Chapter 21- Communication & Therapeutic Relationships- Knowledge Checks and NCLEX

A mother comes to the emergency department after receiving a phone call informing her that her son was involved in a motor vehicle accident. When she approaches the triage desk, she frantically asks, "How is my son?" Which response by the nurse is best? 1) "He's being examined now; he's awake and talking. We'll take you to see him soon." 2) "Don't worry, I'm sure he'll be fine; we have an excellent trauma team caring for him." 3) "Everything will be okay; please take a seat and I'll check on him for you." 4) "Your son is strong and has youth on his side; I'm sure he'll be fine."

1) "He's being examined now; he's awake and talking. We'll take you to see him soon."

A patient is admitted to the medical-surgical floor with a kidney infection. The nurse introduces herself to the patient and begins her admission assessment. Which goal is most appropriate for this phase of the nurse-patient relationship? The patient will be able to: 1) Describe how to operate the bed and call for the nurse 2) Discuss communication patterns and roles within the family 3) Openly express his concerns about the hospitalization 4) State expectations related to discharge

1) Describe how to operate the bed and call for the nurse This is the orientation phase of the relationship. The orientation phase begins when the nurse introduces herself to the patient and begins to gather data. In this phase, the nurse and patient are getting to know each other. As part of the orientation phases, the nurse will orient the patient to the hospital room and routines. In the preinteracion phase, the nurse gathers information about the patient before she meets him. Discussion of personal information, particularly if sensitive or complex, is suitable for the working phases of the nurse—patient interaction. The patient expressing feelings and concerns also occurs during the working phase. Durgin the working phase, care is communicated, thoughts and feelings are expressed, and honest verbal and nonverbal communication occurs. Stating expectations related to discharge is most appropriate for the termination phase— the conclusion of the relationship.

During a presentation at a nursing staff meeting, the unit manager speaks very slowly in a monotone voice. She uses medical and technical terminology to convey her message. Dressed in business attire, the manager stands erect and smiles occasionally while speaking. Which elements of her approach are likely to cause the staff to lose interest in what she has to say? Select all that apply. 1) Slow speech 2) Monotone 3) Occasional smile 4) Formal dress

1) Slow speech 2) Monotone

Which situation requires Intrapersonal communication? 1) Staff meetings 2) Positive self-talk 3) Shift report 4) Wound care committee meeting

2) Positive Self-talk

A local church organizes a group for people who are having difficulty coping with the death of a loved one. Which type of group has been organized? 1) Work-related social support group 2) Therapy group 3) Task group 4) Community committee

2) Therapy group

The nurse suspects that a patient is being physically abused at home. What is the best environment in which to discuss the possibility of abusive events? 1) The patient's shared semiprivate room 2) The hallway outside the patient's room 3) An empty corner at the nurse's station 4) A conference room at the end of the hall

4) A conference room at the end of the hall

In which phase of therapeutic relationship does the patient learn to trust the nurse? A. Orientation B. Working C. Termination D. Beneficial

A. Orientation

In the context of assertive communication, describe what "fogging" is:

"Fogging" helps you accept criticism without becoming anxious or defensive. It acknowledges that here may be some truth to the criticism but allows the person to remain the judge of her own action (e.g., Suppose a physician says, "Are you playing pharmacist today?" You might respond, "I agree that I may not be a pharmacist and that I do not know everything there is to know about analgesics.")

Which of the following is the best method for nurses to encourage clients to reveal their worries and concerns? A. Stand close to the patient and maintain eye contact B. Sit down next to the patient and provide her with privacy C. Look professional and confident D. Provide privacy and avoid eye contact with the patient

B. Sit down next to the patient and provide her with privacy Sitting close to the patient and providing privacy conveys respect and empathy for the patient and her concerns. Maintaining eye contact is a technique that demonstrates concern for the patient. However, standing next to the patient and appearing professional and confident can convey an attitude of authority but may be intimidating and may inhibit the patient from sharing her concerns. This position in the room also conveys the nurse is too rushed to come into a more personal space and communicate at a more deeper level.

Use of the phrases "Tell me more about....." or "I see" encourages clients to continue talking and expressing themselves. This is called: A. Summarizing B. Asking open-ended questions C. Focusing D. Encouraging elaboration

D. Encouraging elaboration

Assertive communication includes expression of both positive and negative thoughts and feelings openly, honestly, and non-judgmentally. T/F

True