Ch. 8 - Exam 3

A nurse in the rehabilitation division states to the head nurse: "I need the day off and you didn't give it to me!" The head nurse replies, "Well, I wasn't aware you needed the day off, and it isn't possible since staffing is so inadequate." Instead of this exchange, what communication by the nurse would have been more effective? A. "I placed a request to have 8th of August off, but I'm working and I have a doctor's appointment." B. "I would like to discuss my schedule with you. I requested the 8th of August off for a doctor's appointment. Could I make an appointment?" C. "I will need to call in on the 8th of August because I have a doctor's appointment." D. "Since you didn't give me the 8th of August off, will I need to find someone to work for me?"

B

A home care nurse discusses with a patient when visits will occur and how long they will last. In what phase of the helping relationship is this type of agreement established? A. Orientation phase B. Working phase C. Termination phase D. All of the above

A

A nurse caring for a patient who is hospitalized following a double mastectomy is preparing a discharge plan for the patient. Which action should be the focus of this termination phase of the helping relationship? A. Determining the progress made in achieving established goals B. Clarifying when the patient should take medications C. Reporting the progress made in teaching to the staff D. Including all family members in the teaching session

A

A nurse is attempting to communicate with a patient who speaks a different language and does not understand what is being communicated. Which nursing action would best facilitate the communication process? A. Speaking slowly and distinctly but not loudly B. Repeating the message in the same manner many times until understood C. Using medical terms and abbreviations more frequently D. Avoiding using a dictionary to help maintain focus on the patient

A

A nurse notices a patient is walking to the bathroom with a stooped gait, facial grimacing, and gasping sounds. Based on these nonverbal clues, for which condition would the nurse assess? A. Pain B. Anxiety C. Depression D. Fluid volume deficit

A

A public health nurse is leaving the home of a young mother who has a special needs baby. The neighbor states, "How is she doing, since the baby's father is no help?" What is the nurse's BEST response to the neighbor? A. "New mothers need support." B. "The lack of a father is difficult." C. "How are you today?" D. "It is a very sad situation."

A

When interacting with a patient, the nurse answers, "I am sure everything will be fine. You have nothing to worry about." This is an example of what type of inappropriate communication technique? A. Cliché B. Giving advice C. Being judgmental D. Changing the subject

A

A nurse is communicating the care plan to a patient who is cognitively impaired. Which nursing actions facilitate this process? Select all that apply. A. The nurse maintains eye contact with the patient B. The nurse is patient and gives the patient time to respond C. The nurse communicates in a busy environment to hold the patient's attention D. The nurse keeps communication simple and concrete E. The nurse gives lengthy explanations of the care that will be given F. If there is no response, the nurse does not repeat what is said and takes a break

A, B, D

A nurse is using the SBAR technique for hand-off communication when transferring a patient. What are examples of the use of this process? Select all that apply A. S: the nurse handling the transfer described the patient's situation to the new nurse B. S: the nurse discusses the patient's symptoms with the new nurse in charge C. B: the nurse gives the background of the patient by explaining the patient's history D. A: the nurse presents an assessment of the patient to the new nurse E. R: the nurse explains the rules of the patient to the new nurse F. R: the nurse gives recommendations for the future care of the patient to the new nurse

A, C, D, F

Which nursing actions would most likely help improve communications with patients and achieve a more effective helping relationship? Select all that apply A. The nurse controls the tone of his or her voice so that it conveys exactly what is meant B. The nurse remains focused on the topic at hand and does not allow the patient to divert from the topic C. The nurse makes statements that are as simple as possible, gearing the conversation to the patient's level D. The nurse feels free to use words that might have different interpretations when using the same language as the patient E. The nurse never admits a lack of knowledge to the patient to avoid undermining the patient's confidence in the helping relationship F. The nurse takes advantage of any available opportunities to communicate information to patients in routine caregiving situations

A, C, F

During a nursing staff meeting, the nurses resolve a problem of delayed documentation by agreeing unanimously that they will make sure all vital signs are reported and charted within 15 minutes following assessment. This is an example of which characteristics of effective communication? Select all that apply. A. Group decision making B. Group leadership C. Group power D. Group identity E. Group patterns of interaction F. Group cohesiveness

A, D, E, F

A nurse is providing instruction to a patient regarding the procedure to change a colostomy bag. During the teaching session, the patient asks, "What type of foods should I avoid to prevent gas?" The patient's question allows for what type of communication on the nurse's part? A. A closed-ended answer B. Information clarification C. The nurse to give advice D. Assertive behavior

B

A 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? A. Aggressive B. Assertive C. Nonassertive D. Therapeutic

B

A nursing student is preparing to administer morning care to a patient. What is the MOST important question that the nursing student should ask the patient about personal hygiene? A. "Would you prefer a bath or a shower?" B. "May I help you with a bed bath now or later this morning?" C. "I will be giving you your bath. Do you use soap or shower gel?" D. "I prefer a shower in the evening. When would you like your bath?"

B

A nurse is communicating the care plan for a patient who is unconscious. Which nursing actions best facilitate this process? Select all that apply. A. The nurse speaks to the patient in a louder-than-normal voice B. The nurse is careful about what is said in the patient's presence since hearing is the last sense to go. C. The nurse assumes the patient can hear and discusses things that would normally be discussed D. The nurse raises environmental noises to stimulate the patient E. The nurse does not use touch to communicate with the patient F. The nurse speaks with the patient before touching him or her

B, C, F

Nurses on a hospital burn unit meet a a group to discuss procedures. Which statements accurately describe the functions of group dynamics? Select all that apply. A. Ideally, a group leader is selected who alone uses his or her talents and interpersonal strengths to assist the group to accomplish goals B. Effective groups possess members who elicit mutually respectful relationships C. The group's ability to function at a high level depends on only the group leader's sensitivity to the needs of the group and its individual members D. If a group member dominates or thwarts the group process, the leader or other group members must confront him or her to promote the needed collegial relationship E. In an effective group, power is used to "fix" immediate problems without considering the needs of the powerless F. In an effective group, members support, praise, and critique one another

B, D, F

A 36-year-old patient who underwent a hysterectomy 4 days ago says to the nurse, "I wonder if I'll still feel like a woman." Which response would most likely encourage the patient to expand on this and express her concerns in more specific terms? A. "When did you begin to wonder about this?" B. "Do you want more children?" C. "Feel like a woman..." D. Remaining silence

C

A nursing student is nervous and concerned about working at a clinical facility. Which action would BEST decrease anxiety and ensure success in the student's provision of patient care? A. Determining the established goals of the institution B. Ensuring that verbal and nonverbal communication is congruent C. Engaging in self-talk to plan the day and decrease fear D. Speaking with fellow colleagues about how they feel

C

In a helping relationship, the nurse would most likely perform what action? A. Encourage the patient to independently explore goals the allow his or her human needs to be satisfied B. Set up a reciprocal relationship in which patient and nurse are both helper and person being helped C. Establish communication that is continuous and reciprocal D. Establish goals for the patient that are not set in a specific time frame

C

When attending a staff meeting, a nurse is participating in what type of communication? A. Intrapersonal communication B. Interpersonal communications C. Small-group communication D. Organizational communication

C

Which technique would a nurse employ when using listening skills appropriately? A. The nurse would try to avoid body gestures when listening to the patient B. The nurse would not allow conversation to lapse int periods of silence C. The nurse would listen to the themes in the patient's comments D. The nurse would stand close to the patient and maintain eye contact

C

During an interaction with a patient diagnosed with epilepsy, a nurse notes that the patient is silent after communicating the nursing care plan. What would be appropriate nurse responses in this situation? Select all that apply. A. Fill the silence with lighter conversation directed at the patient. B. Use the time to perform the care that is needed uninterrupted. C. Discuss the silence with the patient to ascertain its meaning. D. Allow the patient time to think and explore inner thoughts. E. Determine if the patient's culture requires pauses between conversation. F. Arrange for a counselor to help the patient cope with emotional issues.

C, D, E

Which nursing actions help improve listening skills when conversing with patients? Select all that apply A. The nurse sits with the patient in a comfortable environment with arms and legs crossed in a relaxed position B. The nurse always maintains eye contact with the patient in a face-to-face pose C. The nurse uses appropriate facial expressions and body gestures to indicate that he or she is paying attention to what the patient is saying D. The nurse thinks before responding to the patient, even if this creates a lull in the conversation E. The nurse listens for themes in the patient's comments F. If an action being performed does not allow for conversation, the nurse pretends to listen to the patient rather than interrupting the patient's conversation

C, D, E

Nurses develop helping relationships with patients when caring for them. Which statements describe qualities of a helping relationship? Select all that apply A. The helping relationship occurs spontaneously B. The helping relationship is characterized by an equal sharing of information C. The helping relationship is built on the patient's needs, not on those of the helping person D. A friendship must develop from an effective helping relationship E. A helping relationship is dynamic F. A helping relationship is purposeful and time limited

C, E, F

A 3-year-old child is being admitted to a medical division for vomiting, diarrhea, and dehydration. During the admission interview, the nurse should implement which communication techniques to elicit the most information from the parents? A. The use of reflective questions B. The use of closed questions C. The use of assertive questions D. The use of clarifying questions

D

A nurse enters a patient's room and examines the patient's IV fluids and cardiac monitor. The patient states, "Well, I haven't seen you before. Who are you?" What is the nurse's BEST response? A. "I'm just the IV therapist checking your IV." B. "I've been transferred to this division and will be caring for you." C. "I'm sorry, my name is John Smith and I am your nurse." D. "My name is John Smith, I am your nurse and I'll be caring for you until 11 PM."

D

A nurse enters the room of a patient with cancer. The patient is crying and states, "I feel so alone." Which response by the nurse is the most therapeutic action? A. The nurse stands at the patient's bedside and states, "I understand how you feel. My mother said the same thing when she was ill." B. The nurse places a hand on the patient's arm and states, "You feel so alone." C. The nurse stands in the patient's room and asks, "Why do you feel so alone? Your wife has been here every day." D. The nurse holds the patient's hand and asks, "What makes you feel so alone?"

D

A nurse who "unblocks" and "cleans" congested areas of energy in a patient's body to promote comfort is applying the phenomenon known as: A. "Unruffling" touch B. Interpersonal touch C. Tactile manipulation D. Therapeutic touch

D

A nurse who is caring for newborn infants delivers care by using the sense that is most highly developed at birth. Which example of nursing care achieves this goal? A. The nurse speaks to the infant in a loud voice to get attention B. The nurse plays "peek-a-boo" with the infant C. The nurse wears colorful clothing to stimulate the infant D. The nurse gently strokes the baby's cheek to facilitate breastfeeding

D

A patient states, "I have been experiencing complications of diabetes." The nurse needs to direct the patient to gain more information. What is the MOST appropriate comment or question to elicit additional information? A. "Do you take two injections of insulin to decrease the complications?" B. "Most health care providers recommend diet and exercise to regulate blood sugar." C. "Most complications of diabetes are related to neuropathy." D. "What specific complications have you experienced?"

D

During rounds, a charge nurse hears the patient care technician yelling loudly to a patient regarding a transfer from the bed to chair. Upon entering the room, what is the nurse's BEST response? A. "You need to speak to the patient quietly so you don't disturb the other patients." B. "Let me help you with your transfer technique." C. "When you are finished, be sure to apologize for your rough demeanor." D. "When your patient is safe and comfortable, meet me at the desk."

D

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. A nurse describes a patient on Twitter by giving the room number rather than the name of the patient B. A nurse posts pictures of a patient who accomplished a goal of losing 100lbs and later deletes the photo C. A nurse describes a patient on Twitter by giving the patient's diagnosis rather than the patient's name D. A nurse uses a disclaimer to verify that any views expressed on Facebook are his or hers alone and not the employer's

D