observes the nonverbal behavior of the client as the client speaks.

A nurse is caring for a client admitted to the hospital for dehydration. Which physical findings should the nurse acknowledge as nonverbal communication concerning this diagnosis? cold intolerance and brittle nails. pallor and diaphoresis. slow heart rate and prolonged capillary refill. easy wrinkling of the skin and sunken eyes.

easy wrinkling of the skin and sunken eyes.

The nurse is collecting health data and avoids using closed-ended questions. Which are examples of closed-ended questions? Select all that apply. "Are you ready to get out of bed?" "Do you smoke cigarettes?" "Is there any chance you might be pregnant?" "What plans do you have after you are discharged?" "Does it hurt when I touch you here?" "What sorts of things do you do for fun?"

"Are you ready to get out of bed?" "Do you smoke cigarettes?" "Is there any chance you might be pregnant?" "Does it hurt when I touch you here?"

The nurse is performing an admission interview with a new client diagnosed with acute coronary syndrome. For the nurse to obtain information and allow the client free verbalization, which question would elicit the most information? "I have had chest pain before, and it is really scary!" "Did you take any medication when you had the pain?" "Have you ever had chest pain prior to this admission?" "Could you tell me more about how you are feeling right now?"

"Could you tell me more about how you are feeling right now?"

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. "Don't worry. You will be just fine in another day or two." "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." "Everything will be all right."

"Don't worry. You will be just fine in another day or two." "Cheer up. Tomorrow is another day." "Your doctor knows best." "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 concerns in more specific terms? "Do you want more children?" "Feel like a woman . . ." Remaining silent "Do you feel like you are not a woman?"

"Feel like a woman . . ."

A client presents to the urgent care clinic with ear pain. The client reports a medical history of trigeminal neuralgia. The nurse is not familiar with trigeminal neuralgia. When the client asks whether the two conditions could be related, which response by the nurse is best? "When you were diagnosed with trigeminal neuralgia, did you have ear pain?" "I honestly do not remember specific details regarding trigeminal neuralgia; let me research it." "That is a good question. You should ask the health care provider if the two conditions could be related." "I am not sure. I am not familiar with trigeminal neuralgia and it could be that the trigeminal neuralgia is causing the ear pain."

"I honestly do not remember specific details regarding trigeminal neuralgia; let me research it."

A nurse is asking a colleague about a situation. Which response best demonstrates assertive communication? "I think there is a better way to handle this." "Why are you treating me this way?" "What is your problem with me?" "You always act like this."

"I think there is a better way to handle this."

The nurse is collecting health data and avoids using closed-ended questions. Which are examples of closed-ended questions? Select all that apply. "Is there any chance you might be pregnant?" "What plans do you have after you are discharged?" "Do you smoke cigarettes?" "Are you ready to get out of bed?" "What sorts of things do you do for fun?"

"Is there any chance you might be pregnant?" "Do you smoke cigarettes?" "Are you ready to get out of bed?"

A client comes into the urgent care center to have sutures removed on an arm. The nurse finds significant crusting along the suture line. The client states not having time to get the sutures removed a week prior, as directed. The nurse soaks the crust and attempts to remove the sutures. As the nurse attempts the suture removal, the client frequently pulls the arm away and tells the nurse, "You are taking too long and it is hurting a little bit. Just pull them out and get it over with." Which statement is an example of appropriate therapeutic response? "It is taking longer for me to remove the sutures because the delay allowed the crust to form and adhere to the sutures, making it harder and sometimes painful to remove them." "I am sorry it is taking so long. Tell me how you hurt your arm?" "It will not hurt if you relax and stop pulling your arm away." "I am sorry it is taking so long and I am hurting you; next time do not wait too long to get sutures removed or the same thing will happen"

"It is taking longer for me to remove the sutures because the delay allowed the crust to form and adhere to the sutures, making it harder and sometimes painful to remove them."

A pregnant client presents to the emergency department with vaginal bleeding. A transvaginal ultrasound is performed, and the health care provider informs the client that there are normal fetal heart tones noted. The client begins to tear-up and has a worried appearance. To facilitate therapeutic communication, what statement would the nurse make after observing the client's nonverbal communication? "Take your time and tell me how you are feeling. I have plenty of time to answer your questions and discuss any thoughts or feelings with you." "Close your eyes and take a deep breath. I know you were frightened, but the baby is healthy and everything is going to be okay." "This is great news. You don't have anything to worry about and the baby is doing well." "I can help you, please talk to me so that I know how I can help you."

"Take your time and tell me how you are feeling. I have plenty of time to answer your questions and discuss any thoughts or feelings with you."

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

"What did your health care provider tell you about your need to be admitted?"

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." "Don't worry about labor, I have been through it and it is not so bad." "I would recommend keeping a positive attitude." "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."

What nursing care behavior by the nurse engenders a client's trust in the nurse? A nurse answers the client's questions about an upcoming test while completing documentation in the EHR. 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 tells the client, "Do not 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 in a calm gentle voice while making eye contact with the client.

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

In which situation would the SBAR technique of communication be most appropriate? A nurse is teaching a client about the benefits of smoking cessation and the risks of continuing to smoke. A nurse is facilitating a family meeting to coordinate a client's discharge planning. A nurse is explaining the process of bone marrow biopsy to a client who is scheduled for the procedure. A nurse is calling a physician to report a client's new onset of chest pain.

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

A nurse needs to complete an assessment and vital signs on a client who has Alzheimer disease. How should the nurse approach this client to gain cooperation? Select all that apply. Approach the client from the front. Focus on the nursing tasks. Use the client's name. Smile and maintain eye contact. Speak loudly and clearly.

Approach the client from the front. Use the client's name. Smile and maintain eye contact.

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.

A nurse is planning care for an adult client with severe hearing impairment who uses sign language and lip reading for communication and who has a new diagnosis of cancer. Which nursing action is most appropriate when establishing the plan of care for this client? Consult the oncology nurse specialist. Use a text-telephone device (TTD) for daily communication. Talk with the client's children to determine needs. Arrange for a sign language interpreter when discussing treatment.

Arrange for a sign language interpreter when discussing treatment.

During an assessment of a newly admitted client the nurse asks the client many questions. The nurse begins the assessment by asking, "Have you been hospitalized this year for your back pain?" This is an example of which type of question? Open-ended question Closed question Reflective question Sequencing question

Closed question

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

Contact a professional interpreter.

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? Pity Indifference Sympathy Empathy

Empathy

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? Giving information Seeking clarification Encouraging elaboration Giving false reassurance

Giving false reassurance

The nurse is providing care to an older adult client who has visual and hearing deficits. What action by the nurse is appropriate to help with communication? Remove the COVID protection face mask while speaking with the client. Speak in a loud voice over the volume of the television set. Obtain the client's attention by calling out the client's first name. Identify oneself by name and title with each entry into the client's room.

Identify oneself by name and title with each entry into the client's room.

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 Orientation phase Working phase Evaluation phase

Orientation phase

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

Orientation phase

The nurse is reporting to an oncoming nurse about the care of a client using the SBAR format. The nurse informs the oncoming nurse that the client should continue to have neurological checks every 2 hours and the nurse should report any alterations to the health care provider. In which section should this information be relayed? Assessment Recommendation Background Situation

Recommendation

The community health nurse is preparing a campaign to educate the public about heart health. Which forms of verbal communication would be effective to use in this campaign? Select all that apply. Television Brochures Radio A public speech Eye contact

Television Radio A public speech Brochures

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 smiles at the nurse and states, "I cannot wait to go home." The client stares at the floor and states, "I feel fine." 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."

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 termination phase The working phase The orientation phase The introduction phase

The working phase

Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship? Orientation phase Working phase Evaluation phase Termination phase

Working phase

When communicating with a client, the nurse uses reflection for which purpose? To determine the sequence of events in the conversation To keep the client on the topic of concern To have the client elaborate on thoughts and feelings To investigate the situation to help problem solve

To have the client elaborate on thoughts and feelings

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: nurturing. aggressive. assertive. passive.

aggressive.

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: use only open-ended questions. ask questions as quickly as possible. 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.

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? empathy analysis comfortable sense of self positive regard

analysis

The nurse communicates with a newly admitted client. Which nonverbal behavior will the nurse note? client's gestures client's religious practices client's ethnicity client's accent

client's gestures

The nurse is caring for a postoperative client who refuses a blood transfusion due to religious beliefs. The nurse is demonstrating trustworthiness when taking which action in response to the client's treatment wishes? contacting the interprofessional care team to discuss alternative treatment options explaining the health consequences of refusing to undergo the prescribed treatment recommending assessment of the client's cognitive capacity to make health care decisions asking the client's family to discuss the importance of the prescribed treatment with the client

contacting the interprofessional care team to discuss alternative treatment options

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

eliminate as many distractions as possible

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: have group members confront the dominant member to promote the needed team work. have group members issue a written warning to the dominant member. pick a team leader who is not the dominant member. plan a meeting where the dominant person cannot attend.

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

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

remain honest, open, and frank

A nurse is attempting to calm an infant in the nursery. The nurse responds to the highest developed sense by: softly humming a song near the neonate. offering the neonate infant formula. swaddling the child and gently stroking its head. staring into the neonate's eyes and smiling.

swaddling the child and gently stroking its head.

A nurse is preparing to enter a client's room to perform wound care. The shift report revealed that this client has a tunneling wound in the sacral area that cannot be staged. The wound was also documented as having a foul odor. The nurse is nervous because the nurse has not often performed wound care on a complex wound. Using effective intrapersonal communication, this nurse should: tell oneself to "remain calm" and remember that the nurse was trained to perform this skill. tell the unlicensed assistive personnel (UAP) to gather supplies and to prepare to cleanse and dress the wound. inform the client that several nurses will be needed to care for this wound. ask the charge nurse to change the assignment.

tell oneself to "remain calm" and remember that the nurse was trained to perform this skill.