Taylor: 20 Communication

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

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

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

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

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

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

A nurse and an older adult patient with chronic back pain are beginning to communicate. What activity should the nurse focus on at this point?

The nurse will be sensitive to the patient's emotional barriers.

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

an audiologist

The nurse is caring for a client. When does the nurse determine that nursing care will be most effective related to nurse-client communication?

common understanding

A unit-based infection control task force was developed in an attempt to reduce catheter-acquired infections. The group consists of 10 team members. During the past three meetings, one person dominated the meeting and did not allow other members ample time to speak. The best way to address the team dysfunction is to:

have group members confront the dominant member to promote the needed team work.

A nurse is assessing vital signs on a pregnant client during a routine prenatal visit. The client states, "I know labor will be so painful, it sounds awful. I am sure I will not be able to stand the pain; I really dread going into labor." What is the best response from the nurse?

youre worried about how you will tolerate the pain associated with labor

A nurse is caring for a client experiencing biliary colic from uncomplicated cholelithiasis. The client asks, "My doctor says I should have surgery to remove my gallbladder. Do you think it is really necessary?" What is the nurse's best response?

"Share with me the advantages and disadvantages of your options as you see them."

A nurse anticipates collaborating with the nurse aide, physical therapist, surgeon, and respiratory therapist in which circumstance?

caring for a client following a total hip replacement

The nurse caring for a client with a recent head injury asks the client to raise his left arm as high as possible. The client repeatedly raises his right arm. What does this indicate?

difficulty with decoding messages

A nurse is caring for a client who presents with a skin infection. While obtaining the client's medical history, it is determined that the client is an intravenous drug abuser. To foster effective communication, the nurse should:

remain honest, open, and frank.

A nurse is preparing to enter a client's room to perform wound care. The shift report revealed that this client has a tunneling wound in the sacral area that cannot be staged. The wound was also documented as having a foul odor. The nurse is nervous because she has not performed wound care on a complex wound in the past. Using effective intrapersonal communication, this nurse should:

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

A nurse is planning care for an adult client with severe hearing impairment that uses sign language and lip reading for communication that has a new diagnosis of cancer. Which nursing action is most appropriate when establishing the plan of care?

Arrange for a sign language interpreter when discussing treatment.

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

Speak directly to the client.

A nurse is attempting to complete an admission database. While taking the history, the nurse notices the client appears uncomfortable and slightly tachypneic. The nurse should:

allow the client to set the pace.

An older adult client who has had a colostomy for over 10 years states, "I won't need any teaching about colostomies. I understand how to change the bag and care for my colostomy, but I'm not sure how to best clean my stoma." What does this statement indicate?

an incongruent relationship

A client arrives at a crisis center in a state of bipolar mania. The client has a flight of ideas and it is difficult for the nurse to obtain an adequate intake assessment. Which statement or question will elicit the most specific information?

are you allergic to any medications?

An evening shift nurse is caring for a client scheduled for a colon resection in the morning. The client tells the nurse she is afraid of waking up during surgery. The best response by the nurse is to:

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

A female nurse states the following to another nurse who is constantly forgetting to wash her hands between patients: "It looks like you keep forgetting to wash your hands between patients. It's really not safe for your patients. Let's think of some type of reminder we can use to help you remember." This communication is an example of what type of speech?

assertive

A nurse touches the client's hand while discussing his diagnosis. This action is a(an):

communication channel

When documenting client care, the nurse understands that the most important reason for correct and accurate documentation is:

conveying information.

A nurse is caring for a client admitted to the hospital for dehydration. The physical findings consistent with the diagnosis include:

easy wrinkling of the skin and sunken eyes.

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

facial expression

A nurse who is preparing to administer an injection to the client states, "This injection will not be painful." The nurse has used which communication technique?

giving false reassurance

The mother of a toddler is deciding if she wants to allow her child to receive the recommended immunizations. The clinic nurse responds, "If you don't immunize your child you are jeopardizing the health of other children." What type of approach does this response indicate?

guilt inducement or approval/disapproval

It is important for the nurse to empathize with the client to develop a positive, therapeutic relationship. What is a characteristic of empathy?

identifying with the client's feelings

A nurse who has been caring for a client for the past few days is preparing the client for discharge and termination of the nurse-client relationship. Which activity would the nurse be carrying out?

reviewing health changes

A nurse is caring for a client who suffered a spinal cord injury and has paraplegia. The client is frustrated, crying, and tells the nurse, "I just want to die." The nurse best displays empathy when she:

says, "I can only imagine how hard this is on you. How can I help you?"

The nurse has arranged to start an IV line for a client with pancreatitis. The nurse notes that the client appears anxious about the procedure. What is the most appropriate response by the nurse to decrease the client's anxiety?

"I will start an IV that will add fluids directly to the blood stream."

The nurse is communicating with a client following a routine physical examination. Which statement best demonstrates summarization of the appointment?

"We reviewed your plans for your new diet and medications. Do you have any other questions?"

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

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

A 70-year-old female client had a cholecystectomy four days ago. The client's daughter tells the nurse, "My mother seems confused today." Which question would be best for the nurse to ask in order to assess the client's orientation?

"What day of the week is it?"

A nurse is collecting a health history on a client. When asked about alcohol, tobacco, and drug use, the client states, "I quit smoking 10 years ago." However, the nurse observes an open package of cigarettes in the client's shirt pocket. What is the most appropriate response by the nurse?

"You said that you do not smoke, but you have an open package of cigarettes in your pocket."

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

A nurse who easily developed a rapport with clients.

When caring for a psychiatric client, a formal contract is made with the client during which phase of the nurse-client relationship?

Orientation phase

The student nurse is studying the concepts of communication. Which description demonstrates the student understands the concept of feedback?

The sender and the receiver use one another's reactions to produce further messages.

A nurse during orientation notices that the preceptor gives all subcutaneous injections on a 45-degree angle. When the new nurse asks the preceptor the rationale for the practice the preceptors states, "This is how I do it, and this is how you will do it." The new nurse recognizes this behavior to be:

aggressive

A client arrives at the emergency department after experiencing several black, tarry stools. The nurse will develop a cause and effect by:

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

During an assessment of a newly admitted client the nurse asks the client many questions. The nurse begins the assessment by asking, "How many times have you been hospitalized this year for your back pain?" This is an example of which type of question?

closed question

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

eliminate as many distractions as possible

A family has lost a member who was treated for leukemia at a nursing unit. The nurse provides emotional support to the family and counsels them to cope with their loss. Which quality should the nurse use in this situation?

empathy

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

empathy

The nurse and the physical therapist discuss the therapy schedule and goals for a client on a rehabilitation unit. What type of communication is occurring between the nurse and the therapist?

interpersonal

What quality do clients most value in nurses?

trustworthiness

Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship?

working phase

Paramedics arrive in the emergency department with a victim of a motor vehicle collision. The paramedic reports the driver was restrained, the car was traveling about 30 miles per hour (48 Km/hour) , and the air bags were not deployed. The paramedic continues to report the car was struck from behind and that all individuals in the car were able to self-extricate. Which statement made by the nurse is verifying the report from the paramedic?

"All of the victims got themselves out of the car?"

During an admission intake assessment, a nurse uses open-ended questions to gather information. An example of an open-ended question is:

"Can you tell me why your physician sent you here to be admitted?"

The nurse is performing an admission interview with a new client diagnosed with acute coronary syndrome. For the nurse to obtain information and allow the client free verbalization, which question would elicit the most information?

"Could you tell me more about how you are feeling right now?"

A nurse is calling a physician to communicate a change in the client's condition. According to the I-SBAR-R format for hand-off communication among healthcare personnel, which is the most appropriate way to begin the conversation?

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

A client is scheduled for thoracentesis. The nurse assesses that the client appears anxious about the procedure and needs honest support and reassurance. What is the most appropriate response by the nurse to this client?

"The needle causes discomfort or pain when it goes in, but I will be by your side throughout and will help you hold your position."

The nurse faculty is observing a student nurse gather data from a client. Which question, if asked by the student, would indicate to the faculty that the student has a clear understanding of open-ended questions?

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

A nurse is having problems communicating with a client. Which statement by the nurse would open up the most dialogue with the client?

"You are back from therapy; tell me about it."

The nurse completes the admission process of a client to an acute care facility. Which statement by the nurse demonstrates the communication technique of focusing?

"You are hoping to figure out the cause of your extreme fatigue during this hospital stay."

Nurses use social media to share ideas, develop professional connections, access educational offerings and forums, receive support, and investigate evidence-based practices. What is an example of the proper use of social media by a nurse?

A nurse uses a disclaimer to verify that any views expressed on Facebook are his or hers alone and not the employer's.

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

medical terminology

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

open ended question

The nursing instructor is discussing communication with a student. The student identifies that a contract is made with the client during which phase of the nurse-client relationship?

orientation phase

A nurse is on his lunch break in the hospital cafeteria and sits at a table near a group of physicians eating their lunch. The nurse recognizes one of the physicians as being in charge of his clients. The nurse witnesses the physician point at the nurse and state, "That guy needs to get fired." The best response by the nurse would be to:

ask to speak to the physician in private and address any disrespectful remarks or behaviors.

A nurse is completing a health history with a newly admitted client. During the interview, the client presents with an angry affect and states, "If my doctor did a good job, I would not be here right now!" What is the nurse's best response?

be silent and allow the client to continue speaking when ready

A nurse communicating with a client states, "I will be changing your dressing, but we have plenty of time to talk first." She is already wearing sterile gloves and a mask and is busy working with her back to the client. The nurse is conveying a (an)

incongruent relationship

the term meta communication is best defined as:

interpersonal bridge between verbal and nonverbal communication

The nurse observing an interaction between a mother and her daughter appropriately identifies the interaction as which communication zone?

intimate

A nurse is providing care to a 3-year-old child admitted with a diagnosis of infectious diarrhea. The nurse needs to insert an intravenous catheter in order to administer prescribed intravenous fluids. In an attempt to foster communication, the nurse should:

involve the child's stuffed animal in the educational session

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

is unacceptable and breaches the client's confidentiality rights.

A nurse is interviewing a client for the establishment of long-term care insurance. During the interview, the nurse asks questions regarding the client's past medical history. The nurse is the:

sender

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

sits at the clients bedside and faces the client

A client is reluctant to undergo surgery and is discussing it with the nurse. Which response by the nurse would reflect an authoritarian approach?

surgery is your only option. You need this operation

An experienced nurse has been working with a client with heart failure. The client's lungs were clear to auscultation during the morning assessment; however, the afternoon assessment revealed bibasilar crackles and tachypnea. The nurse calls to give SBAR report to the covering health care provider. In the final step of the report the nurse should:

recommend 40 mg of furosemide be administered because the client had improvement with past administration.

The nurse is reporting to an oncoming nurse about the care of a client using the SBAR format. The nurse informs the oncoming nurse that the client should continue to have neurolgoical checks every 2 hours and the nurse should report any alterations to the health care provider. In which section should this information be relayed?

recommendation

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

swaddling the child and gently stroking its head.

The nurse is visiting a hospice client in his home. He is explaining the difficulties he is having with his home infusion pump. By making statements such as "I see" and "go on" during the conversation, the nurse is utilizing which therapeutic nurse-client communication technique?

Encouraging elaboration

The client is talking to the nurse about recent health problems of immediate family members and the strain she has been under trying to care for them. She begins to cry between sentences. What response by the nurse demonstrates the most empathy?

just take your time. I am listening

The nurse is communicating with a client who begins to cry. The nurse places a hand on the client's arm and sits quietly at the client's beside. What mode of communication is the nurse using to offer caring and comfort for the client?

kinesthetic

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

message

A nurse has been caring for a client who suffered a myocardial infarction 2 days ago. During the morning assessment, the nurse asks the client how he feels. Which scenario warrants further investigation?

the client stares at the floor and states "I feel fine"

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

this must be difficult for you to hear. how do you feel right now?

When the nurse communicates with a newly admitted client, the nurse must pay particular attention to nonverbal behaviors. The nurse considers which characteristic as nonverbal communication?

the client's tone of voice

A nurse is caring for a client who is newly diagnosed with terminal cancer. The nurse enters the client's room and finds the client sitting in the dark crying. Which of the following statements conveys empathy on part of the nurse?

"I know this is hard for you. Is there any way I can help?"

A client reports to the primary health care facility reporting chest pain. After the investigations and initial treatment, the client anxiously inquires if he had a heart attack. What should be the nurse's reply?

the physician want to monitor you and control your pain

The newly hired nurse is collecting assessment data for an upcoming surgical procedure from a client who speaks English as a second language. Which statement made by the newly hired nurse would indicate to the nurse educator that intervention is needed?

"Do you have any questions about your cholecystectomy?"

A home care nurse discusses with a client when visits will occur and how long they will last. In what phase of the nurse-client relationship is this type of agreement established?

Orientation phase

In order to provide effective nursing care, the nurse should engage in what type of communication with the client and significant others?

Therapeutic communication

When the preoperative client tells the nurse that he cannot sleep because he keeps thinking about the surgery, an appropriate reflection of the statement by the nurse is:

the thought of having surgery is keeping you awake

A dialysis nurse is educating a client on caring for the dialysis access that was inserted into the client's right arm. The nurse assesses the client's fears and concerns related to dialysis, the dialysis access, and care of the access. This information is taught over several sessions during the course of the client's hospitalization. Which phase of the working relationship is best described in this scenario?

the working phase