communication

The registered nurse (RN) is teaching the licensed practical nurse (LPN) about the elements of professional communication while interacting with patients. Which statements by the LPN indicate effective learning?

"I should avoid referring to patients by diagnosis, room number, or other attribute." "I should avoid terms such as honey, dear, or grandma while addressing the patients." "I should introduce myself by giving my name and designation." The nurse should introduce himself or herself by giving his or her name and status, such as nursing student, RN, or LPN. It is important that the nurse avoid referring to patients by diagnosis, room number, or other attribute, because this approach would be demeaning to the patient. The nurse should avoid terms of endearment such as "honey," "dear," "grandma," or "sweetheart" while addressing patients, even with close nurse-patient relationships. Using first names is appropriate for infants, young children, and patients who are confused or unconscious, as well as close team members. Addressing patients by the last name is respectful in most cultures; nurses usually use a patient's last name in an initial interaction and then use the first name if the patient requests it. p. 325

The registered nurse (RN) is teaching a nursing student about communicating with a patient who has a hearing impairment. Which statements made by the nursing student indicate the need for further learning?

"I should repeat rather than rephrase if there is any misunderstanding." "I should speak at an elevated volume." When communicating with the patient who has hearing impairment, the nurse should communicate at normal volume rather than shouting. The nurse should rephrase rather than simply repeat statements if the patient misunderstands. While speaking to the patient, the nurse face the patient with his or her mouth visible to facilitate lip reading. The nurse should reduce the environmental noise so the patient can hear properly without any disturbance. The nurse should check for the patient's hearing aids and glasses before communicating. pg 333

Which nontherapeutic communicative statement indicates a defensive response?

"No one here would intentionally lie to you." Stating that no one would intentionally lie indicates defensive behavior. Blaming someone for incomplete work indicates an aggressive response. Stating that things are bad and nothing can be done is a passive response. Asking how someone can claim not to have slept when he or she was heard snoring indicates disapproval. p. 332

What does the term referent mean in the communication process?

An event that motivates a person to communicate with another A is any factor that motivates a person to communicate with others. This can include sights, sounds, odors, emotions, or perceptions that can be the basis for a person to talk with another. The term does not refer to the primaryhealth care provider, the patient, or the service being provided. p. 319

The nurse is caring for a Spanish-speaking patient with a hand fracture. Which approaches are likely to be ineffective when communicating with the patient?

Designating a family member of the patient as an interpreter Perceiving patient nodding or statements such as "OK" as indications of effective understanding While caring for a non-English speaking patient, a professional interpreter should be provided; a family member should not be used as an interpreter. Nodding or making statements such as "OK" are not necessarily indications of understanding. It is necessary to assess the patient's primary language and level of fluency in English. Incorporating the patient's communication methods or need into plan of care is an important action. Providing written information in English and in the primary language of the patient is an essential action while communicating with a non-English speaking patient. p. 327

Which situational context factors influence communication?

Expression of feelings Information exchange Expression of feelings and information exchange are the situational context factors that influence communication. Privacy level is an environmental context factor that influences communication. Emotional status is a psychophysiological context factor that influences communication. Balance of power and control is a relational context factor that influences the communication. p. 326

The nurse is asking relevant questions to seek specific information from a patient while making decisions. Which question would be most appropriate in this context?

How has your pain affected your life at home?" Open-ended and focused questions should be asked to a patient when more specific information is needed in an area. Asking open-ended questions will allow the patients to give pertinent information about a topic. "How has your pain affected your life at home?" is a open-ended and focused question. Therefore this is the most appropriate question in this situation. "Are you feeling better now?" is a closed-ended, yes-or-no question. Although they are helpful during assessment, they are generally less useful during therapeutic exchange. "How many times a day do you take pain medication?" is also a yes/no question. "Are you worried that you will not be able to return to your usual way of life?" is a validatory question. This is used to recognize and acknowledge a patient's thoughts, feelings, and needs. p. 330

Which phase of the helping relationship is involved when the nurse and a patient meet and become acquainted?

In the orientation phase, the nurse and a patient meet and become acquainted. In the working phase, the nurse and patient work together to solve problems and accomplish goals. In the termination phase, the nurse evaluates goal achievement with the patient and relinquishes responsibility for patient care. In the preinteraction phase, the nurse reviews available data, including medical and nursing history. p. 323

Which form of communication is appropriate to assess understanding and clarify misinterpretations when the nurse is teaching a patient about a health concern?

Interpersonal communication Interpersonal communication is one-on-one interaction between a nurse and another person that often occurs face-to-face. This interaction is useful to assess understanding and clarify misinterpretations when teaching a patient about a health concern. Public communication is interaction with an audience. Nurses often speak with groups of consumers about health-related topics. Small group communication occurs when a small number of people meet. This type of communication is usually goal directed and requires an understanding of group dynamics. Intrapersonal communication is a powerful form of communication that you use as a professional nurse. This level of communication is also called self-talk. p. 319

The nurse is performing a mental rehearsal on how to deal effectively in difficult situations with increased confidence. Which level of communication is exhibited by the nurse?

Intrapersonal communication Intrapersonal communication involves developing self-awareness and self-esteem that enhances appropriate self-expression. This level of communication is also called self-talk and may involve a mental rehearsal to deal effectively with difficult tasks or situations with increased confidence. Public communication is interaction with an audience, which may include speaking to groups of consumers about health-related topics. Small-group communication is the interaction that occurs when a small number of people meet and discuss. Interpersonal communication is one-on-one interaction between a nurse and another person that often occurs face to face. p. 319

The registered nurse (RN) is interviewing patients who are breast cancer survivors and asking them to share their views on how they went through treatment and how their family members supported them. Which type of communication is suitable in this situation?

Narrative interaction In a therapeutic relationship, it is helpful to encourage patients to share personal stories, a process called narrative interaction. Through listening to the patients' stories, the nurse understands the context of patient's lives, their concerns, experiences, and challenges. During the orientation phase of the helping relationship, the nurse and patient meet and get to know one another. In the termination phase of the helping relationship, the nurse reminds the patient that termination is near and evaluates goal achievement with the patient. In the preinteraction phase of the helping relationship, the nurse talks with other caregivers who have information about the patient. p. 324

The nurse is reviewing the available data, including the medical and nursing history, of a patient. Which phase of the helping relationship is the nurse performing?

Preinteraction phase The phase before meeting a patient is the preinteraction phase. Reviewing available data, such as the medical and nursing history, is included in the preinteraction phase. Working phase is when the nurse and patient work together to solve problems and accomplish goals. The nurse and patient meet and get to know one another during the orientation phase. The termination phase occurs at the end of the relationship with the patient. p. 323

While taking the history of a patient, the nurse states, "I see you haven't eaten anything." Which therapeutic communication technique is the nurse exhibiting through this statement?

Sharing observations Sharing observations involves the nurse making observations on how the other person looks, sounds, or acts. For example, the nurse may comment on the fact that the patient hasn't eaten. Sharing hope may be exhibited by reassuring patients that there are many kinds of hope. Sharing humor is exhibited when the nurse provides emotional support to patients and professional colleagues and humanizes the illness experience. Sharing empathy involves making statements are neutral and nonjudgmental to help foster trust in difficult situations. pg 329

The nurse is instructing a patient's visitors to avoid talking loudly inside the hospital. Which zone of personal space is involved in this interaction?

Socio-consultative zone The socio-consultative zone may involve giving directions to visitors in the hallway. The public zone may involve speaking at community forum. The intimate zone may involve changing a patient's surgical dressing. Taking a patient's nursing history involves the use of the personal zone. p. 323

Which is a nontherapeutic communication technique?

Sympathy Nurses may take patient feelings on as their own, which may hinder the nurse's ability to be objective and help the patient process their feelings. Focusing is a therapeutic communication technique that involves centering a conversation on key elements or concepts of a message. Clarifying is therapeutic communication technique to check whether you understand a message accurately by restating an unclear or ambiguous message to clarify the sender's meaning. Summarizing is a therapeutic communication technique that involves a succinct review of key aspects of an interaction. p. 331

The nurse is recalling a funny shared experience with a patient shortly before the patient is discharged from the hospital. Which phase of the helping relationship does this action indicate?

Termination phase When the nurse ends the relationship with a patient, it indicates the termination phase of the helping relationship. This phase may involve the nurse and the patient reminiscing about their relationship. The working phase involves taking actions to meet the goals set for the patient. The nurse sets the tone for the relationship by adopting a warm, empathetic, caring manner during the orientation phase. The preinteraction phase involves the nurse's initial interaction with the patient. pg 323

While interacting with a patient, the nurse sits and faces the patient and listens attentively. What does this posture toward the patient convey?

The nurse is interested in what the patient is saying. Sitting and facing the patient and listening attentively conveys that the nurse is interested in what the patient is saying. When the nurse is leaning toward the patient and listening to the conversation, it conveys that the nurse is involved in the interaction. When the nurse is relaxed, it conveys that the nurse is comfortable with patient. When the nurse maintains eye contact with the patient, it conveys that the nurse is willing to listen to what the patient is saying. p. 328

The nurse is interviewing a patient with cognitive impairment. Which strategy should the nurse avoid while communicating with this patient?

Use detailed explanations while asking questions to help the patient understand. The nurse should use simple sentences and avoid long explanations while communicating with patients who are cognitively impaired. Giving sufficient time to the patient to answer a question is an appropriate strategy in communicating with patients who are cognitively impaired. Using pictures or gestures that resemble the desired action and involving a family member in conversation while providing counseling are also the effective strategies for communicating. p. 333

Which special zone of touch requires special care?

Vulnerable zone

The nurse is assessing four patients with different symptoms. Which patient is most likely to challenge the nurse's decision-making skills and call for careful use of therapeutic communication techniques?

pt 1 Patient 1's symptoms and behavior indicate depression. The nurse would likely face challenges in decision-making and need to be careful while using therapeutic techniques with this patient. A physically challenged patient would not necessarily present a challenge for the nurse while communicating. There is nothing to suggest that patient 3, who communicates only in English, would present difficulty communicating with the nurse. Likewise, there is no indication that patient 4, who notices the outfit, shoes, accessories, body language, and makeup of others, would present communication challenges for the nurse. p. 319