Chapter 20: Communicator

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?" "All right, you have four children, is that correct?" "How old are your children?" "Were these term births?"

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

In which of the following situations would the SBAR technique of communication be most appropriate? A nurse is calling a physician to report a client's new onset of chest pain. A nurse is facilitating a family meeting in order to coordinate a client's discharge planning. A nurse is explaining the process of bone marrow biopsy to a client who is scheduled for the procedure. A nurse is teaching a client about the benefits of smoking cessation and the risks of continuing to smoke.

A nurse is calling a physician to report a client's new onset of chest pain.

Which of the following nurses most likely is the best communicator? An advanced practice nurse. A nurse who easily developed a rapport with clients. A nurse who is bilingual. A nurse who is proficient in sign language.

A nurse who easily developed a rapport with clients.

A student nurse is attempting to improve their communication skills. Which therapeutic communication skill is appropriate? Control the tone of the voice to avoid hidden messages. Avoid the use of periods of silence. Use cliches to enhance a client's understanding of information. Be precise and inflexible regarding the intent of the conversation.

Control the tone of the voice to avoid hidden messages.

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 is sitting in a chair and states, "I feel a lot better than I did yesterday. The client stares at the floor and states, "I feel fine." The client smiles at the nurse and states, "I cannot wait to go home." The client looks at the nurse and states, "I am still not feeling my best."

The client stares at the floor and states, "I feel fine."

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

Working phase

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. assertive. passive. nurturing.

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 to provide a stool specimen for guaiac testing. asking the client if he or she has recently taken ferrous sulfate (iron) or bismuth subsalicylate. determining if the client has any food or drug allergies. insisting the client not eat or drink anything until further instructed.

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

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. slow heart rate and prolonged capillary refill. pallor and diaphoresis. cold intolerance and brittle nails.

easy wrinkling of the skin and sunken eyes

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? Indifference Pity Sympathy Empathy

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 Intrapersonal Small-group Organizational

interpersonal

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

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: ask the child's parents to leave the room while the nurse and child talk. involve the child's stuffed animal in the educational session. provide both verbal and written information to the child. show the child the intravenous catheter and explain how it works.

involve the child's stuffed animal in the educational session.

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? Situation Background Assessment Recommendation

recommendation

A nurse is at the end of a busy shift on a medical-surgical unit. The nurse enters a room to empty the client's urinary catheter and the client says, "I feel like you ignored me today." In response to the statement, the nurse should: sit at the bedside and allow the client to explain the statement. smile at the client and apologize. ignore the statement and empty the urinary catheter. inform the client that the unit was very busy that day.

sit at the bedside and allow the client to explain the statement.

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: inform the client that several nurses will be needed to care for this wound. tell herself to "remain calm" and remember that she was trained to perform this skill. tell the unlicensed assistive personnel (UAP) to gather supplies and to prepare to cleanse and dress the wound. ask the charge nurse to change her assignment.

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

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

therapeutic

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 the client in order to assess the her orientation? "Is your name Evelyn?" "Are you in a hospital?" "Is today the first day of the month?" "What day of the week is it?"

what day of the week is it? (better to ask open ended questions)