Communication

A nurse is assessing a client who came to the emergency department reporting chest pain. The client tells the nurse they have hearing loss and forgot to bring their hearing aid with them. Which of the following actions should the nurse take to improve communication with the client? (Select all that apply.)

Move the client to a quiet area or private room is correct. The nurse should reduce environmental noise as much as possible to enhance communication with this client. Speak at a slower pace is correct. Speaking at a slower pace might help the client to be able to better understand and communicate with the nurse. Avoid using medical terminology is correct. The nurse should avoid using medical terminology. These words are unfamiliar and can impede communication with all clients.

A nurse is caring for a client who has a new prescription for dialysis three times a week. The client avoids eye contact while talking to the nurse and explains that they work two jobs to support their partner and two children. The client also states, "I don't know how I am going to have time for dialysis." Which of the following factors are influencing the client's communication? (Select all that apply.)

Psychosocial factors is correct. The nurse should recognize that psychosocial factors are influencing communication with the client. Psychosocial factors include the client's financial situation. The client is working two jobs and going to dialysis appointments twice a week, which might require them to miss work time and pay. Furthermore, the client is the only income for this household. Situational factors is correct. The nurse should recognize situational factors, such as the new prescription for dialysis, influencing the communication with the client. Situational factors that can affect communication cause emotions including fatigue, anxiety, grief, and fear. This client's verbal and nonverbal communication are indicators of worry, anxiety, sadness, and grief.

A nurse is planning to reconcile medications for a client who speaks a different language than the nurse. Which of the following actions should the nurse take?

Request assistance from the facility's interpreter. The nurse should request a facility-approved interpreter to assist with the communication barrier. This would also ensure that the information is correct and gives both the nurse and client an opportunity to ask questions.

A nurse in the PACU is determining if a client has pain. The client is drowsy and opens their eyes to verbal stimuli but is unable to communicate their pain level. Which of the following actions should the nurse take?

Use an alternative method for determining the client's pain level. Medications such as general anesthesia can cause cognitive deficits that could make it difficult for the client to communicate their needs. The nurse should use an alternative method for determining the client's pain level by observing facial expressions (grimacing or clenching of the teeth); body movements, including restlessness, muscle tension, or resisting movement; and vocalizing discomfort by moaning, grunting, or crying.

A nurse in a provider's office is caring for a client who has hypertension during a follow-up appointment and is focusing on the client's ability to make healthy behavior changes. Which of the following statements by the nurse is an example of the use of affirmations?

"I'm glad you decided to continue your fitness routine." This statement by the nurse builds the client's confidence and acknowledges the client's efforts to make positive changes. It is an example of the use of affirmations to acknowledge the client's efforts to make healthy behavior changes.

A nurse is planning teaching for a client about wound care. Which of the following actions should the nurse take?

Ensure the client is wearing their glasses during teaching. The nurse should take steps to facilitate learning, such as ensuring the client's assistive devices, including eyeglasses or hearing aids, are being used.

A nurse is caring for a client who has dementia. Which of the following communication strategies should the nurse implement to communicate with the client?

Speak to the client clearly and at a slow pace. The nurse should speak to the client who has cognitive or developmental delays clearly and at a slower pace. The nurse should also avoid the use of complicated terms or medical terminology.

A nurse calls the unit to tell say that they will be late for their shift. The charge nurse responds, "Don't worry, take your time and be safe." After hanging up the phone, the charge nurse then says to staff at the nurses' station, "I'm tired of that nurse always being late. I wish someone would do something about their tardiness." Which of the following communication styles is the charge nurse demonstrating?

Passive-aggressive During the phone call while talking with the oncoming nurse, the charge nurse was pleasant and accepting that the nurse would be late. However, once the phone call ended, the charge nurse then complained about the nurse always being late to the other staff. The charge nurse exhibited a passive-aggressive style of communication.

A hospice nurse is caring for a client who states that they want to have their last rites before they die. The nurse recognizes that which of the following factors is influencing the client's request?

Cultural factor Death-related rituals might be very closely tied to cultural factors such as religion. The nurse should recognize that this client is expressing a death ritual of the last rites, which is associated with Catholicism.

A nurse is planning a presentation about skin care for a group of older adult clients at a senior center. Which of the following actions should the nurse take to enhance client learning?

Ensure the room is well lit. The nurse should identify that a well-lit room can allow the participants to better see the presentation as well as the nurse during the teaching.

A nurse is planning to teach new assistive personnel (AP) how to use a bedside glucose monitor to check a client's blood glucose level. The nurse will include a 30-min face-to-face lecture and a written copy of the step-by-step procedure. Which of the following modes of communication is the nurse using in the teaching plan? (Select all that apply.)

Verbal is correct. The nurse planned on teaching in a face-to-face presentation of the information. The verbal mode of communication occurs during face-to-face communication between the sender (the nurse) and the receiver (the APs). It can also occur during a telephone call. Written is correct. The written mode of communication is any form of communication in which the receiver reads the message from the sender. The nurse plans to use both face-to-face verbal communication and a written mode of communication. Nonverbal is correct. The nonverbal mode of communication is comprised of body language. Actions such as eye contact, facial gestures, posture, and overall appearance all send messages to the receiver in addition to what the sender is saying. The nurse will be sending and receiving messages with the AP as they deliver the verbal information in a face-to-face environment.

A nurse receives a phone call from a client who was discharged yesterday. The client asks the nurse to email them a copy of their discharge instructions. Which of the following responses should the nurse make?

"I am unable to send your discharge instructions via email due to the HIPAA Privacy Act." The HIPPA Privacy Act consists of rules that govern the protection of the client's protected health information (PHI). The use of emails, texting, and faxing must occur with equipment and communication lines that are secure and encrypted. All electronic communication of PHI must have these safeguards in place. Sending the discharge instructions to a personal email outside the facility would breach this law.

A nurse is obtaining a health history from a client who is newly admitted. The nurse notices that the client does not make eye contact and that their arms are folded across their chest. The nurse should recognize that the client is using which of the following forms of communication?

Nonverbal The nurse should recognize the client is exhibiting nonverbal communication through their physical gestures. Nonverbal communication, also known as body language, plays an important role in interactions among nurses, clients, and their families. For instance, not making eye contact, not being engaged in the conversation, or having closed posture (folded arms, slouching) can portray a negative message.

A nurse manager is planning to introduce a new scheduling policy to the unit staff. Which of the following methods of communication should the nurse manager use?

Schedule a face-to-face unit staff meeting. In-person communication of this important policy would permit for both verbal and nonverbal modes of communication between the sender (the nurse manager) and the receiver (the unit staff).

A nurse is instructing a client regarding heart-healthy activities. This action represents which of the following phases of the nurse-client relationship?

Exploitation The nurse is actively coaching the client toward a healthier lifestyle.

A nurse enters a client's room and stands near the client to ask them if they need anything. The client continues to watch the television, which is at a loud volume. Which of the following actions should the nurse take?

Lower the volume on the television. The nurse should minimize the noise in the environment by decreasing the volume on the television when communicating with the client. Auditory communication is what the receiver hears when the sender speaks a message. It can be affected by environmental noise. The loud television presents a barrier to communication and the nurse should reduce the environmental noise.

A nurse is teaching a client who is newly diagnosed with diabetes mellitus. The client tells the nurse, "Thank you. I never really knew what caused diabetes." Using the Schramm model of communication, the nurse should recognize the client's statement as an example of which of following components of the model?

Feedback In the Schramm model, one of the three components is feedback. Feedback is demonstrated when the receiver is allowed to let the sender know that the message was properly received.

A nurse is preparing to provide education to a group of newly licensed nurses about methods to enhance communication with clients. Which of the following statements should the nurse include? (Select all that apply.)

"Respect the client during the conversation" is correct. The nurse should respect the client during the conversation to enhance communication. "Allow time for reflection during the conversation with the client" is correct. The nurse should allow time for reflection. This would enhance communication with the client. "Show empathy during the conversation with the client" is correct. Showing empathy during the conversation enhances communication with the client.

A nurse is conducting a preoperative assessment of a client. Which of the following statements is an example of the nurse using motivational interviewing?

"You said that you're sad. What is making you feel sad?" Motivational interviewing uses OARS (open-ended questions, affirmations, reflective listening, summarizing), which includes open-ended questions. This is an example of an open-ended question because it requires more than a yes or no answer.

A nurse is caring for a client who has refused to have a biopsy. The client states, "I don't need the biopsy; I wouldn't do anything about it anyways if it's cancer." The nurse replies, "You don't want to have the biopsy because you would not seek treatment if it was cancer. Is that correct?" Which of the following therapeutic communication techniques is the nurse using?

Restating The nurse is summarizing, paraphrasing, or restating the client's thoughts to confirm the nurse understands what the client is attempting to communicate.

A nurse is providing discharge instructions to a client during a follow-up telephone call. Based on the Shannon-Weaver communication model, which of the following components of the model is the nurse demonstrating?

Sender The nurse is initiating the message; therefore, the nurse is the sender.