NURS Ch. 8 Communication

A nurse is communicating the plan of care for a client who is unconscious. Which nursing actions best facilitate this process? Select all that apply. a. The nurse raises environmental noises to help stimulate the client. b. The nurse speaks to the client in a louder-than-normal voice. c. The nurse assumes the client can hear and discusses things that would ordinarily be discussed. d. The nurse is careful what is said in the client's presence because hearing is the last sense to go. e. The nurse speaks with the client before touching the client. f. The nurse does not use touch to communicate with the client.

c. The nurse assumes the client can hear and discusses things that would ordinarily be discussed. d. The nurse is careful what is said in the client's presence because hearing is the last sense to go. e. The nurse speaks with the client before touching the client.

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

a. swaddling the child and gently stroking its head.

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? a. asking the client's family to discuss the importance of the prescribed treatment with the client b. contacting the interprofessional care team to discuss alternative treatment options c. explaining the health consequences of refusing to undergo the prescribed treatment d. recommending assessment of the client's cognitive capacity to make health care decisions

b. contacting the interprofessional care team to discuss alternative treatment options

A nurse is completing a health history on a client who has a hearing impairment. Which action should the nurse take first to enhance communication? a. Use facial and hand gestures b. Provide paper and pencil for written communication c. Assess how the client would like to communicate d. Contact a person skilled in sign language

c. Assess how the client would like to communicate

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

d. Orientation phase

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

a. "Have you ever thought of laser surgery?"

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

a. have group members confront the dominant member to promote the needed teamwork.

A nurse who is caring for newborn infants delivers care by utilizing the sense that is most highly developed at birth. Which example of nursing care achieves this goal? a. The nurse wears colorful clothing to stimulate the infant. b. The nurse gently strokes the baby's cheek to facilitate breastfeeding. c. The nurse plays "peek-a-boo" with the infant. d. The nurse speaks to the infant in a loud voice to get attention.

b. The nurse gently strokes the baby's cheek to facilitate breastfeeding.

A client was recently diagnosed with metastatic lung cancer. The nurse finds the client crying in the room. Which statement made by the nurse best demonstrates the use of empathy? a. "I am sorry to hear you have cancer. I would be upset too, is there anything I can do?" b. "I see you have been crying. Do you want me to call someone for you?" c. "Don't worry, I have seen lots of people with cancer do fine." d. "I see you are upset. Would you like to talk?"

d. "I see you are upset. Would you like to talk?"

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: a. provide both verbal and written information to the child. b. ask the child's parents to leave the room while the nurse and child talk. c. show the child the intravenous catheter and explain how it works. d. involve the child's stuffed animal in the educational session.

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

Which is an open-ended question? a. "Why did the health care provider prescribe this medication for you?" b. "How many tablets do you take at one time?" c. "Do you take this medication daily?" d. "When was the last time you had your prescription refilled?"

a. "Why did the health care provider prescribe this medication for you?"

The nurse observing an interaction between a mother and her child appropriately identifies the interaction as which communication zone? a. Intimate b. Public c. Social d. Personal

a. Intimate

A nurse touches the client's hand while discussing the client's diagnosis. This action is: a. a communication channel. b. a dynamic process. c. a translation. d. an auditory channel.

a. a communication channel.

A nurse suspects that a client may have a hearing problem. The nurse should attempt to consult: a. an audiologist. b. a clinical psychologist. c. an optometrist. d. an ophthalmologist.

a. an audiologist.

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

a. closed-ended questions.

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? a. Exhibit a professional demeanor while examining the client and obtaining specimens, asking questions that are not intrusive. b. Practice active listening by allowing the client to express fears and concerns then restating in the nurse's own words to demonstrate understanding. c. Use strategic pauses to allow the client to provide information that will be used to help officials in their investigation. d. Approach the client with empathy and understanding and allow the client to share feelings without being judged.

d. Approach the client with empathy and understanding and allow the client to share feelings without being judged.

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? a. Giving information b. Encouraging elaboration c. Giving false reassurance d. Seeking clarification

c. Giving false reassurance

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. a. The nurse keeps communication simple and concrete. b. The nurse shows patience with the client and gives the client time to respond. c. The nurse maintains eye contact with the client. d. The nurse gives lengthy explanations of the care that will be given. e. The nurse communicates in a busy environment to hold the client's attention. f. If there is no response, the nurse does not repeat what is said and takes a break.

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

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

b. Working 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? a. Situation b. Background c. Recommendation d. Assessment

c. Recommendation

A nurse is assessing a client's nutritional intake prior to admission the client has lost 10 lb (4.5 kg) over the last 2 months. Which example best represents therapeutic communication technique? a. "Do you eat breakfast every morning?" b. "How often do you snack between meals?" c. "You know eating according to the MyPlate food recommendations is important, correct?" d. "Tell me about the type of foods you like to eat."

d. "Tell me about the type of foods you like to eat."

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? a. "I would recommend keeping a positive attitude." b. "Don't worry about labor, I have been through it and it is not so bad." c. "There are many good medications to decrease the pain; it will not be so bad." d. "You're worried about how you will tolerate the pain associated with labor."

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

A nurse and an older adult client with chronic back pain are beginning to communicate. What activity should the nurse focus on at this point? a. Reassuring the client that back surgery will likely alleviate the pain completely b. Explaining in detail all of the pain management options available c. Being sensitive to the client's emotional barriers d. Sharing the nurse's own family and personal history of back pain

c. Being sensitive to the client's emotional barriers

A nurse is completing a health history with a newly admitted client. During the interview, the client presents with an angry affect and states, "If my doctor did a good job, I would not be here right now!" What is the nurse's best response? a. Be silent and allow the client to continue speaking when ready. b. Smile and say, "Don't worry, I am sure the physician is doing a good job." c. Nod and say, "I agree. If I were you, I would get a new doctor." d. Stand and say, "I can see this interview is making you uncomfortable, so we can continue later."

a. Be silent and allow the client to continue speaking when ready.

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? a. "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." b. "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." c. "This is great news. You don't have anything to worry about and the baby is doing well." d. "I can help you, please talk to me so that I know how I can help you."

b. "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."

A nurse is caring for a client who sustained head trauma. The client is in a medically induced coma and on mechanical ventilation. The client's parent is at the bedside in tears. The parent states, "I just want my child to know I am here." To address the needs of the parent and the client, what would be the nurse's most appropriate response? a. Place a chair next to the bed and then leave the room to allow the parent to grieve. b. Place a chair next to the bed and encourage the parent to hold the client's hand. c. Encourage the parent to bring in pictures of the family that can be displayed in the room. d. Place the client's hand on the parent's hand and reassure the parent that things will be fine.

b. Place a chair next to the bed and encourage the parent to hold the client's hand.

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 nervous about the surgery. The best response by the nurse is to: a. look directly at the client and state, "You are nervous about the surgery." b. ask the client "Can you tell me more about what is worrying you?" c. ask the surgeon to come to the bedside to reassure the client. d. state "Everyone is nervous before surgery."

b. ask the client "Can you tell me more about what is worrying you?"

A nurse is calling a physician to communicate a change in the client's condition. According to the ISBARR format for handoff communication among health care personnel, which is the most appropriate way to begin the conversation? a. "Good morning, I am calling about Mrs. Jones, who is a client of yours." b. "My name is Sue, and I am calling about Mrs. Jones, a client of yours at Jefferson Hospital." c. "My name is Sue Smith, RN, and I am calling regarding Mrs. Jones in room 356 at Jefferson Hospital." d. "I have a client of yours at Jefferson Hospital who is experiencing a change in condition and needs to be seen immediately!"

c. "My name is Sue Smith, RN, and I am calling regarding Mrs. Jones in room 356 at Jefferson Hospital."

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

c. Control the tone of the voice to avoid hidden messages.

Which guideline should a nurse use when choosing a position (location) in relation to a client during a verbal interaction? a. The nurse should ask the client where he would like the nurse to position herself and move accordingly. b. Assess the client's culture during the initial meeting or assessment. c. Take note of the client's cues when choosing a position and act on these cues. d. Choose a position that is no closer than 2 feet, but no farther than 4 feet.

c. Take note of the client's cues when choosing a position and act on these cues.

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? a. "The procedure may take only 2 minutes, so you might get through it by mentally counting up to 120." b. "I will be by your side throughout the procedure; the procedure will be painless if you don't move." c. "You may feel very uncomfortable when the needle goes in, but you should breathe rhythmically." d. "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."

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

d. Contact a professional interpreter.

The nurse meets with the client to teach self-administration of low molecular weight heparin. During the initial part of the training the client shakes the head and asks the nurse to repeat the instructions. What action demonstrates that the nurse has assessed the client's communication abilities? a. The nurse faces the client, speaks slowly and clearly, and demonstrates the procedure using a needleless syringe. b. The nurse asks the client if he or she is worried about giving oneself an injection. c. The nurse stops the instruction and tells the client that a call will be placed to the health care provider to get an order to have a home health nurse administer the medication. d. The nurse continues with the instructions and makes a mental note to repeat the initial instructions at the end of the training.

a. The nurse faces the client, speaks slowly and clearly, and demonstrates the procedure using a needleless syringe.

The nurse is communicating with a client who has been newly diagnosed with cancer. Which statement(s) by the nurse is nontherapeutic? Select all that apply. a. "What are your thoughts about what your health care provider has recommended?" b. "You will be OK. Your health care provider is an excellent surgeon." c. "Why did you not seek help when you first noticed a problem?" d. "This is upsetting news for you. Let's talk about it." e. "Keep your chin up. People survive this type of cancer all the time."

b. "You will be OK. Your health care provider is an excellent surgeon." c. "Why did you not seek help when you first noticed a problem?" e. "Keep your chin up. People survive this type of cancer all the time."

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

b. A nurse uses a disclaimer to verify that any views the nurse expresses on Facebook are the nurse's alone and not the employer's.

A nurse has developed strong rapport with the spouse of a client who has been receiving rehabilitation following a debilitating stroke. The spouse has just been informed that the client is unlikely to return home and requires care that can only be provided in a facility with constant nursing care. The client's spouse tells the nurse, "I can't believe it's come to this." How should the nurse best respond? a. "Why do you think that the care team has made this recommendation?" b. "Do you understand that everyone here has your spouse's best interest at heart?" c. "What would help you accept that this is best for both of you?" d. "This must be very difficult for you to hear. How do you feel right now?"

d. "This must be very difficult for you to hear. How do you feel right now?"

The client is being discharged, and the nurse observes the client crying. What is the nurse's most appropriate response? a. "What is your pain level at this time?" b. "Would you like to talk about anything before you go home?" c. "Are you scared because you are going home?" d. "Let's discuss your discharge plan."

b. "Would you like to talk about anything before you go home?"