Chapter 8 communication prep u

Which statements describe the qualities of a helping relationship? Select all that apply.

-The helping relationship is built on the client's needs, not on those of the helping person. -A helping relationship is purposeful and time limited. -A helping relationship is dynamic. Several statements accurately describe the qualities of a helping relationship. The helping relationship is built on the client's needs, not on those of the helping person. A helping relationship is dynamic. A helping relationship is purposeful and time limited. The helping relationship does not occur spontaneously. The helping relationship is not characterized by an equal sharing of information. A friendship should not develop from an effective helping relationship. Pg 161

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 Aggressive behavior involves asserting one's rights in a negative manner that violates the rights of others. Comments such as "do it my way" or "that's just enough out of you" are examples of aggressive verbal statements. In this scenario, the preceptor is neither nurturing the new nurse nor being passive. Assertive behavior is the ability to stand up for oneself and others using open, honest, and direct communication. Pg 171

The nurse is communicating with a client following a routine physical examination. Which statement best demonstrates summarization of the appointment?

"We reviewed your plans for your new diet and medications. Do you have any other questions?" Summarization highlights the important points of a conversation or interaction. Reminding the client that the diet plan and new medications were discussed best summarizes the appointment. The other answers do not review the topics discussed. Pg 158

Nurses on a hospital burn unit meet as a group to discuss procedures. Which statements accurately describe effective functioning in a group? Select all that apply.

-Group members elicit mutually respectful relationships. -The leader or other group members confront any member who dominates or thwarts the group process. -Group members support, praise, and critique one another. Effective groups possess members who elicit mutually respectful relationships. If a group member dominates the group process, the leader or other group members must confront the individual to promote the needed collegial relationship. In an effective group, members support, praise, and critique one another. A group leader would not be chosen for only the leader's talents and interpersonal strengths but also for the ability to bring the group's talents and interpersonal strengths to the forefront. The group's ability to function depends on more than just the leader's sensitivity to the needs of the group and its individual members. Power is not used to "fix" immediate problems without considering the needs of the powerless. Pg 155

A nurse is planning care for an adult client with severe hearing impairment who uses sign language and lip reading for communication and who has a new diagnosis of cancer. Which nursing action is most appropriate when establishing the plan of care for this client?

Arrange for a sign language interpreter when discussing treatment. During the planning step of the nursing process the nurse develops and prioritizes an individualized plan of care in partnership with the client, family, and others as appropriate. The client with mental or physical limitations should be included in the plan as much as possible. A sign language interpreter allows the client to participate fully in the plan of care. Consulting with the client's children is not as beneficial because it places them in the difficult position of translating while experiencing the emotional strain of the parent's illness. A TTD line can assist in communication but is not as helpful as a medical interpreter. Consulting the oncology nurse specialist is not as helpful in communicating with this client as an interpreter. Pg 176

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?" To reassure the client, the nurse should provide education about the stress test so the client can make an informed decision. The nurse should not assume the health care provider has provided complete information about the stress test. By first inquiring with an open-ended question, the nurse allows the client to share his or her knowledge. Then the nurse can provide the education needed, which may include a booklet or other approaches based on the client's learning style. By providing information without first understanding the client's knowledge, the nurse may be repeating something the client already knows. Pg 168

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 The nurse and physical therapist are engaging in interpersonal communication, which occurs between two or more people with the goal to exchange messages. Intrapersonal communication, or self-talk, is the communication that happens within the individual. Small-group communication occurs when nurses interact with two or more individuals. Organizational communication occurs when individuals and groups within an organization communicate to achieve established goals. Pg 155

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

Working phase During the working phase, the nurse and client explore and develop solutions that are enacted and evaluated in subsequent interactions. The orientation phase involves making introductions and establishing client goals. The termination phase involves evaluating client progress toward goals and concluding the relationship. There is no evaluation phase in the nurse-client relationship. Pg 163

A nurse is caring for a client admitted to the hospital for dehydration. Which physical findings should the nurse acknowledge as nonverbal communication concerning this diagnosis?

easy wrinkling of the skin and sunken eyes. Most illnesses cause at least some alterations in general physical appearance. Observing for changes in appearance is an important nursing responsibility for detecting illness or evaluating the effectiveness of care and therapy. For example, a person with an insufficient intake of fluids has dry skin that wrinkles easily, eyes that might be sunken and dull in appearance, and poor muscle tone. On the other hand, a person in good health tends to radiate this healthy status through general appearance. Although prolonged capillary refill is consistent with dehydration, slow heart rate is not. Pallor may be associated with dehydration but diaphoresis is not associated with this condition. Cold intolerance and brittle nails are consistent physiologic changes seen in clients with hypothyroidism. Pg 153

A nurse is caring for a client who presents with a skin infection. While obtaining the client's medical history, it is determined that the client is an intravenous drug user. To foster effective communication, the nurse should:

remain honest, open, and frank. One key factor to effective communication is to be open, accepting, frank, respectful, and without prejudice. When a client feels that a nurse is being judgmental, the client might withhold significant information. The nurse needs to develop sensitivity to the unique challenges presented by each client. A urine drug screen may eventually be ordered but is not necessary at this time. There is no evidence the client wants drug rehabilitation at this time. There is no evidence that the skin infection is secondary to the drug use.