PrepU Funds Assignment 3 CH. 6

What is the primary focus of communication during the nurse-client relationship?

Client and client needs

A nurse is standing 6 feet away from another nurse. In what zone are the nurses?

Social space

What is an example of positive body language?

Tilt of head

Each of the following facilitates a therapeutic nurse-client relationship except:

closed-ended questions.

A nurse is preparing to provide discharge instructions to a postpartum client regarding infant care. Before beginning the education session, the nurse should:

eliminate as many distractions as possible.

Which statement is true of factors that influence communication?

Culture and lifestyle influence the communication process.

A nurse is discussing cataract treatment with a client. Which statement by the nurse would be most therapeutic?

"Have you ever thought of laser surgery?"

A nurse caring for a client who was recently diagnosed with metastatic lung cancer finds the client crying in the room. Which statement made by the nurse best demonstrates the use of empathy?

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

A nurse is obtaining a history from an adult female client. When the nurse asks how many times the client has been pregnant, the client answers, "I have four kids." Which statement, made by the nurse, seeks clarification of the original question?

"I understand you have four kids; how many times have you actually been pregnant?"

The nurse is talking with a client who is thinking about obtaining a second opinion regarding the surgeon's recommendation for surgery. Which response by the nurse is considered an advocacy response?

"Let us know if we can answer any further questions after you obtain your second opinion."

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 nurse has developed strong rapport with the wife of a client who has been receiving rehabilitation following a debilitating stroke. The wife has just been informed that her husband will be unlikely to return home and will require care that can only be provided in a facility with constant nursing care. The client's wife tells the nurse, "I can't believe it's come to this." How should the nurse best respond?

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

The wife of a client who is terminally ill expresses to the nurse that she is unable to see her husband die and she may not come to the health care facility anymore. What should the nurse's response to her be?

"You have been coming here every day; are you taking some time for yourself?"

A client with chronic hyperparathyroidism expresses that she is fed up with her diet and can no longer continue with it. What should the nurse's appropriate response to the client be?

"You may be having a difficult time staying on that diet; let's discuss it."

The student nurse is practicing communication skills by talking with several different clients in the hospital. In which instances would silence be appropriate? Select all that apply.

-allowing the client time to reflect on his thoughts -reflecting on the communication that has occurred -after asking the client a question -when the client is upset and needs time to compose himself

Which of the following nurses most likely is the best communicator?

A nurse who easily developed a rapport with clients.

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?

Analysis

A nurse is planning care for an adult client with severe hearing impairment and a new diagnosis of cancer. Which nursing action is most appropriate when establishing the plan of care?

Arrange for an interpreter when discussing treatment.

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?

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

A client is having difficulty with self-administration of insulin. The nurse states, "Many people learn to give themselves insulin." The nurse is using which nontherapeutic communication technique?

Belittling

Which is a client responsibility in the nurse-client relationship?

Comply with the therapeutic regimen

An LPN is discussing the medication regimen with a client. The client is exhibiting negative body language. Which is an example of negative body language?

Downcast eyes

Which qualities in a nurse help the nurse to become effective in providing for a client's needs while remaining compassionately detached?

Empathy

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

When assessing a client's nonverbal communication, the nurse will assess which characteristic as the most expressive part of the body?

Facial expressions

A nurse on a subacute geriatric ward is working with a male client who has a diagnosis of Alzheimer disease. How can the nurse best enhance therapeutic communication with this client?

Give the client plenty of time to make responses to questions that the nurse asks.

A nurse gives a speech on nutrition to a group of pregnant women. What is the speech itself known as?

Message

The nurse encourages a client to participate in the communication process by using an opening remark based on observations and assessment. Which approach would be most effective for the nurse to use to promote trust?

Neutral

A male client has always prided himself in maintaining good health and is consequently shocked at his recent diagnosis of diabetes. The nurse has asked the client, "How do you think your diabetes is going to affect your lifestyle?" The nurse has utilized which of the following interviewing techniques?

Open-ended question

A nurse enters the client's room and introduces himself stating, "Hello, Mr. Alonso. My name is Anthony Bader. I will be your registered nurse today. I will be providing your nursing care and I will be with you until 3:30 PM. If you need anything, please call me on my phone or put your light on." He then gives the client a printed card with this information. In the helping relationship, what does this represent?

Orientation phase

The nurse has to complete a cardiac assessment on a client. Which level of human proxemics would be appropriate for the nurse in completing this assessment on the client?

Personal

The nurse-client relationship is dependent on communication. Effective communication between the nurse and the client includes which of the following? Select all that apply.

Spoken words Sight Touch Observation

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 nurse has entered a client's room after receiving a morning report. The nurse rapidly assessed the client's airway, breathing, and circulation and greeted the client by saying "Good morning." The client has made no reciprocal response to the nurse. How should the nurse best respond to the client's silence?

The nurse should ask appropriate questions to understand the reasons for the client's silence.

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 working phase

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 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.

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:

allow the client to set the pace.

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

an audiologist.

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:

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

A graduate nurse has been working on a telemetry unit for 6 months. The nurse arrives at work in the morning and overhears a night shift nurse talking about the graduate nurse. The night shift nurse is heard saying, "That new nurse is only here to meet a doctor and get married." The best response by the new nurse would be to:

ask to speak to the night shift nurse in private and explain how the comment made her feel.

A pregnant female 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 on the study. When the nurse observes the client's facial expression, she is:

evaluating the client's nonverbal response to the findings.

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?

false reassurance

Several nurses on the same hospital unit communicate on the same social networking site. A nurse posts the following statement to the social networking page, "The lady in room 34 with heart failure was a train wreck!" This statement:

is unacceptable and breaches the client's confidentiality rights.

When communicating with clients nurses need to be very careful in their approach. This is particularly true when communicating using:

medical terminology.

A nurse is caring for a client who suffered a head trauma. The client is in a medically induced coma and on mechanical ventilation. The client's mother is at the bedside in tears. The mother states, "I just want him to know I am here with him." To address the needs of the mother and the client, the nurse should:

place a chair next to the bed and encourage the mother to hold the son's hand.

A nurse is attempting to calm an infant in the nursery. The nurse responds to the highest developed sense by:

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 she has not performed wound care on a complex wound in the past. Using effective intrapersonal communication, this nurse should:

tell herself to "remain calm" and remember that she was trained to perform this skill.

A palliative care nurse possesses numerous skills that have enhanced the nurse-client relationship and communication in the past. One of these skills that has benefited previous clients is affective touch. Before using this technique, the nurse must consider:

the client's culture.

What is the goal of the nurse in a helping relationship with a client?

to assist the client to identify and achieve goals

What quality do clients most value in nurses?

Trustworthiness

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, 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?"

The nurse is collecting health data and avoids using closed-ended questions. Which are examples of closed-ended questions?

"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?"

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 nurse is asking a colleague about a situation. Which statement demonstrates assertive communication?

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

A client with a cardiac dysrhythmia was recently prescribed metoprolol and is at a follow-up appointment at the cardiologist's office. The client tells the nurse, "I feel depressed, tired, and I have no desire to exercise." To determine a cause-and-effect relationship, the nurse should ask:

"Were you tired and depressed before starting the new medication?"

The nurse is having a discussion with a client diagnosed with breast cancer. Which statement would be most effective in promoting communication?

"What are some of your ideas about how to handle this?"

A nurse understands the need for effective communication with clients during assessments. The nurse is completing the admission history for a client admitted to the health care facility. Which can result from the nurse using open-ended questions during the client admission history assessment?

In-depth information

Which is a component of the termination phase of the nurse-client relationship?

Mutual agreement that the client's health problem has improved

The client recently immigrated to the United States from Mumbai, India. She was just admitted to the nurse's unit postoperatively following gallstone removal. She does not speak English. When using the hospital's interpretive services, which is most important?

Speak directly to the client.

A nurse is educating a home care client on how to administer a topical medication. The client is watching television while the nurse is talking. What might be the result of this interaction?

The message will likely be misunderstood.

Which best describes an element of the nurse-client relationship?

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

The nurse educator on a busy medical unit that serves a diverse population is discussing the importance of therapeutic nurse-client relationships with a group of recent nursing graduates. What principle should the nurse educator promote?

View each client as a unique individual with unique needs and priorities

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

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 false reassurance

A nursing student caring for an unconscious client knows that communication is important even if the client does not respond. Which nonverbal action by the nursing student would communicate caring?

holding the client's hand while talking

Which action by the nurse will facilitate the nurse-client relationship during the orientation phase?

introducing oneself to the client by name

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:

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?

reviewing health changes

A nurse is at the end of a busy shift on a medical-surgical unit. The nurse enters a room to empty the client's urinary catheter and the client says, "I feel like you ignored me today." In response to the statement, the nurse should:

sit at the bedside and allow the client to explain the statement.

A nurse enters a client's room to complete an admission history. The nurse will convey interest in the client's story if the nurse:

sits at the client's bedside and faces the client.