NUR 108 Ch8: Communication
A client has cancer, but the significant other does not want the client to know the diagnosis. The nurse demonstrates sensitivity to the significant other and works with the couple to achieve desired outcomes. What kind of behavior is the nurse exhibiting? Sympathy Curiosity Empathy Humility
Empathy Explanation: An empathic nurse is sensitive to the client's feelings and problems but remains objective enough to help the client work to attain positive outcomes. Sympathy is the expression of sorrow for someone's situation, involving compassion and kindness. Sympathy shifts the emphasis from the client to the nurse, as the nurse shares feelings and personal concerns and projects them onto the client. Curiosity is a strong desire to know or learn something. Empathy is perceptive awareness of what a client is experiencing. Humility is a modest or low view of one's own importance.
During an assessment of a newly admitted client the nurse asks the client many questions. The nurse begins the assessment by asking, "How many times have you been hospitalized this year for your back pain?" This is an example of which type of question? Open-ended question Closed question Sequencing question Reflective question
Closed question Explanation: An open-ended question is often used when the nurse is obtaining a nursing history and allows the client to reply with a wide range of possible responses, thus encouraging free verbalization. A closed question is answered by one or two words, often "yes" or "no." A sequencing question is used to place events in a chronological order and to investigate a possible cause-and-effect relationship. A reflective question involves repeating what the person has said or describing the person's feelings.
The nurse and the physical therapist discuss the therapy schedule and goals for a client on a rehabilitation unit. What type of communication is occurring between the nurse and the therapist? Interpersonal Intrapersonal Small-group Organizational
Interpersonal Explanation: The nurse and physical therapist are engaging in interpersonal communication, which occurs between two or more people with the goal to exchange messages. Intrapersonal communication, or self-talk, is the communication that happens within the individual. Small-group communication occurs when nurses interact with two or more individuals. Organizational communication occurs when individuals and groups within an organization communicate to achieve established goals.
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 during this phase of the relationship? Reviewing health changes Attending to physical health care needs Establishing trust and rapport Developing solutions that will be enacted
Reviewing health changes Explanation: During the termination phase of the nurse-client relationship, the nurse and the client review health changes and how the client has dealt with physical and emotional responses. During the orientation phase of the nurse-client relationship, the nurse and client work toward establishing trust and rapport. During the working phase of the nurse-client relationship, the nurse attends to the physical health care needs of the client and develops solutions that the client will act on.
A client in a mental health unit discusses personal thoughts and feelings with the nurse. The nurse can maintain the circle of confidentiality when reporting this information to which individuals? Select all that apply. The client's physician The client's family The nurse from the oncoming shift The unit's mental health technicians The client's closest friend
The client's physician The nurse from the oncoming shift The unit's mental health technicians Explanation: Unless the client has specifically given permission to provide information to family and friends, this information should remain among individuals on the health care team who are directly involved with care of the client.
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 maintains eye contact with the client. The nurse shows patience with the client and gives the client time to respond. The nurse communicates in a busy environment to hold the client's attention. The nurse keeps communication simple and concrete. The nurse gives lengthy explanations of the care that will be given. If there is no response, the nurse does not repeat what is said and takes a break.
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. Explanation: There are several nursing actions that would be appropriate to facilitate. The nurse would maintain eye contact with the client. The nurse shows patience and gives the client time to respond. The nurse keeps communication simple and concrete. The nurse would not communicate in a busy environment because this could be distracting to the client. The nurse would not give lengthy explanations to the client regarding the care to be given. The nurse would repeat the information if no response was shared by the client.
Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship? Orientation phase Working phase Termination phase Evaluation phase
Working phase Explanation: During the working phase, the nurse and client explore and develop solutions that are enacted and evaluated in subsequent interactions. The orientation phase involves making introductions and establishing client goals. The termination phase involves evaluating client progress toward goals and concluding the relationship. There is no evaluation phase in the nurse-client relationship.
A nurse suspects that a client may have a hearing problem. The nurse should attempt to consult: an audiologist. an ophthalmologist. a clinical psychologist. an optometrist.
an audiologist. Explanation: A nurse who suspects a speech, language, or hearing problem should refer the client to a speech-language pathologist or audiologist. A speech-language pathologist is a professional educated in the study of human communication, its development, and its disorders. An audiologist is a professional educated in the study of normal and impaired hearing. An ophthalmologist is a medical doctor who specializes in the treatment of eye disorders. An optometrist has a practice doctorate and focuses on vision. A clinical psychologist is a behavioral health expert.
An evening shift nurse is caring for a client scheduled for a colon resection in the morning. The client tells the nurse that the client is afraid of waking up during surgery. The best response by the nurse is to: 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. state "everyone is afraid of that." ask why the client thinks the client will wake up during surgery.
ask why the client thinks the client will wake up during surgery. Explanation: Asking why the client thinks the client will wake up during surgery opens the lines of communication. Making a sweeping generalization that does not necessarily apply to a specific client hinders communication and makes the person feel insignificant. Restating the client's concern is inappropriate at this time. The nurse should not ask the surgeon to reassure the client. The nurse could ask the anesthesiologist to speak with the client to help alleviate any fears the client has.
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 positive regard analysis comfortable sense of self
analysis Explanation: Empathy, positive regard, and a comfortable sense of self were among the key ingredients. Empathy is an objective understanding of the way in which a patient sees his or her situation, identifying with the way another person feels, putting yourself in another person's circumstances, and imagining what it would be like to share that person's feelings. Communication is crucial because it affects the nurse's behavior and can enhance or detract from positive interactions or regard with the patient and family. Comfortable sense of self is part of the nursing confidence in caring for clients. Analysis is part of the nursing process and not the key elements of therapeutic communication.