Chapter 8: Communication and the Nurse-Patient Relationship

A nurse using active listening techniques would:

Use nonverbal cues such as leaning forward, focusing on the speaker's face, and slightly nodding to indicate that the message has been received.

To convey the intervention of active listening, the nurse would:

make a conscious effort to block out other sounds in the immediate environment

When the nurse makes the statement "We can come back to that later- right now, I need to know about when your symptoms started." the nurse is:

refocusing the patient to the issue at hand when the conversation has wondered.

The nurse caring for a patient who states, "I tossed and turned last night." The nurse responds to the patient, "You feel like you were awake all night?" This is an example of:

restatement

The practical nursing student who is engaged in therapeutic communication with a patient will have the most difficulty with the technique of:

silence

Which statement is true regarding the use of silence in communication?

silence is a difficult technique to devlope

When the nurse observes a resident in a long-term care facility pounding his fists on his legs and grinding his teeth the nurse will validate her perception of the patient's nonverbal expression of anger by:

sitting down near the patient and saying "You seem upset...can I help?"

A patient with a nursing diagnosis of Sensory perception, disturbed auditory, would most appropriately require the nurse to:

speak slowly and distinctly but not shout

A patient who has had a stroke is unable to speak clearly and has right sided hemiplegia. The nurse will design the approach to the assessment interview by:

speaking slowly and giving the patient time to respond.

When interacting with an older adult patient, the nurse would enhance communication by:

speaking slowly in order to allow the patient to process the message.

Verbal communication includes:

spoken words

When communicating with a hearing-impaired patient, a nurse should:

stand or sit three feet from the patient

The nurse tells the patient, "For the last 2 days we have talked about whether to notify your daughter of your upcoming surgery in 2 days. You have indicated you do not want to be a burden to her, but you also would like to have her here. You may have to decide rather quickly because of the time constraint." The nurse is using the technique of:

summarizing

The nurse explains that the therapeutic nurse-patient relationship differs from the social relationship because:

the nurse-patient relationship ends when the patient is discharged.

A nurse says to a patient " I am going to your TPR, and then i'll check to see whether you can have PRN analgesic." in considering factors that affect communication, the nurse has:

used medical jargon which may not be understood by the patient

When communicating with a hearing-impaired patient, the nurse appropriately:

uses short, simple sentences.

The nurse caring for a patient who is concerned about her 10-pound weight loss relative to her chemo tell the patient, "Lucky you! Every cloud has a silver lining." The nurse's statement is an example of which type of communication block?

using cliches

When an office nurse asks the patient to repeat information that he has just given to the patient over the telephone, the nurse is:

verifying that the patient understands the info.

While interviewing a Native American man for the admission history, the nurse should expect to:

wait patiently through long pauses in the conversation.

The nurse recognizes a verbal response when the patient:

writes the answer to a question asked by the nurse

The nurse recognizes the patient who demonstrates communication congruency when the patient

is tearful and slow in speech when talking about her husbands death.

A 67 yo woman had a major abdominal surgery yesterday. She has IV lines, a urinary catheter, and an abdominal wound dressing, and she is receiving PRN pain medication. The end of the shift report that best conveys the patient status is:

"Abdominal dressing dry, IVs-800 mL left in #6; NS running at 125 mL/hr; urine output 800 mL this shift; had morphine 15 mg for pain at 8:00 am and at 1:30 pm. She is comfortable now. Vital signs are stable, no fever."

When the nurse giving direction to a nursing assistant who is being delegated part of the patient care, the nurse's most effective direction would be:

"Give the patient in 204A a shower after breakfast, and call me to check her feet before you get her dressed"

When a patient begins crying during a conversation with the nurse about the patient's upcoming surgery for possible malignancy, the nurse's most therapeutic response would be:

"Here is a tissue. I'd like sit here for a while if you want to talk."

A home health patient with a bleeding ulcer informs the nurse that she ate a bowl of chili with jalapeños. An appropriate communication block with a judgmental tone by the nurse would be:

"I don't think that was a smart thing for you to do considering your ulcer."

A nurse is delegating to a NA. The most appropriate form of this type of communication would be:

"If Mr. Jones' heart rate is greater than 100, let me know."

When a patient says "I get so anxious just lying here in this hospital bed. I have a million things I should be doing at home." the most therapeutic response would be:

"It sounds like you're having a tough time dealing with this situation.

When the nurse enters the room, the patient is laughing out loud at something on TV. The patient stops and apologizes for the laughter saying "I guess I ought not be laughing at all since I am stuck here with two broken legs." The nurse can use evidence-based info when she responds:

"Laughter truly is the best medicine as it has a positive effect on the immune system."

To begin talking to a newly admitted patient about pain management, the nurse would most appropriately state:

"Tell me about the pain you've been having"

A hispanic patient approaches the Asian nurse and, standing very close, touches the nurses shoulder during their conversation. The begins to step back to 18 to 24 inches, while smiling and nodding at the patient. This situation is most likely an example of:

A difference in culturally learned personal space of the nurse and the patient

A patient asks the nurse, "What would you do if you had cancer and had to choose between surgery and chemo?" The reply that can best help the patient is:

"What solutions have you considered?"

An example of a nurse communicating with a patient using open-ended questions would be:

"What was your daughter's reaction to your desire for hospice?"

The nurse is caring for a patient who is concerned about living alone. The best response by the nurse would be:

"Where have you considered living?"

A 36 yo woman who is in traction for a fractured femur that she received in an auto accident is found crying quietly. The nurse can best address this situation by saying:

"You are upset. Can you tell me what's wrong?"

When the patient says "I don't want to go home." the nurse's best therapeutic verbal response would be:

"You don't want to go home?"

When a patient states, "I don't feel like walking today," the nurse's most therapeutic verbal response would be:

"You don't want to walk today?"

The nurse is caring for a patient who has just had a mastectomy (breast removal). The patient expresses concern that her husband will no longer find her attractive because of her mastectomy. The nurse appropriately responds:

"You're concerned your husband will find you unattractive because of your mastectomy?"

When a patient states, "My son hasn't been to see me in months," the nurses best verbal response is:

"Your son hasn't been around lately?"

During the initial interview of the patient, the nurse should: (select all that apply)

1. assess the language capabilities of the patient 2. limit the interview to approx. 30 minutes 3. assess comprehension ability of the patient. 4. make the patient as comfortable as possible

The nurse will appropriately and deliberately use the closed question technique when the patient is: (select all that apply)

1. being asked for specific info 2. extremely anxious and unfocused 3. confused

The nurse is alert to avoid using blocks to effective communication that include: (select all that apply)

1. changing the subject 2. giving advice 3. asking probing questions 4. using cliches

When using the telephone to communicate with PCP about a patient, the student nurse should have ready: (select all that apply)

1. current info relative to patient's condition change 2. assessment of vitals 3. info on urinary output 4. medications received

Behaviors that indicate to the patient that the nurse is inattentive to the patient's concerns are such activities as: (select all that apply)

1. turning back to straighten the beside table while the patient is talking 2. tapping feet or fingers 3. sitting down in a chair near the bed with arms crossed 4. leaving a hand on the door to go out

Which technique is used when a nurse asks a patient, "Tell me how your night was?"

General Lead

The nurse has selected the outcome for the patient to eat all of the food on the breakfast tray each day. Assessing that the patient has eaten all of the breakfast, the nurse would give positive feedback by saying:

Hurray! you finished your whole meal! What would you like for tomorrow?

A nurse uses the ISBAR R format for an end-of-shift report. ISBAR-R is an abbreviation for:

Introduction, situation, background, assessment, recommendation, and readback.

The nurse can best ensure that communication is understood by:

Obtaining Feedback from the patient that indicates accurate comprehension

To enhance the establishment of rapport with a patient, the nurse should:

act in a trustworthy and reliable manner; respect the individuality of the patient

A nurse is communicating with an aphasic patient. The nurse should:

ask one question at a time

The primary care provider informs the student nurse that he would like to give a telephone order. The best response by the student is:

ask the RN to take the telephone order.

When a nurse is conducting an assessment interview, the most efficient technique would be:

asking closed questions to obtain essential info.

A nurse caring for a patient who fell off the roof while he was intoxicated asks the patient, "Why in the world were you on the roof when you had been drinking?" The nurse's statement is an example of which type of communication?

asking probing questions

When communicating with an aphasic patient, the nurse appropriately:

assumes the patient can understand what is heard.

An aspect of computer use in patient care in which the LPN may need to be proficient includes:

input of data such as requests for radiographs or lab services

When communicating with an adolescent, the nurse should be very sensitive to avoid:

interrupting frequently

The nurse chooses to use touch in the nurse-patient relationship because touch:

can convey caring and support when words are difficult

In order to safeguard patient info. when using a computer the nurse should:

change the computer password frequently

A patient states, "I'm so worried that I might have cancer." The nurse responds, "It is time for you to eat your breakfast." The nurse's response is an example of:

changing the subject

When communicating with a preschooler the nurse should:

consider the developmental level, using familiar words.

A patient tells the nurse that she dislikes the food that is served in the hospital. The nurse responds, "Our cooks work very hard; the food that is served is very good." The nurse's response is an example of the communication block of:

defensive response

The nurse is aware that the use of false reassurance is harmful to the nurse-patient relationship, because this communication block:

discounts the patient's stated concerns

A nurse tells a patient "Don't worry, everything will be fine." This is an example of what type of blocked communication?

false reassurance

The nurse is aware that the purpose of therapeutic communication is to:

focus on the patient and the patient needs to facilitate interaction.

Active listening includes:

focused energy

The characteristic that is representative of the nurse-patient relationship is that this relationship:

focuses on the assessed patient health problems

The nurse is caring for a patient with a diagnosis of lung cancer. The nurse states, "If I were you, I would have radiation therapy." The nurse's response is an example of which type of communication block?

giving advice