Professional Nursing EAQ: Ch. 24A- Communication

Which nontherapeutic communicative statement indicates a defensive response? "No one here would intentionally lie to you." "This work is incomplete, and it's all your fault." "Things are bad, and there's nothing I can do about it." "How can you say you didn't sleep when I heard you snoring all night?"

"No one here would intentionally lie to you."

The nurse and a patient are talking about a baseball game. Both of them are using the word baseball to refer to the sport. Which best describes the use of the word baseball in this context? Denotative Connotative Intonation Metacommunication

1 A word that has the same meaning for all people who speak the same language is considered denotative. The dictionary meaning of the word baseball is denotative. A connotative meaning is influenced by the thoughts, feelings, or ideas of individuals. Intonation refers to the tone of voice. Metacommunication refers to all factors influencing communication.

While communicating with a patient, the nurse keeps arms and legs uncrossed. What message does this convey to the patient? The nurse is open to what the patient says. The nurse is feeling uncomfortable with the patient. The nurse is involved and interested in the interaction. The nurse is listening and interested in what the patient is saying.

1 Body language like keeping the arms and legs uncrossed indicates an open position, which suggests that the nurse is open to what the patient says. Feelings of discomfort may be indicated by fidgeting or restless behavior. Leaning toward the patient conveys that the nurse is involved and interested in the interaction. Likewise, the posture of sitting facing the patient conveys the message that the nurse is listening and interested in what the patient is saying.

The nurse notices tension on the face of a patient before going to the operating room. The patient says, "I don't mind going in for surgery." The nurse acknowledges the patient's nonverbal indications of stress and prompts the patient to elaborate on his or her feelings. Which type of communication is the nurse exhibiting? Metacommunication Nonverbal communication Intrapersonal communication Nontherapeutic communication

1 Metacommunication is a broad term that refers to all factors that influence communication. It involves being aware of influencing factors and helping people understand better what is communicated. Therefore, by acknowledging the patient's nonverbal signs of stress and understanding the situation better, the nurse employs metacommunication. Nonverbal communication involves the five senses and anything that does not involve the spoken or written word; the patient's facial expression is an example of nonverbal communication. Nurses use intrapersonal communication to develop self-awareness and a positive self-esteem that enhances appropriate self-expression. Nontherapeutic communication involves asking personal questions or giving personal opinions, which discourages further expression of patient's feelings and ideas.

The nurse is assessing four patients with different symptoms. Which patient is most likely to challenge the nurse's decision-making skills and call for careful use of therapeutic communication techniques? Patient 1 Patient 2 Patient 3 Patient 4

1 Patient 1's symptoms and behavior indicate depression. The nurse would likely face challenges in decision-making and need to be careful while using therapeutic techniques with this patient. A physically challenged patient would not necessarily present a challenge for the nurse while communicating. There is nothing to suggest that patient 3, who communicates only in English, would present difficulty communicating with the nurse. Likewise, there is no indication that patient 4, who notices the outfit, shoes, accessories, body language, and makeup of others, would present communication challenges for the nurse.

The nurse is caring for a patient with breast cancer and says, "You are a brave person and you will find a way to face this illness." Which type of therapeutic communication technique was involved in this interaction? Sharing hope Sharing feelings Sharing empathy Sharing observations

1 Sharing hope is the therapeutic technique that involves the nurse recognizing the patient's condition and giving encouragement and positive feedback while fostering self-confidence, which is essential for healing. Sharing feelings involves helping patients share emotions by encouraging openness and modeling healthy self-expression. Sharing empathy is the ability to understand and accept another person's reality, accurately perceive feelings, and communicate this understanding to the other individual. Sharing observations involves commenting on how the other person looks, sounds, or acts.

Which activity does the nurse carry out while maintaining a zone of personal space? Teaching or educating a patient Making rounds with a physician Performing a physical assessment Exchanging patient information at nurses' station

1 The nurse maintains varying distances while carrying out different activities. The zone of personal space is 18 inches to 4 feet. The nurse maintains a personal zone while teaching a patient and taking a patient's nursing history. The nurse maintains a social zone, or a distance of 4 to 12 feet, while making rounds with a physician. The nurse enters the intimate zone, a distance of 0 to 18 inches from the patient, when performing physical assessment or when exchanging patient information at the nurses' station in order to protect the patient's privacy in a public area.

The nurse is performing a routine health checkup for a patient and reports abnormal vital signs to the primary health care provider. Which phase of nurse-patient relationship is involved in this scenario? Working phase Orientation phase Termination phase Preorientation phase

1 The working phase of the nurse-patient relationship is exhibited when nursing interventions and assessment of current health status of the patient is done. In the orientation phase, the nurse gathers basic information about the patient. The termination phase is the final stage of the nurse-patient relationship, in which validating plans for the future may be a useful strategy. The preorientation phase occurs before meeting a patient; the review of available data, including the medical and nursing history, takes place in this phase.

The registered nurse (RN) is teaching a nursing student about interacting with a patient in the orientation phase. Which statements by the student nurse indicate the need for further learning? Select all that apply. "I should encourage and help the patient set goals." "I should begin to make inferences and judgments about patient messages." "I should achieve a smooth transition for the patient to other caregivers as needed." "I should set the tone for the relationship adopting a warm, empathetic, caring manner." "I should closely observe the patient and expect to be closely observed by the patient."

1, 3 The nurse should encourage and help the patient set goals in the working phase not the orientation phase. In the termination phase at the end of the relationship, the nurse should facilitate a smooth transition for the patient to other caregivers as needed. In the orientation phase, the nurse should begin to make interferences and judgments about patient messages and set the tone for the relationship by adopting a warm, empathetic, caring manner. The nurse should also closely observe the patient and expect to be closely observed by the patient.

The nurse understands that effective verbal communication is important in nursing practice. Which aspects of verbal communication improve effectiveness? Select all that apply. Pacing Posture Intonation Vocabulary Facial expression

1, 3, 4 Pacing is the appropriate rate at which speech is delivered and is important for effective verbal communication. Intonation is the use of tone that indicates the expression and the emotions of the speaker. Vocabulary is the use of words; the ability to understand words forms an important part of verbal communication. Posture is maintaining and moving the body and is part of nonverbal communication. Facial expression is the emotion conveyed by the movement of facial structures and is also part of nonverbal communication.

The nurse is caring for a 65-year-old patient who is visually impaired. Which communication strategies by the nurse would demonstrate a lack of competence? Select all that apply. Using direct light Checking for use of glasses Employing at least 9-point type Using nonverbal communication Articulating in a normal tone of voice

1, 3, 4 When the nurse is caring for a visually impaired patient, it is effective to use indirect lighting and to avoid glare. It is recommended to use at least 14-point type when providing reading material to a visually impaired patient. Do not rely on gestures or nonverbal communication while communicating with visually impaired patients. Make sure that the patient is using glasses or contact lenses. The nurse should communicate in a normal tone of voice.

The registered nurse (RN) is teaching a nursing student about the personal zones of space while communicating with patients. Which statements by the nursing student indicate effective learning? Select all that apply. "I should be in the personal zone while counseling the patient." "I should maintain a distance of 9 ft (274 cm) while taking patient history." "Speaking at a community forum generally involves the public zone." "I should ask for permission before assessing the patient's wrist or feet." "I should be in the socio-consultative zone while performing physical assessment."

1, 3, 4 While counseling a patient, the nurse should be in the personal zone of 18 in (46 cm) to 4 ft (122 cm). While speaking at a community forum, the public zone of 12 ft (366 cm) or more is generally maintained. The special zones of touch in which the nurse should ask for permission include the wrist or feet. While taking patient history, the nurse should be in the personal zone of 18 in (46 cm) to 4 ft (122 cm). While performing physical assessment, the nurse would enter the intimate zone of 0-8 in (0-20 cm).

A registered nurse (RN) is teaching a nursing student about the different ways of communicating with patients who are cognitively impaired. Which statements by the nursing student indicate effective learning? Select all that apply. "I will ask one question at a time." "I will ask the patient to listen attentively." "I will exclude family and friends during conversation." "I will use simple sentences and avoid long explanations." "I will use pictures or gestures that mimic the action desired."

1, 4, 5 Dementia is a condition in which the patient will be cognitively impaired and require special care while communicating. Only one question should be asked at a time to avoid confusion. Avoiding long explanations and using simple sentences will avoid confusion in the patient. Pictures and gestures will help facilitate patient understanding. The nurse should listen to the patient attentively rather than asking the patient to listen attentively. Family members and friends should be included in the conversation and especially when discussing subjects familiar to the patient.

The registered nurse (RN) is teaching the licensed practical nurse (LPN) about the elements of professional communication while interacting with patients. Which statements by the LPN indicate effective learning? Select all that apply. "I should introduce myself by giving my name and designation." "I should address the patient by their first names during initial interactions." "I should address a patient with a confused cognitive status by their last names." "I should avoid referring to patients by diagnosis, room number, or other attribute." "I should avoid terms such as honey, dear, or grandma while addressing the patients."

1, 4, 5 The nurse should introduce himself or herself by giving his or her name and status, such as nursing student, RN, or LPN. It is important that the nurse avoid referring to patients by diagnosis, room number, or other attribute, because this approach would be demeaning to the patient. The nurse should avoid terms of endearment such as "honey," "dear," "grandma," or "sweetheart" while addressing patients, even with close nurse-patient relationships. Using first names is appropriate for infants, young children, and patients who are confused or unconscious, as well as close team members. Addressing patients by the last name is respectful in most cultures; nurses usually use a patient's last name in an initial interaction and then use the first name if the patient requests it.

A registered nurse (RN) is teaching a nursing student about the different assessments required while communicating throughout the nursing process. Which statement by the nursing student indicates the need for further teaching? Select all that apply. "I will document the diagnostic procedure." "I will verbally interview and ask for history." "I will visually observe for nonverbal behavior." "I will gather data during physical examination." "I will verbally communicate with the health care team."

1, 5 Documenting the nursing diagnostic procedure is included under the nursing diagnosis phase of communicating throughout the nursing process. Verbally communicating or discussing with the health care team is included under the implementation phase. Verbally interviewing and asking for history is an effective form of communication. Visually observing the nonverbal behavior of others and gathering data during physical examination are also included in effective communication.

The registered nurse (RN) is teaching a nursing student about communicating with a patient who has a hearing impairment. Which statements made by the nursing student indicate the need for further learning? Select all that apply. "I should speak at an elevated volume." "I should reduce environmental noise." "I should face the patient with my mouth visible." "I should check the patient for hearing aids and glasses." "I should repeat rather than rephrase if there is any misunderstanding."

1, 5 When communicating with the patient who has hearing impairment, the nurse should communicate at normal volume rather than shouting. The nurse should rephrase rather than simply repeat statements if the patient misunderstands. While speaking to the patient, the nurse face the patient with his or her mouth visible to facilitate lip reading. The nurse should reduce the environmental noise so the patient can hear properly without any disturbance. The nurse should check for the patient's hearing aids and glasses before communicating.

The registered nurse (RN) is teaching a nursing student about assertive behavior when interacting with patients and coworkers. Which statement by the nursing student indicates effective learning? "It helps the nurse avert ethical dilemmas." "It helps to resist intentionally imposed guilt." "It helps the nurse move beyond superficial care." "It may result in an environment conducive to lateral violence."

2 Assertive behavior can help nurses deal with criticism and manipulation by others and learn to say no, set limits, and resist intentionally imposed guilt. Assertive behavior will not necessarily help nurses avoid ethical dilemmas; on the contrary, ethical dilemmas may arise that make assertiveness difficult to implement for fear of retaliation. Fostering trust through conveying warmth, honesty, consistency, and competence helps the nurse move beyond superficial care. Effective assertive behavior can help reduce the incidence of lateral violence in the workplace.

Which phase of the helping relationship is involved when the nurse and a patient meet and become acquainted? Working phase Orientation phase Termination phase Preinteraction phase

2 In the orientation phase, the nurse and a patient meet and become acquainted. In the working phase, the nurse and patient work together to solve problems and accomplish goals. In the termination phase, the nurse evaluates goal achievement with the patient and relinquishes responsibility for patient care. In the preinteraction phase, the nurse reviews available data, including medical and nursing history.

The nurse is asking relevant questions to seek specific information from a patient while making decisions. Which question would be most appropriate in this context? "Are you feeling better now?" "How has your pain affected your life at home?" "How many times a day do you take pain medication?" "Are you worried that you will not be able to return to your usual way of life?"

2 Open-ended and focused questions should be asked to a patient when more specific information is needed in an area. Asking open-ended questions will allow the patients to give pertinent information about a topic. "How has your pain affected your life at home?" is a open-ended and focused question. Therefore this is the most appropriate question in this situation. "Are you feeling better now?" is a closed-ended, yes-or-no question. Although they are helpful during assessment, they are generally less useful during therapeutic exchange. "How many times a day do you take pain medication?" is also a yes/no question. "Are you worried that you will not be able to return to your usual way of life?" is a validatory question. This is used to recognize and acknowledge a patient's thoughts, feelings, and needs.

The registered nurse (RN) is communicating with a patient in the surgical unit. Which statement by the RN indicates the technique of sharing hope? "You seem to be cheerful today." "You are a fighter and I know you can find a way to face this condition." "I understand that you may be frustrated that you are bedridden for a month." "You have to walk for five minutes, as directed by the primary health care provider."

2 Stating that the patient is a fighter and will find a way to face the condition is an example of the therapeutic communication technique of sharing hope. Stating that the patient seems cheerful indicates the therapeutic communication technique of sharing observations. Stating that the patient might be irritated by being bedridden for a month due to a leg fracture indicates the therapeutic communication technique of sharing empathy. Instructing the patient to walk for five minutes, as suggested by the primary health care provider, indicates the therapeutic communication technique of sharing observations.

A patient with posttraumatic stress disorder is admitted into a psychiatric unit. Which action performed by the nurse indicates the working phase of the helping relationship? Assessing the patient's health status Encouraging and helping the patient set goals Making inferences about patient messages and behaviors Anticipating the health concerns or issues that has aroused

2 The patient with posttraumatic stress disorder will have persistent mental and emotional stress and may not be able to set goals and make decisions properly. In this context, the nurse encourages and helps the patient set goals during the working phase of the helping relationship. Assessing the status of health in the patient occurs during the orientation phase. The orientation phase includes making inferences about patient messages and behaviors. The nurse anticipates health concerns or issues during the preinteraction phase.

The nurse is changing a patient's surgical dressing. Which zone of personal space is the nurse entering? Public zone Intimate zone Personal zone Socio-consultative zone

2 When changing a patient's surgical dressing, the nurse enters the intimate zone of personal space. Speaking at a community forum involves the public zone. When sitting at a patient's bedside and taking a patient's history, the nurse is in the personal zone. When giving a verbal report to a group of nurses, the nurse is in the socio-consultative zone.

The nurse is caring for a 55-year-old patient who is unresponsive. Which communication strategies would be appropriate? Select all that apply. Converse only verbally with the patient. Call the patient by name during interactions. Discuss the patient with others in his presence. Provide orientation to person, place, and time. Articulate to the patient, as though he or she can hear.

2, 4, 5 While the nurse is caring a patient who is unresponsive, the nurse should address the patient by name during communication. The nurse should also orient the patient to place and time. It is important to communicate to the patient in a voice that he or she can hear clearly. It is essential to communicate not only verbally, but also by touch. The nurse should avoid discussing the patient with others in his or her presence.

According to the circular transactional model, which element motivates one person to communicate with another? Channels Message Referent Environment

3 According to the circular transactional model, the referent motivates one person to communicate with another, initiating the communication process. Communication channels are means of sending and receiving messages through visual, auditory, and tactile senses. The message is the content of the communication. It contains verbal and nonverbal expressions of thoughts and feelings. The environment is the setting for sender-receiver interaction. Environmental distractions are common in health care settings and interfere with messages sent between people.

While the nurse explains the steps of a procedure to a patient, the patient frequently nods and says, "I see." Which element of the communication process is the patient displaying? Channel Referent Feedback Interpersonal variable

3 Feedback is the verbal and nonverbal messages that the receiver sends indicating whether or not he or she has understood the sender's message. In this case, the feedback indicates whether the patient has understood the meaning of the nurse's message. Channels of communication are means of sending and receiving messages through different aids, such as visual, auditory, and tactile senses. The referent process helps motivate one person to communicate with the other. Interpersonal variables such as educational, developmental, and socio-cultural background, and values and beliefs are characteristics of both the sender and receiver that influence communication.

The nurse provides a semi-solid diet to a patient, but the patient wants to have a solid diet. The nurse convinces the patient that having a solid diet would delay recovery and the patient ultimately agrees to the semi-solid diet. Which attitude does the nurse exhibit that promotes effective communication? Humility Curiosity Integrity Creativity

3 Integrity involves recognizing patients' opinions when they conflict with the nurse's opinions, reviewing positions, and finally determining how to communicate to reach mutually beneficial decisions. Humility involves the nurse asking for help if he or she is uncomfortable with an aspect of patient care. Curiosity involves the nurse being motivated to communicate and know more about a person. Creativity involves identifying innovative solutions.

The nurse is performing a mental rehearsal on how to deal effectively in difficult situations with increased confidence. Which level of communication is exhibited by the nurse? Public communication Small-group communication Intrapersonal communication Interpersonal communication

3 Intrapersonal communication involves developing self-awareness and self-esteem that enhances appropriate self-expression. This level of communication is also called self-talk and may involve a mental rehearsal to deal effectively with difficult tasks or situations with increased confidence. Public communication is interaction with an audience, which may include speaking to groups of consumers about health-related topics. Small-group communication is the interaction that occurs when a small number of people meet and discuss. Interpersonal communication is one-on-one interaction between a nurse and another person that often occurs face to face.

A patient is admitted to the hospital with congestive heart failure. The nurse immediately notifies the primary health care provider using the SBAR (Situation, Background, Assessment, and Recommendation) technique. Which statement by the nurse demonstrates "background"? "The blood pressure of the patient is 150/90 mm Hg." "The patient has severe perspiration and chest pain." "The patient has a history of congestive heart failure." "The nurse requests an order from the primary health care provider to treat the patient."

3 SBAR is an acronym for Situation, Background, Assessment, and Recommendation, which is used as a communication technique. The patient nurse informs the primary health care provider about the patient's history of congestive heart failure when communicating the patient's background information. Blood pressure findings are included when communicating assessment information. The complaint of perspiration and chest pain is included when communicating the patient's situation. Requesting an order from PHCP to treat the patient represents a recommendation.

While interacting with a patient, the nurse sits and faces the patient and listens attentively. What does this posture toward the patient convey? The nurse is involved in the interaction. The nurse is comfortable with the patient. The nurse is interested in what the patient is saying. The nurse is willing to listen to what the patient is saying.

3 Sitting and facing the patient and listening attentively conveys that the nurse is interested in what the patient is saying. When the nurse is leaning toward the patient and listening to the conversation, it conveys that the nurse is involved in the interaction. When the nurse is relaxed, it conveys that the nurse is comfortable with patient. When the nurse maintains eye contact with the patient, it conveys that the nurse is willing to listen to what the patient is saying.

While interacting with a woman who underwent a mastectomy, the nurse says, "I'm worried that you might feel devastated after your surgery." Which nontherapeutic communication technique does the nurse exhibit? Sharing humor Sharing feelings Showing sympathy Giving personal opinions

3 Sympathy is the nontherapeutic communication technique exhibited by the nurse in this scenario. Sympathy is concern, sorrow, or pity felt for another person. Sharing humor is a therapeutic communication technique. Humor is an important, but often underused, resource in nursing interactions. Sharing feelings is a therapeutic communication technique. Sharing feelings can be a therapeutic communication technique; feelings are not right, wrong, good, or bad, although they may be pleasant or unpleasant. Giving personal opinions is a nontherapeutic communication technique in which the nurse injects his or her own views regarding care options; this may serve to take decision-making power away from patients.

Which situational context factors influence communication? Select all that apply. Privacy levels Emotional status Expression of feelings Information exchange Balance of power and control

3, 4 Expression of feelings and information exchange are the situational context factors that influence communication. Privacy level is an environmental context factor that influences communication. Emotional status is a psychophysiological context factor that influences communication. Balance of power and control is a relational context factor that influences the communication.

Which factors influence the relational context of communication? Select all that apply. Expression of feelings Customs and expectations Balance of power and control Shared history of participants Growth and development status

3, 4 Factors of communication that influence the nature of the relationship among participants include the shared history of participants, balance of power, and control. Expression of feelings is a factor related to situational context. Customs and expectations are sociocultural elements that affect an interaction. Growth and development status is the internal factor of communication related to psycho-physiological context.

The registered nurse (RN) is teaching a nursing student about nonverbal skills that facilitate attentive listening while interacting with the patient. Which statement by the nursing student indicates the need for further teaching? Select all that apply. "I should sit facing the patient." "I should maintain eye contact." "I should lean away from the patient." "I should be relaxed and comfortable." "I should keep my arms and legs crossed."

3, 5 Nonverbal skills enhance trust and helps the nurse communicate acceptance and respect for a patient. It is important to lean toward the patient and not away from the patient, because this position conveys that the nurse is involved and interested. The nurse should sit in an open position by keeping her or his arms and legs uncrossed, because this position suggests that the nurse is "open" to what the patient says. A "closed" position, such as crossing arms, conveys a defensive attitude. It is essential to sit facing the patient, because this posture conveys the message that the nurse is there to listen to what the patient is saying. The nurse should maintain intermittent eye contact to convey involvement in and willingness to listen to what the patient is saying. It is important to communicate with a sense of being relaxed and comfortable with the patient.

What does the term referent mean in the communication process? A primary healthcare provider who refers a patient A patient who is being referred A service to which the patient is being referred An event that motivates a person to communicate with another

4 A referent is any factor that motivates a person to communicate with others. This can include sights, sounds, odors, emotions, or perceptions that can be the basis for a person to talk with another. The term does not refer to the primaryhealth care provider, the patient, or the service being provided.

The nurse is observing the nonverbal cues of a patient who has a quick and purposeful gait. What does the patient's gait indicate? The patient is attentive. The patient is nervous. The patient is depressed. The patient is confident.

4 Posture and gait convey important clues about a patient's health. A quick and purposeful gait indicates well-being and confidence. A patient who is attentive may lean forward. A nervous or depressed patient usually has a slumped posture and slow, shuffling gait.

The nurse is interviewing a patient with cognitive impairment. Which strategy should the nurse avoid while communicating with this patient? Give sufficient time for the patient to answer questions Use pictures or gestures that resemble the desired action Involve a family member in conversation while providing counseling Use detailed explanations while asking questions to help the patient understand.

4 The nurse should use simple sentences and avoid long explanations while communicating with patients who are cognitively impaired. Giving sufficient time to the patient to answer a question is an appropriate strategy in communicating with patients who are cognitively impaired. Using pictures or gestures that resemble the desired action and involving a family member in conversation while providing counseling are also the effective strategies for communicating.

The nurse is instructing a patient's visitors to avoid talking loudly inside the hospital. Which zone of personal space is involved in this interaction? Public zone Intimate zone Personal zone Socio-consultative zone

4 The socio-consultative zone may involve giving directions to visitors in the hallway. The public zone may involve speaking at community forum. The intimate zone may involve changing a patient's surgical dressing. Taking a patient's nursing history involves the use of the personal zone.

The nurse is caring for a patient with diabetes. Which nursing action is involved in the termination phase of the nurse-patient relationship? Advise the patient to change his or her lifestyle Assess the patient for blood sugar level and for any foot ulcers Encourage the patient to maintain a checklist of food habits and blood sugar level Evaluate whether the patient has achieved the goal of maintaining normal blood sugar levels

4 The termination phase is the final stage in the nurse-patient relationship. During this phase, the nurse reminds the patient that termination is near and also evaluates goal achievement. Advising the patient to change his or her lifestyle is involved in the working phase. Asking the patient about blood sugar levels and any foot ulcers is an aspect of checking the health status of the patient, which occurs during the orientation phase. Encouraging the patient to maintain a checklist of food habits and blood sugar levels would occur in the working phase.

The pediatric nurse finds that one of the mothers in the unit is not able to console her infant who is crying, so the nurse holds the infant. Which zone of personal space does this gesture belong to? Social Public Personal Intimate

4 There are four zones of personal space, based on how close the nurse is to the patient. These include intimate (0 to 18 inches), personal (18 inches to 4 feet), social (4 to 12 feet), and public (12 feet and greater). Holding a crying infant or bathing, dressing, and grooming a patient come under the intimate zone category. The social zone includes activities such as making rounds with the primary healthcare provider. Speaking at a community forum comes under the public zone. The personal zone includes activities such as sitting at a bedside and taking a history.

The registered nurse (RN) is teaching a nursing student about the development of trust while caring for patients. Which statement by the nursing student indicates the need for further learning? Select all that apply. "I should treat the patient with respect." "I should answer the patient honestly." "I should display consistent behavior when responding to patients." "I should withhold key information that may make the patient depressed." "I should leave immediately after providing care to allow the patient to rest."

4, 5 Trust is a firm belief in the reliability, truth, or ability of someone without doubt or question. Withholding key information may violate the legal and ethical standards of practice and result in a breach of trust. Leaving the patient immediately after providing care may be perceived as avoiding spending time with the patient and may thereby hinder the development of trust. Treating the patient with respect fosters trust, as does answering the patient with honesty and responding to patients with consistent behavior.

The nurse is caring for a Spanish-speaking patient with a hand fracture. Which approaches are likely to be ineffective when communicating with the patient? Select all that apply. Assessing the patient's level of fluency in English Incorporating the patient's communication methods Providing written information in English and the primary language Designating a family member of the patient as an interpreter Perceiving patient nodding or statements such as "OK" as indications of effective understanding

4, 5 While caring for a non-English speaking patient, a professional interpreter should be provided; a family member should not be used as an interpreter. Nodding or making statements such as "OK" are not necessarily indications of understanding. It is necessary to assess the patient's primary language and level of fluency in English. Incorporating the patient's communication methods or need into plan of care is an important action. Providing written information in English and in the primary language of the patient is an essential action while communicating with a non-English speaking patient.

Which distance of personal space is involved when giving a verbal report to a group of nurses? 2 ft (61 cm) 3 ft (92 cm) 9 ft (274 cm) 13 ft (396 cm)

9 ft (274 cm) While giving verbal report to a group of nurses, a socio-consultative zone of 9 to 12 feet (274 to 366 cm) is appropriate. While taking a patient's nursing history or teaching an individual patient, a personal zone of 18 inches (46 cm) to 4 feet (122 cm) is followed. While speaking at a community forum, a public zone of 12 feet (366 cm) or more is typical.

What does metacommunication include? Nonverbal communication skills All factors influencing communication Communication skills used for individuals who are hearing impaired Communication skills used for children

All factors influencing communication Metacommunication includes all factors influencing communication, such as the tone of a verbal response and associated nonverbal behavior. An understanding of these factors helps the nurse to explore more details of a patient's history. Metacommunication does not refer to the communication skill used for individuals who are hearing impaired or for children.

Which special zone of touch requires the nurse to get permission to touch patient`s wrist? Social zone Consent zone Intimate zone Vulnerable zone

Consent zone In the consent zone, the nurse needs permission to touch patient`s mouth, wrists, and feet. In the social zone, the nurse does not need permission to touch the patient's hands, arms, or shoulders. In the intimate zone, great sensitivity is needed in the areas of genitalia and rectum. In the vulnerable zone, the nurse takes special care to handle the patient`s face, neck, and front of body.

Which special zone of touch is involved during teeth replacement? Social zone Consent zone Intimate zone Vulnerable zone

Consent zone The consent zone of touch is a special zone that is involved during tasks such as replacing teeth. This zone requires permission for touching. The social zone is a special zone that does not require permission for touching; it includes the arms, hands, shoulders, and back of patients. The intimate zone is a special zone that requires great sensitivity. The vulnerable zone is a special zone that needs special care.

Which critical thinking attitude motivates the nurse to communicate and know more about a patient? Curiosity Creativity Perseverance Self-confidence

Curiosity Curiosity motivates the nurse to communicate and know more about a patient. Creativity and perseverance are attitudes conducive to communication, because they motivate the nurse to identify innovative solutions. Self-confidence is important, because the nurse who conveys confidence and comfort while communicating can more readily establish an interpersonal caring relationship.

he nurse modifies and updates a patient's care plan. Which phase of the nursing process does this situation indicate? Planning Evaluation Assessment Implementation

Evaluation Evaluation involves modifying and updating a patient's care plan. Planning involves writing a document for an expected outcome. Assessment involves verbal interviewing and patient history taking. Implementation involves delegation and verbal discussion within the health care team. p. 319

Which nontherapeutic communication technique is the nurse using when saying, "Don't worry; everything will be all right" to a patient? Sympathy False reassurance Giving personal opinions Asking personal questions

False reassurance When a patient is seriously ill or distressed, the nurse may offer hope statements such as, "Don't worry, everything will be all right." This is known as false reassurance. Sympathy is concern, sorrow, or pity felt for another person. This is indicated by stating, "I'm so sorry about your condition." Giving personal opinions may be indicated by stating, "I think you should consider terminating treatment." "How would you describe your relationship with the doctor?" is an example of asking a personal question.

Which form of communication is appropriate to assess understanding and clarify misinterpretations when the nurse is teaching a patient about a health concern? Public communication Small-group communication Intrapersonal communication Interpersonal communication

Interpersonal communication Interpersonal communication is one-on-one interaction between a nurse and another person that often occurs face-to-face. This interaction is useful to assess understanding and clarify misinterpretations when teaching a patient about a health concern. Public communication is interaction with an audience. Nurses often speak with groups of consumers about health-related topics. Small group communication occurs when a small number of people meet. This type of communication is usually goal directed and requires an understanding of group dynamics. Intrapersonal communication is a powerful form of communication that you use as a professional nurse. This level of communication is also called self-talk.

The registered nurse (RN) is interviewing patients who are breast cancer survivors and asking them to share their views on how they went through treatment and how their family members supported them. Which type of communication is suitable in this situation? Orientation Termination Preinteraction Narrative interaction

Narrative interaction In a therapeutic relationship, it is helpful to encourage patients to share personal stories, a process called narrative interaction. Through listening to the patients' stories, the nurse understands the context of patient's lives, their concerns, experiences, and challenges. During the orientation phase of the helping relationship, the nurse and patient meet and get to know one another. In the termination phase of the helping relationship, the nurse reminds the patient that termination is near and evaluates goal achievement with the patient. In the preinteraction phase of the helping relationship, the nurse talks with other caregivers who have information about the patient.

The nurse is caring for different patients with disabilities. Which patient would benefit from the use of a picture that mimics the desired action? Patient A Patient B Patient C Patient D

Patient D The nurse should use pictures to communicate with Patient D, who is cognitively impaired. Patient A has hearing impairment, so the nurse should speak facing the patient with the mouth visible and arrange for a sign language interpreter if indicated. Patient B has a visual impairment, so the nurse should avoid relying on gestures or nonverbal communication. Patient C has a speaking disability, so the nurse should use visual cues to communicate.

The nurse is reviewing the available data, including the medical and nursing history, of a patient. Which phase of the helping relationship is the nurse performing? Working phase Orientation phase Termination phase Preinteraction phase

Preinteraction phase The phase before meeting a patient is the preinteraction phase. Reviewing available data, such as the medical and nursing history, is included in the preinteraction phase. Working phase is when the nurse and patient work together to solve problems and accomplish goals. The nurse and patient meet and get to know one another during the orientation phase. The termination phase occurs at the end of the relationship with the patient.

The registered nurse (RN) is teaching a group of nursing students about the care of patients in the intensive care unit (ICU). Which level of communication is applicable in this situation? Public communication Electronic communication Small-group communication Interpersonal communication

Public communication Public communication is interaction with an audience. This level of communication may involve the RN speaking to a group of nursing students about patient care. Electronic communication is the use of technology to create ongoing relationships with patients and their health care teams. Small-group communication occurs when a small number of people meet. Interpersonal communication is one-on-one interaction between a nurse and another person that often occurs face to face.

While interacting with a patient, the nurse comments on positive aspects of the patient's behavior and response. Which therapeutic communication technique does the nurse exhibit? Sharing hope Sharing feelings Sharing empathy Sharing observations

Sharing hope Commenting on the positive aspects of a patient's behavior and response develops hope in the patient. Sharing feelings involves helping patients share emotions by encouraging openness and modeling healthy self-expression. Sharing empathy is the ability to understand the patient's reality, perceive feelings accurately, and communicate this understanding to the patient. Sharing observations involves commenting on observations such as the looks, sounds, or actions of the patient.

While taking the history of a patient, the nurse states, "I see you haven't eaten anything." Which therapeutic communication technique is the nurse exhibiting through this statement? Sharing hope Sharing humor Sharing empathy Sharing observations

Sharing observations Sharing observations involves the nurse making observations on how the other person looks, sounds, or acts. For example, the nurse may comment on the fact that the patient hasn't eaten. Sharing hope may be exhibited by reassuring patients that there are many kinds of hope. Sharing humor is exhibited when the nurse provides emotional support to patients and professional colleagues and humanizes the illness experience. Sharing empathy involves making statements are neutral and nonjudgmental to help foster trust in difficult situations.

The nurse manager calls a meeting of members of the nursing team to resolve problems surrounding patient complaints of slow and sometimes discourteous responses to requests. What role does problem resolution play in this communication? Relational context Situational context Environmental context Psychophysiological context

Situational context Situational context involves the reason for communication, which is problem resolution in this instance. Relational context indicates the nature of the relationship among participants, such as a social, helping, or working relationship. Environmental context involves the physical surroundings in which communication occurs. The psychophysiological context involves internal factors affecting communication, such as physiological status and emotional status.

The nurse manager is providing a verbal report to a group of team members. Which zone of personal space is indicated in the nurse's action? Public zone Intimate zone Personal zone Socio-consultative zone

Socio-consultative zone Communication in the socio-consultative zone may involve giving directions to visitors in the hallway or giving a verbal report to a group of nurses. In the public zone, the nurse speaks at a community forum and delivers a lecture to a class of students. In the intimate zone, the nurse performs physical assessment and changes a patient's surgical dressing. In the personal zone, the nurse sits at the patient's bedside.

Which is a nontherapeutic communication technique? Sympathy Focusing Clarifying Summarizing

Sympathy Nurses may take patient feelings on as their own, which may hinder the nurse's ability to be objective and help the patient process their feelings. Focusing is a therapeutic communication technique that involves centering a conversation on key elements or concepts of a message. Clarifying is therapeutic communication technique to check whether you understand a message accurately by restating an unclear or ambiguous message to clarify the sender's meaning. Summarizing is a therapeutic communication technique that involves a succinct review of key aspects of an interaction.

The nurse is recalling a funny shared experience with a patient shortly before the patient is discharged from the hospital. Which phase of the helping relationship does this action indicate? Working phase Orientation phase Termination phase Preinteraction phase

Termination phase When the nurse ends the relationship with a patient, it indicates the termination phase of the helping relationship. This phase may involve the nurse and the patient reminiscing about their relationship. The working phase involves taking actions to meet the goals set for the patient. The nurse sets the tone for the relationship by adopting a warm, empathetic, caring manner during the orientation phase. The preinteraction phase involves the nurse's initial interaction with the patient.

In the communication process, who is the receiver of the message? The person who encodes a message The person who decodes a message The person who delivers a message The person who seeks feedback

The person who decodes a message Communication is an active process between a sender and a receiver. The receiver is the person who receives and decodes a message. The receiver also provides feedback to the sender. The sender is the person who encodes and delivers a message. The sender also seeks both verbal and nonverbal feedback.

Which special zone of touch requires special care? Social zone Consent zone Intimate zone Vulnerable zone

Vulnerable zone Vulnerable zones of the body like the face, neck, and front of the body require special care. Social zones like hands, arms, shoulders, and back do not need any permission for touching. The consent zone includes the mouth, wrists, and feet and needs permission for touching. Great sensitivity is needed while touching the intimate zone like the genitalia and rectum. p. 323