Communication 138
1. It is important for the nurse to take the opportunity to provide communication opportunities while providing routine patient care.
A new nurse complains to her preceptor that she has no time for therapeutic communication with her patients. Which of the following is the best strategy to help the nurse find more time for this communication? 1. Include communication while performing tasks such as changing dressings and checking vital signs. 2. Ask the patient if you can talk during the last few minutes of visiting hours. 3. Ask Pastoral care to come back a little later in the day. 4. Remind the nurse to complete all her tasks and then set up remaining time for communication.
Answer: 3. Talking with a preceptor, manager, or mentor, notifies others of the problem, provides support for the nurse, and helps the nurse learn skills in addressing lateral violence.
A new nurse is experiencing lateral violence at work. Which steps could the nurse take to address this problem? 1. Challenge the nurses in a public forum to embarrass them and change their behavior 2. Talk with the department secretary and ask if this has been a problem for other nurses 3. Talk with the preceptor or manager and ask for assistance in handling this issue 4. Say nothing and hope things get better
1. The nurse assists the patient in the identification of goals and expression of feelings during the working phase of the helping relationship.
A nurse has been gathering physical assessment data on a patient and is now listening to the patient's concerns. The nurse sets a goal of care that incorporates the patient's desire to make treatment decisions. This is an example of the nurse engaged in which phase of the nurse-patient relationship? 1. Working phase 2. Preinteraction phase 3. Termination phase 4. Orientation phase
4. Humility is admitting to limitations in knowledge and skill. This enables the nurse to admit a knowledge deficit, so that guidance is sought from the patient. Humility helps improve the therapeutic relationship, and enables a nurse to provide safe and effective care
A nurse is assigned to care for a patient for the first time and states, "I don't know a lot about your culture and want to learn how to better meet your health care needs." Which therapeutic communication technique did the nurse use in this situation? 1. Validation 2. Empathy 3. Sarcasm 4. Humility
Normally patient education occurs in a personal zone (18 inches to 4 feet) and not in the intimate zone where direct touch has occurred. The nurse must be respectful of this patient. Touch is something that might make the patient uncomfortable. The nurse needs to learn to be sensitive to others' reactions to touch and use it wisely. It should be as gentle or as firm as needed and delivered in a comforting, nonthreatening manner The nurse should confirm that touching the patient is acceptable.
A nurse is explaining to a patient how to follow infection control practices at home. During the discussion the nurse touches the patient on the shoulder. Explain which zone of touch the nurse should be practicing and what problems the action might cause.
2. In this example, the nurse's question is a way to obtain feedback. Feedback is the message a receiver receives from the sender. It indicates whether the receiver, in this case the patient, understood the meaning of the sender's message.
A nurse is talking with a young-adult patient about the purpose of a new medication. The nurse says, "I want to be clear. Can you tell me in your words the purpose of this medicine?" This exchange is an example of which element of the transactional communication process? 1. Message 2. Obtaining feedback 3. Channel 4. Referent
4S, 1B, 2A, 3R. The nurse describes the patient's complaint of nausea and vomiting to the physician (Situation). Specific patient demographic information and reason for admission with current symptomology is provided (Background). The physician is informed of the patient's complaint of nausea after receiving levaquin (Assessment). Physician is asked if they would like to make a change in the antibiotic or provide a nutritional supplement prior to medication administration (Recommendation).
A nurse prepares to contact a patient's physician about a change in the patient's condition. Put the following statements in the correct order using SBAR (Situation, Background, Assessment, and Recommendation) communication. 1. "She is a 53-year-old female who was admitted 2 days ago with pneumonia and was started on Levaquin at 5 PM yesterday. She complains of a poor appetite." 2. "The patient reported feeling very nauseated after her dose of Levaquin an hour ago." 3. "Would you like to make a change in antibiotics, or could we give her a nutritional supplement before her medication?" 4. "The patient started complaining of nausea yesterday evening and has vomited several times during the night."
4. By reviewing a conversation with a patient and determining whether the student encouraged openness and allowed the patient to "tell his story," expressing both thoughts and feelings - involves evaluation.
A nursing student is reviewing a process recording with the instructor. The student engaged the patient in a discussion about availability of family members to provide support at home once the patient is discharged. The student reviews with the instructor whether the comments used encouraged openness and allowed the patient to "tell his story." This is an example of which step of the nursing process? 1. Planning 2. Assessment 3. Intervention 4. Evaluation
3. Focusing gives direction which enables the nurse to obtain more clear information without probing. Asking why questions can convey judgment on the part of the nurse. Giving false reassurance is not a therapeutic communication technique.
A patient is evaluated in the emergency department after causing an automobile accident while being under the influence of alcohol. While assessing the patient, which statement would be the most therapeutic? 1. "Why did you drive after you had been drinking?" 2. "We have multiple patients to see tonight as a result of this accident." 3. "Tell me what happened before, during, and after the automobile accident tonight." 4. "It will be okay. No one was seriously hurt in the accident."
3. Professional certified interpreters can assist with simple or complex healthcare communications such as teaching instructions, test results, or education related to surgical consent. Other healthcare workers who are not certified interpreters cannot be relied on to provide clear and effective communication of healthcare information or teaching.
A patient who is Spanish-speaking does not appear to understand the nurse's information on wound care. Which action should the nurse take? 1. Arrange for a Spanish-speaking social worker to explain the procedure 2. Ask a fellow Spanish-speaking patient to help explain the procedure 3. Use a professional interpreter to provide wound care education in Spanish 4. Ask the patient to write down questions that he or she has for the nurse
1. 3. 5. Motivational interviewing is a technique used to promote an understanding of patients' motivation, health goals, and current behaviors in a non-judgmental environment while focusing on the patient's strengths and efforts. The nurse provides a supportive approach to assist the patient in establishing and promoting positive healthcare changes.
Motivational interviewing (MI) is a technique that applies understanding a patient's values and goals in helping the patient make behavior changes. What are other benefits of using MI techniques? (Select all that apply.) 1. Gaining an understanding of patient's motivations 2. Focusing on opportunities to avoid poor health choices 3. Recognizing patient's strengths and supporting their efforts 4. Providing assessment data that can be shared with families to promote change 5. Identifying differences in patient's health goals and current behaviors
it down in a chair facing Mr. Simpson to convey a willingness to listen. Use active listening techniques to explore what is upsetting him. This could include sharing observations, "You look angry," or a general opening statement such as "Tell me what happened." Avoid defending the dietitian. Sometimes it seems like you need to come to the defense of co-workers, but it is important to allow the patient to verbalize his or her feelings in a nonjudgmental environment.
Mr. Simpson is a 78-year-old patient whose wife died last year. He has been living alone. He has limited cooking skills; thus he eats out a lot. Since his wife died, his blood sugar has been poorly controlled. To help Mr. Simpson gain better blood sugar control, the dietitian came to see him. After she left, Mr. Simpson was angry and stated his desire to leave the hospital right now. He stated, "That diet person came to see me, and she doesn't know anything." 1. How would you approach Mr. Simpson? Which communication techniques would you use and which would you avoid?
Sharing feelings helps the patient clarify and express his concerns and fears. A statement such as "I understand the dietitian gave you some recipes. This may seem a little overwhelming," can open up communication.
Mr. Simpson is a 78-year-old patient whose wife died last year. He has been living alone. He has limited cooking skills; thus he eats out a lot. Since his wife died, his blood sugar has been poorly controlled. To help Mr. Simpson gain better blood sugar control, the dietitian came to see him. After she left, Mr. Simpson was angry and stated his desire to leave the hospital right now. He stated, "That diet person came to see me, and she doesn't know anything." 2. You talk with the dietitian and learn that she gave the patient information about his diet and recipes that he could try. As you talk further with Mr. Simpson, you learn that the physician told him he might not be able to live alone anymore. You realize that he doesn't know how to cook. Knowing this, how would you respond to him?
S: Mr. Simpson would like help to return home rather than go to a rehabilitation center. B: He managed his diabetes well when his wife was alive, but she did all the cooking. Now he eats out all the time, and he has consistently elevated blood sugar. A: He is very motivated to take better care of himself but does not know how to plan and prepare his meals. He would like some help with meals. R: I think he needs a social service referral before going home to identify support services.
Mr. Simpson is a 78-year-old patient whose wife died last year. He has been living alone. He has limited cooking skills; thus he eats out a lot. Since his wife died, his blood sugar has been poorly controlled. To help Mr. Simpson gain better blood sugar control, the dietitian came to see him. After she left, Mr. Simpson was angry and stated his desire to leave the hospital right now. He stated, "That diet person came to see me, and she doesn't know anything." 3. After talking with Mr. Simpson, you determine that he is able to care for himself at home but will need some assistance. He is willing to consider various options for meal preparation. You call the physician to discuss this. Your hospital has established SBAR (Situation-Background-Assessment-Recommendation) as a standard communication tool. How do you effectively communicate your concerns and the patient's need to the physician using SBAR?
2. 3. Silence can provide that patient an opportunity to think and gain insight. Often the patient feels compelled to break the silence and is prompted to talk.
The nurse uses silence as a therapeutic communication technique. What is the purpose of the nurse's silence? (Select all that apply.) 1. Prevent the nurse from saying the wrong thing 2. Prompt the patient to talk when he or she is ready 3. Allow the patient time to think and gain insight 4. Allow time for the patient to drift off to sleep 5. Determine if the patient would prefer to talk with another staff member
1. 3. 4. Communication techniques such as assessing the need for adaptive equipment, keeping communication short and direct, and giving the patient time to respond, assist the nurse in providing clear effective communication. Patients may have difficulty with rapid or lengthy explanations. Exaggerated lip reading may be difficult or demeaning to individuals with hearing deficits.
When working with an older adult who is hearing-impaired, the use of which techniques would improve communication? (Select all that apply.) 1. Check for needed adaptive equipment. 2. Exaggerate lip movements to help the patient lip read. 3. Give the patient time to respond to questions. 4. Keep communication short and to the point. 5. Communicate only through written information.
1. 3. Providing a standardized process, policy and tool can assist in a predictable, safe transfer of important patient information between healthcare facilities. Communication and collaboration between the sender and receiver of information enables the staff to validate the information was received and understood. Requiring a patient visit is not always necessary and relying on family member to share information does note release staff from their responsibilities.
Which strategies should a nurse use to facilitate a safe transition of care during a patient's transfer from the hospital to a skilled nursing facility? (Select all that apply.) 1. Collaboration between staff members from sending and receiving departments 2. Requiring that the patient visit the facility before a transfer is arranged 3. Using a standardized transfer policy and transfer tool 4. Arranging all patient transfers during the same time each day 5. Relying on family members to share information with the new facility
