Chapter 8- Communication
The newly hired nurse is collecting assessment data for an upcoming surgical procedure from a client who speaks the dominant language as a second language. Which statement or question made by the newly hired nurse would indicate to the nurse manager that intervention is needed?
"Do you have any questions about your cholecystectomy?"
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 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 the staff. d. Including all family members in the teaching session.
a
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 finds that a client has infiltration around the IV line that needs to be removed. What explanation should the nurse give to reduce the client's anxiety?
"I know that you are anxious, but the IV location needs to be changed."
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 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 close questions c. The use of assertive questions d. The use of clarifying questions
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 patients 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 alone." c. The nurse stands in the patients room and ask, "Why do you feel so alone? Your wife has been here every day." d. The nurse holds the patient's hand and ask, "What makes you feel so alone?"
d
Which is an open-ended question?
"Why did the health care provider prescribe this medication for you?"
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
Carl Rogers (1961) studied the process of therapeutic communication. Through his research, the elements of a "helpful" person were described. They include all of the following except which choice?
analysis
The nurse is beginning an assessment on a nonverbal client. The nurse must first:
establish eye contact prior to assessing, touching, and interacting with the client.
A client comes into the urgent care center to have sutures removed on an arm. The nurse finds significant crusting along the suture line. The client states not having time to get the sutures removed a week prior, as directed. The nurse soaks the crust and attempts to remove the sutures. As the nurse attempts the suture removal, the client frequently pulls the arm away and tells the nurse, "You are taking too long and it is hurting a little bit. Just pull them out and get it over with." Which statement is an example of appropriate therapeutic response?
"It is taking longer for me to remove the sutures because the delay allowed the crust to form and adhere to the sutures, making it harder and sometimes painful to remove them."
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
Group Decision making Group Identity Group patterns of interaction Group cohesiveness
The nurse makes a contract with the client during which phase of the nurse-client relationship?
Orientation phase
A nurse is attempting to communicate with a client who speaks a different language and is not fluent in the nurse's language. Which nursing action would best facilitate the communication process?
Speaking slowly and distinctly, but not loudly
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 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.
A client reports to a primary health care provider with aggravated chest pain. The health care provider prescribes a stress test. The client tells the nurse about not wanting to take the test and wanting to continue taking medication for now. Understanding that the client is anxious, which action should the nurse take first to provide education needed for this client?
Ask the client "What has your health care provider shared with you about stress tests?"
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 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
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
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
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 milligrams of furosemide (Lasix) be administered because the client had improvement with past administration.
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.
Discuss the silence with the patient to ascertain its meaning. Allow the patient time to think and explore inner thoughts. Determine if the patient's culture requires pauses between conversation.
To provide effective nursing care, the nurse should engage in what type of communication with the client and significant others?
Therapeutic communication
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
