Test 2 - The Nursing Process, Communication and Meds

What is communication?

- includes verbal and non-verbal messages, must be purposeful and helps build working relationships and meet human needs

The nurse understands that human responses can be classified as objective or subjective. Identify those that are subjective: SELECT ALL THAT APPLY 1. Nausea 2. Jaundice 3. Dizziness 4. Diaphoresis 5. Hypotension

1, 3

Which route is unrelated to the parenteral administration of medications? 1. Buccal 2. Z-Track 3. IV 4. Intradermal

1. A parenteral medication is one that does not use the GI tract. A medicine administered in the buccal area is in the mouth, which is part of the GI tract.

The nurse plans to administer a bolus dose of a medication via a currently running IV infusion. The nurse should first: 1. Ensure that it is compatible with the IV solution being infused. 2. Pinch the tubing above the the infusion port while instilling the bolus. 3. Instill it into a 50 mL bag of NS and infuse it via a secondary line. 4. Administer it via a volume-control infusion set with microdrip tubing.

1. An incompatible solution can increase, decrease or neutralize the effects of medications.

The nurse is administering an intradermal injection. The nurse inserts the needle at a: 1. 15 degree angle 2. 30 degree angle 3. 45 degree angle 4. 90 degree angle

1. An intradermal injection is administered by inserting a needle at a 10 to 15 degree angle through the skin with the bevel facing upwards in the skin.

During which of the 5 steps in the nursing process does the nurse analyze the data critically? 1. Diagnosis 2. Clustering 3. Collection 4. Assessment

1. During the diagnosis step of the Nursing Process data are critically analyzed and interpreted, significance of the data is determined, inferences are made and validated, sues and clusters of cues are compared with the defining characteristics of nursing diagnoses, contributing factors are identified, and nursing diagnoses are identified and prioritized.

What is being communicated when the nurse leans forward during a patient's interview?

1. Leaning forward is a nonverbal behavior that conveys involvement. It is a form of physical attending, which is being present to another.

The physician orders a rectal suppository for an adult patient. When administering the rectal suppository, the nurse should: 1. Lubricate the medication before insertion 2. Warm the medication to body temperature 3. Insert the medication at least two inches into the rectum. 4. Place the patient in the prone position to administer the medication.

1. Lubrication ease insertion by reducing friction which limits tissue trauma and discomfort.

The planning step of the nursing process is influenced most directly by the: 1. Related factors 2. Diagnostic label 3. Secondary factors 4. Medical diagnosis

1. Related factors (etiology, contributing factors) contribute to the problem statement of the nursing diagnosis and directly impact on the planning step of the NP.

The nurse understands that the appropriateness of a Nursing diagnosis is supported by: 1. Defining characteristics 2. Planned interventions 3. Diagnostic statement 4. Related risk factors

1. The defining characteristics are the major and minor cues that form a cluster that support or validate a nursing diagnosis. At least one major defining characteristic must be present for a nursing diagnosis to be considered appropriate for that patient.

The nurse plans to administer a 3-mL intramusclar injection. The nurse understands that LEAST desirable muscle for the administration of this medicine is: 1. Deltoid 2. Dorsogluteal 3. Ventrogluteal 4. Vastus Lateralis

1. The deltoid, on the lateral aspect of the upper arm, is a small muscle that is incapable of absorbing a large medication volume. The site is more appropriate for 1mL of solution.

The nurse understands that evaluation most directly relates to which aspect of the nursing process? 1. Goal 2. Problem 3. Etiology 4. Implementation

1. The evaluate the effectiveness of a nursing action, the nurse needs to compare the actual patient outcome with the expected patient outcome. The expected outcomes are measurable data that reflect goal achievement, while the actual outcomes are what really happened.

An essential concept related to understanding the Nursing Process is that it: 1. Is dynamic rather than static 2. Focuses on the role of the nurse 3. Moves from simple to the complex 4. Is based on the patient's medical problem

1. The nursing process is dynamic process that is designed to diagnose and treat human responses to health problems. The nurse moves among the steps as necessary to meet the needs of the patient.

A patient verbally communicates with the nurse while exhibiting nonverbal behavior. To confirm the meaning of the nonverbal behavior, the nurse should: 1. Look for similarity in meaning between the patient's verbal and nonverbal behavior. 2. Ask family members to help interpret the patient's behavior. 3. Validate inferences by asking patient questions. 4. Recognize that what the patient says is most important.

1. The patient is the primary source of information. When nonverbal communication reinforces the verbal message, the message reflects the true feelings of the patient because non verbal behavior is under less conscious control than verbal statements.

The stage of the interview that establishes the relationship between the nurse and the patient is the: 1. Opening stage 2. Working stage 3. Surrogate state 4. Examining state

1. The purposes of the opening stage of an interview are to establish rapport and orient the interviewee. A relationship is established through a process of creating goodwill and trust. The orientation focuses on explaining the purpose and nature of the interview and what is expected of the patient.

The nurse uses reflective technique when communicating with an anxious patient. The nurse uses reflective technique in this situation because it focuses on: 1. Feelings 2. Content themes 3. Clarification of information 4. Summarization of the topics discussed

1. The reflective technique requires active listening to identify the underlying emotional concerns or feelings contained in a patient's messages. These feelings are then referred back to the patients to promote a clearer understanding of what they have said.

The nurse understands that the statement that is most accurate about communication is: 1. Communication is inevitable 2. Behavior clearly reflects feelings. 3. Hands are the most expressive part of the body. 4. Verbal communication is essential for human relationships.

1. Theory indicates that all behavior has meaning, people are always behaving, and we cannot stop behaving or communicating, therefore communication is inevitable.

The nursing action that best reflects the concept of therapeutic communication is: 1. Using interviewing skills to discuss the patients concerns 2. Letting the patient control the focus of the conversation 3. Setting time aside to talk with the patient 4. Agreeing with the patient's statements.

1. Therapeutic communication is patient-centered and goal-directed. It facilitates the exploration of the patient's thoughts and feelings and helps to establish a constructive relationship between the nurse and patient.

Which interviewing skill is being used when the nurse says, "You mentioned before that you are having a problem with your colostomy?": 1. Focusing 2. Clarifying 3. Paraphrasing 4. Acknowledging

1. This example of focusing helps the patient explore a topic of importance. The nurse selects one topic for further discussion from among several topics presented by the patient.

The nurse is collecting data for an admission nursing history. Which question by the nurse is best to open the discussion? 1. What brought you to the hospital? 2. Would it help to discuss your feelings? 3. Do you want to talk about your concerns? 4. Would you like to talk about why you are here?

1. This is a focused open-ended statement that invites the patient to communicate while centering on the reason for seeking health care.

A patient who is to receive nothing by mouth (NPO) in preparation for a bronchoscopy says,"I am worried about the test and I can't even have a drink of water." What is the best response by the nurse? 1. "Lets talk about your concerns regarding this test." 2. "I'll see if the doctor will let you have some ice chips" 3. "The doctor will review the results of the test as soon as possible." 4. As soon as the test is over I'll get you whatever you would like to drink."

1. This response encourages the patient to explore concerns. Verbalization of concerns, validating of feelings, and patient teaching may help reduce anxiety.

An agitated 80 year old patient states, "I'm having trouble with my bowels." Which response by the nurse incorporates the interviewing skill of reflection? 1. "You seem distressed about your bowels." 2. "You're having trouble with your bowels?" 3. "It's common to have problems with the bowels at your age." 4. "When did you first notice having trouble with your bowels."

1. This response recognizes the and reflects back the underlying feeling in the patients message (reflective technique). When people consider themselves in trouble, they usually feel threatened or stressed.

The nurse is preparing the draw up medication from a vial. What should the nurse do first? 1. Ensure the needle is firmly attached to the syringe. 2. Rub vigorously back and forth over the rubber cap of the medication vial with an alcohol swab. 3. Inject air into the vial with the needle bevel below the surface of the medication. 4. Draw up slightly more air that the volume of the medication to be withdrawn from the vial

1. This will ensure a tight seal and a closed system.

The nurse identifies that the patient statement that provides subjective data is: 1. I am not sure that I am going to be able to manage at home by myself 2. I can call a home-care agency if I feel I need help at home. 3. What should I do if I have uncontrollable pain at home? 4. Will a home health aide help me with my care at home?

1.This is subjective information because it is the patient's perception and can only be verified by the patient

Nurses use the Nursing Process to provide nursing care. These statements reflect nursing care being provided to a variety of patients. Place the statements in order as the nurse progresses through the NP starting with assessment and ending with evaluation: 1. "I am going to give you an enema" 2. What brought you to the hospital today? 3. The patients adaptations indicate that he is dehydrated 4. The patient will have a bowel movement in the morning 5. Did you sleep last night after I gave you the sleeping medication?

2,3,4,1,5

The nurse understands that subjective data has been obtained when the patient states: 1. "I just went in the urinal and it needs to be emptied" 2. "My pain feels like a 5 on a scale of 1 to 5." 3. "The doctor said I can go home today." 4. " I only ate half my breakfast."

2. A patient's perception about pain level is subjective information. It is a feeling only the patient can confirm.

Which human response identified by the nurse is an example of objective data? 1. Pain of 5 on 1 to 10 pain scale. 2. Irregualr rapid pulse of 50 bpm 3. Shortness of breath 4. Dizziness

2. A radial pulse is objective, not subjective, data. Objective data is measurable and checkable.

The main purpose of the working phase of a therapeutic nurse-patient relationship is to: 1. Establish a formal or informal contract that addresses the patients problems 2. Implement nursing interventions designed to achieve expected patient outcomes. 3. Develop rapport and trust so the patient feels protected and an initial care plan can be identified 4. Clearly identify the role of the nurse and establish parameters of the professional relationship.

2. During the working phase of the therapeutic relationship, nursing interventions have a two fold purpose: assisting patients to explore and understand their thoughts and feelings and supporting patient decisions and actions.

During which of the five steps in the Nursing Process does the nurse determine whether outcomes of care are achieved? 1. Implementation 2. Evaluation 3. Diagnosis 4. Planning

2. Evaluation occurs when actual outcomes are compared with expected out comes that reflect goal achievement. If a goal is achieved, the patient's needs are met.

The nurse is changing a patient's dressing over an abdominal wound. What level of space around the patient is entered during the dressing change? 1. Personal 2. Intimate 3. Social 4. Public

2. Physically caring for a patient involves inspection and touch that invades the instinctual, protective distance immediately surrounding an individual. Intimate space (less than 1.5 feet) is characterized by body contact and visual exposure.

Which nursing action reflects an activity associated with diagnosis step of the Nursing Process? 1. Formulating a plan of care. 2. Identifying the patient's potential risks 3. Designing ways to minimize a patients stressors 4. Making decisions about the effectiveness of patient care.

2. Potential risk factors are identified during the diagnosis step of the nursing process.

The patient appears tearful and is quiet and withdrawn. The nurse says, "You seem very sad today." What interviewing approach did the nurse use? 1.Examining 2.Reflecting 3.Clarifying 4.Orienting

2. Reflective technique refers to feelings implied in the content of verbal communication or in exhibited nonverbal behaviors. Patients who are crying, quiet and withdrawn are often sad.

The nurse understands that the primary goal of the assessment phase of the Nursing Process is to: 1. Build trust and rapport 2. Collect and cluster data 3. Establish goals and outcomes 4. Identify and validate the medical diagnosis.

2. The primary purpose of assessment in the NP is to collect data from various sources using a variety of approaches. After data is collected, it should be clustered into meaningful categories.

Which word best describes the role of the nurse when using the Nursing Process to meet the needs of the patient holistically? 1. Teacher 2. Advocate 3. Surrogate 4. Counselor

2. When the nurse supports, protects, and defends a patient from a holistic view point, the nurse functions as an advocate.

The nurse must conduct a focused interview to complete an admission history. Which interviewing technique should the nurse use? 1. Probing 2. Clarification 3. Direct questions 4. Paraphrasing

3. A focused interview explores a particular topic or obtains specific information. Direct questions meet these objectives and avoid extraneous information.

The physician orders a medication that must be administered transdermally. The nurse understands that a drug administered transdermally is: 1. Inhaled into the respiratory tract. 2. Dissolved under the tongue 3. Absorbed through the skin 4. Inserted into the rectum

3. A medicated patch or disk can be applied directly to the skin where the medication is released and absorbed over time.

The nurse instructs a patient to close his/her eyes after the administration of eye drops. The nurse understands this is done to: 1. Limit corneal irritation. 2. Squeeze the excess medication from the eyes. 3. Disperse the medication over eyeballs 4. Prevent medication from entering the lacrimal duct.

3. Closing the eyes moves the medication over the conjunctiva and eyeball and helps ensure even distribution of medication.

During the evaluation step of the Nursing Process, the nurse must: 1. Establish outcomes 2. Determine priorities 3. Take corrective action 4. Set the time frames for goals

3. Corrective action takes place in the evaluation step of the NP. If during an evaluation is it determined that a goal was not met, the reasons for failure must be identified and the plan modified.

When providing nursing care, humor should be used to: 1. Diminish feelings of anger 2. Refocus the patients attention 3. Maintain a balanced perspective 4. Delay dealing with the inevitable

3. Humor is an interpersonal tool and it is a healing strategy. It releases physical and psychic energy, enhances well-being, reduces anxiety, increases pain tolerance, and places experiences within the context of life.

The nurse teaches the patient about taking sublingual nitroglycerin tablets. The nurse evaluates that the patient understands when the patient states "I should place it..." 1.On my skin 2. Inside my cheek 3. Under my tongue 4. In the lower lid of my eye

3. Sublingual medication is placed under the tongue. It is absorbed quickly through the mucous membranes into the systemic circulation.

The nurse collects objective data when a hospitalized patient states: 1. "I am hungry" 2. "I feel very warm" 3. "I ate half my lunch" 4. I have the urge to urinate"

3. The amount of food eaten by a patient can be objectively verified. The nurse measures and documents the percentage of a meal ingested by a patient to quantify the amount of food consumed.

When placing cream into a patient's vaginal canal, the nurse should use: 1. A finger 2. A gauze pad 3. An applicator 4. An irrigation kit

3. The consistency of a cream requires that an applicator be used to ensure that the medication is deposited along the full length of the canal.

When considering the Nursing process, the nurse understands that the word "observe" is to "assess" as the word "determine" is to: 1. Plan 2. Analyze 3. Diagnose 4. Implement

3. The definitions of the words "observe" and "assess" are similar as are the definitions of "determine" and "diagnose".

A pebble dropped into a pond causes ripples on the surface of the water. Which part of the nursing diagnosis is most directly related to this concept? 1. Defining characteristics 2. Outcome criteria 3. Etiology 4. Goal

3. The etiology (also known as contributing factors) are the conditions, situations, or circumstances that add to the development of the human response identified in the problem statement of the nursing diagnoses.

The nurse is attempting to develop a helping relationship with a patient who was recently diagnosed with cancer. The nurse understands that a factor that is unique to this helping relationship is that it is: 1. Characterized by allowing the patient to take the dominant role. 2. Distinguished by an equal sharing of information. 3. Specific to a person while guided by a purpose 4. Based on the needs of both participants.

3. The helping relationship (interpersonal relationship, therapeutic relationship) is a personal, client-focused, goal oriented process whereby the nurse assists a person to problem solve and meet needs.

The nurse understands that the word most closely associated with scientific principles is: 1. Data 2. Problem 3. Rationale 4. Evaluation

3. The word rationale is closely related to the term "scientific principles". Scientific principles are based on rationales.

A young man who had a leg amputated because of trauma says " No one will ever choose to love a person with one leg." What is the best response by the nurse? 1. You are a good looking young man, and you will have no trouble meeting someone who cares. 2. You may feel that way now, but you will feel differently as time passes. 3. Do you feel that no one will marry you because you have one leg? 4. How do you see our situation at this point?

3. This is an example of paraphrasing, which restates the patients message in similar words. It promotes communication.

The nurse evaluates that therapeutic communication is effective when: 1.Verbal and nonverbal communication is congruent. 2. Interaction is conducted in a professional manner. 3. Common understanding is achieved. 4. Thoughts can be put into words.

3. Understanding is the foundation of therapeutic communication. When the nurse comprehends, appreciates and empathizes with the patient, therapeutic communication is achieved.

The nurse is collecting subjective data associated with a patient's anxiety. Which assessment method should be used to collect this information? 1. Observing 2. Inspection 3. Auscultation 4. Interviewing

4 Interviewing a patient is the most effective data collection method when collecting subjective data associated with a patient's anxiety. The patient is the primary source for information about perceptions, feelings, fears, concerns, beliefs and values.

The nurse collects data about the patient. Next the nurse should? 1. Write a patient centered goal 2. Formulate a nursing diagnosis 3. Design a plan of nursing interventions 4. Determine the significance of the information.

4. After data are collected, they are clustered to determine significance.

The nurse comes to the conclusion that a patient's elevated temperature, pulse, and respiration are significant. What step of the Nursing Process is being used when the nurse comes to this conclusion? 1. Implementation 2. Assessment 3. Evaluation 4. Diagnosis

4. During the diagnosis step of the Nursing Process data are critically analyzed and interpreted, significance of the data is determined, inferences are made and validated, sues and clusters of cues are compared with the defining characteristics of nursing diagnoses, contributing factors are identified, and nursing diagnoses are identified and prioritized.

The nurse plans to foster a therapeutic relationship with a patient. It is most important that the nurse: 1. Works on establishing a friendship with the patient. 2. Use humor to defuse emotionally charged topics of discussion. 3. Sympathize with the patient when the patient shares sad feelings. 4. Demonstrate respect when discussing emotionally charged topics.

4. Emotionally charged topics should be approached with respectful, sincere, interactions that are accepting and non-judgmental, which will promote further verbalization.

A patient has multiple diagnostic tests performed. Where in the patient's chart can the nurse find documentation about the current medical diagnosis after the diagnostic test results are reported? 1. Physician's History and Physical 2. Social Service Record 3. Admission Sheet 4. Progress Notes

4. Generally the Progress Notes contain the documentation by all members of the health team. After a patient is admitted and diagnostic tests are completed, the patient's medical diagnosis may change. The ingoing changes are documented in the progress notes.

The nurse is preparing the administer a subcut injection of insulin. The nurse knows that the best site to use to promote it's absorption in: 1. Upper lateral arms 2. Anterior thighs 3. Upper chest 4. Abdomen

4. The abdomen is the preferred site for administration of insulin because is a large area that promotes a systematic rotation of injections and it has the fastest rate of absorption.

A mother whose daughter has died of leukemia is crying, and is unable to talk about her feelings. What is the best response by the nurse? 1. "Everyone will remember he because she was so cute, she was one of our favorites." 2. "As hard as this is, it is probably for the best because she was in a lot of pain." 3. She put up a good fight but now she is out of pain and in heaven." 4. I feel so sad. It can be hard to deal with such a precious loss.

4. The first sentence communicates empathy. The second sentence focuses on the feeling surrounding loss and provides and opportunity for the patient to verbalize.Both of these are therapeutic responses to the situation.

When two nursing diagnoses appear closely related, what should the nurse do first to determine which diagnosis most accurately reflects the needs of the patient?: 1. Reassess the patient 2. Examine the "related to" factors 3. Analyze the "secondary to" factors 4. Review the defining characteristics

4. The first thing the nurse should do to differentiate between two closely related nursing diagnoses is to compare the data collected to the major and minor defining characteristics of each of the diagnoses being considered.

Determine what nursing actions will be employed occurs during which step of the nursing process? 1.Implementation 2. Assessment 3. Diagnosis 4. Planning

4. The identification of nursing actions designed to help a patient achieve a goal occurs during the planning step of the NP.

The patient states " I think that I am dying" The nurse responds, "You feel as though you are dying?". What interview approach did the nurse use? 1.Focusing 2. Reflecting 3.Validating 4. Paraphrasing

4. The nurses response is an example of paraphrasing because it uses similar words to restate the patients message.

A patient states, "Do you think I have cancer?" The nurse responds, "What did the doctor tell you?" What interviewing approach did the nurse use? 1. Paraphrasing 2. Confrontation 3. Reflective Technique 4. Open-ended question

4. The open-ended statement invites the patient to elaborate on the expressed thoughts with more than just a one or two word answer.

The goals of therapeutic communication mainly should depend on: 1. Environment in which communication takes place. 2. Role of the nurse in that particular setting 3. Skill level of the nurse in the situation. 4. Concerns of the patient.

4. The patient and significant others and their needs are always the focus of nursing interventions, including the goals of communication.

The patient states "My wife is going to be very upset that my prostate surgery probably is going to leave me impotent." What is the best response by the nurse? 1.I'm sure your wife will be willing to make the sacrifice in exchange for your well-being 2.The doctors are getting great results with nerve-sparing surgery today. 3.Your wife may not put as much emphasis on sex as you think. 4.Let's talk about how you feel about this surgery.

4. The patient may be using projection to cope with the potential for impotence. This response indicates that it is acceptable to talk about sexuality and invites the patient to verbalize concerns.

The instructions on a medication states to use the Z-track technique when administering the injection. Therefore the nurse should: 1. Pinch the site throughout injection 2. Massage the site after needle is removed 3. Remove the needle immediately after the medication is injected. 4. Change the needle after the medication is drawn into the syringe.

4. This ensures that medication is not on the outside of the needle, which prevents tracking of medication into subcutaneous tissue during needle insertion.

The nurse is caring for a male patient with a urinary elimination problem. Which is the most accurately stated goal? "The patient will...": 1. Be taught how to use the urinal when on bed rest 2. Experience fewer incontinence episodes at night 3. Be assisted to the toilet every two hours and whenever necessary 4. Transfer independently and safely to a commode before discharge.

4. This is a correctly worded goal. Goals must be patient centered, measurable, realistic and include a time frame.

The nurse is caring for a patient with a fever. Which is a well designed goal for this patient? "The patient will..." 1. Have a lower temperature 2. Be given aspirin every eight hours p.r.n 3. Be taught how to take an accurate temperature 4. Maintain fluid intake sufficient to prevent dehydration.

4. This is a well written goal. Goals must be patient centered, measurable, realistic and include a time frame.

The nurse teaches a patient to use visualization to cope with chronic pain. This action reflects which step of the nursing process? 1. Planning 2. Diagnosis 3. Evaluation 4. Implementation

4. This is an example of implementation during the NP. During the implementation step, planned nursing care is delivered.

The patient is exhibiting anxious behavior and states, "I just found out that I have cancer everywhere and I don't have long to live. My life is over." What is the best response by the nurse? 1. It might be good if your wife were here right now. Shall I call her? 2. What might be the best way to approach this terrible news? 3. That is so sad, you must feel like crying. 4. It sounds like you feel hopeless.

4. This is an example of reflective technique. When no solutions to a problem are evident, a person becomes hopeless.

When the nurse considers the Nursing Process, the word "identify" is to "recognize" as the word "do" is to: 1. Plan 2. Evaluate 3. Diagnose 4. Implement

4. This is the correct analogy. The words identify and recognize have the same definition. The words do and implement also have the same definition.

The nurse performs an assessment of a newly admitted patient. The nurse understands that this admission assessment is conducted primarily to: 1. Diagnose if the patient is at risk for falls 2. Ensure that the patient's skin is intact 3. Establish a therapeutic relationship 4. Identify important data

4. This is the primary purpose of a nursing admission assessment. Data must be collected and then analyzed to determine significance, and grouped in meaningful clusters before a nursing diagnosis can be made.

The patient states "I can't believe I couldn't even eat half my breakfast." Which statement by the nurses uses the interviewing skill of reflection? 1. Let's talk about your inability to eat. 2. What part of your breakfast were you able to eat? 3. How long have you been unable to eat most of your breakfast? 4. You seem surprised that you weren't able to eat all of our breakfast.

4. This question is an example of reflective technique because it focuses on the feeling of surprise.

A patient says, "I don't know if I'll make it through this surgery." Which response by the nurse may block further communication by the patient? 1."You sound scared" 2."You think you will die" 3."Surgery can be frightening" 4."Everything will be alright"

4. This response is false reassurance. It denies the patient's concerns about survival and does not invite the patient to elaborate.

The patient is upset and crying and mentions something about her job and the nurse cannot understand. The nurse's best response is: 1. It's natural to be worried about your job. 2. Your job must be very important to you. 3. Calm down so that I can understand what you are saying. 4. I am not quite sure I heard what you were saying about your work.

4. This response requests additional information in an attempt to clarify an unclear message.

The patient says, "I'm really nervous about having a spinal tap tomorrow." The best response by the nurse is: 1. "I'll ask the doctor for a little medication to help you relax." 2."Patients who have had a spinal tap say it's not that uncomfortable." 3. " The doctor is excellent and is very careful when spinal taps are done." 4. " It's alright to be nervous, and I don't remember anyone who wasn't."

4. This statement is therapeutic. It recognizes the patient's feelings, gives the patient permission to feel nervous and reassures the patient that one's behavior is not unusual. This statement sets the groundwork for the next statement, such as "Let's talk a little about the spinal tap and the concerns you may have."

What is connotative meaning vs denotative meaning?

A connotative meaning is one that is implied, a denotative meaning is one that is factual

If a client states they are concerned about a procedure, what can the nurse do to ensure they are not creating a barrier to communication?

Ask open-ended questions, explore the issue in detail and avoid giving false reassurance.

Is asking a client "Why?" a good or bad communication technique?

Bad, it is a barrier to communication

Is changing the subject quickly a good or bad communication technique?

Bad, it is a barrier to communication

What is included in an assessment?

Collecting data by using a systematic and ongoing process and then recording data.

If a nurse makes sure to use clear and specific language when therapeutically communicating, what key characteristic is the nurse using?

Concreteness

What are the key characteristics of therapeutic communication (nurse's characteristics)?

Concreteness, respect, genuineness, empathy, confrontation

What phase of the therapeutic relationship is characterized by finding healthy ways to conclude a relationship?

Phase 4 - Termination phase

What are the phases of the therapeutic relationship?

Pre-interaction phase, orientation phase, working phase, termination phase

The nurse is teaching the client about his upcoming procedure and the client is very stressed. What would it be most important for the nurse to do?

Determine if the teaching should take place at a different time because clients who are stressed may be unable to listen fully and will not receive/understand the intended message.

Use of the statements "Tell me more about..." or "I see" encourage clients to continue talking and expressing themselves is called what?

Encouraging elaboration

What factors affect general communication situations?

Environment, age, gender, culture, sociocultural factors, personal space

What do therapeutic relationships in health care do?

Focus on improving the client's health, provide information about treatments, goal-oriented, client-centered, and uses therapeutic techniques.

A nurse must show a sincere interest in the client and consistently show this. What key characteristic of therapeutic communication is the nurse portraying?

Genuineness

What are the components of communication process?

Includes five parts - message, sender, receiver, channel and feedback. The active part of communication

What are the three levels of communication?

Intrapersonal - within self (positive or negative) Interpersonal - between two or more people Group - with many people at once

What are some client factors that affect the use of therapeutic communication?

Language barriers, impaired cognitive skills, sensory-perception issues.

What phase of the therapeutic relationship is characterized by gathering information before meeting the client?

Phase 1 - Pre-Interaction phase

What phase of the therapeutic relationship is characterized by meeting clients, making conversation, and establishing rapport?

Phase 2 - Orientation phase

What phase of the therapeutic relationship is characterized using techniques related to therapeutic communication and allowing the client to clarify any concerns?

Phase 3 - Working phase

If a client says that they are worried about a procedure and you as the nurse validate their concerns as being normal, what key characteristic of therapeutic communication is the nurse using?

Respect

What are the components of communication content?

Subject, words, gestures, substance of the message, open to interpretation.

What is assessment?

The systematic gathering of information related to the physical, mental, spiritual, socioeconomic, and cultural status of an individual.

What is the purpose of assessment?

To plan for nursing care, to ensure clients receive the proper care by qualified individuals at the time it is needed

Name some factors that affect verbal communication (not therapeutic)?

Vocabulary used, pacing of conversation, clarity, timing, credibility of speaker, humor, relevance of information being given.