NRS. 200 Chapter 8 PrepU
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.
A nurse and an older adult client with chronic back pain are beginning to communicate. What activity should the nurse focus on at this point?
Being sensitive to the client's emotional barriers
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
The nurse cares for a client who is sharing a personal health story. Which behavior(s) demonstrates active listening? Select all that apply.
The nurse makes eye contact while the client is sharing a personal story. The nurse observes the nonverbal behavior of the client as the client speaks. The nurse paraphrases what the client has stated before generating a response.
A dialysis nurse is educating a client on caring for the dialysis access that was inserted into the client's right arm. The nurse assesses the client's fears and concerns related to dialysis, the dialysis access, and care of the access. This information is taught over several sessions during the course of the client's hospitalization. Which phase of the working relationship is best described in this scenario?
The working phase
When communicating with a client, the nurse uses reflection for which purpose?
To have the client elaborate on thoughts and feelings
A nurse is on lunch break in the hospital cafeteria and sits at a table near a group of health care providers eating their lunch. One of the health care providers, who is in charge of the nurse's clients, points at the nurse and states, "That guy needs to get fired." The best response by the nurse would be to:
ask to speak to the health care provider in private and address the disrespectful remark.
The nurse is caring for a postoperative client who refuses a blood transfusion due to religious beliefs. The nurse is demonstrating trustworthiness when taking which action in response to the client's treatment wishes?
contacting the interprofessional care team to discuss alternative treatment options
A nurse is preparing to enter a client's room to perform wound care. The shift report revealed that this client has a tunneling wound in the sacral area that cannot be staged. The wound was also documented as having a foul odor. The nurse is nervous because the nurse has not often performed wound care on a complex wound. Using effective intrapersonal communication, this nurse should:
tell oneself to "remain calm" and remember that the nurse was trained to perform this skill.
A nurse is caring for a client who is newly diagnosed with terminal cancer. The nurse enters the client's room and finds the client sitting in the dark crying. Which statement conveys empathy by the nurse?
"I know this is hard for you. Is there any way I can help?"
The nurse is caring for a client who is being treated following a drug overdose. The client states, "My life is over, I cannot stop using heroin." Which statement would the nurse employ to strengthen the nurse-client relationship?
"Perhaps we can talk about your feelings some more."
Which is a skill appropriate to use in therapeutic communication?
Control the tone of the voice to avoid hidden messages
A nurse who is preparing to administer an injection to the client states, "This injection will not be painful." The nurse has used which communication technique?
Giving false reassurance
Which guideline should a nurse use when choosing a position (location) in relation to a client during a verbal interaction?
Take note of the client's cues when choosing a position and act on these cues.
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 dynamic A helping relationship is purposeful and time limited
Each facilitates a therapeutic nurse-client relationship except:
closed-ended questions
A nurse is attempting to calm an infant in the nursery. The nurse responds to the highest developed sense by:
swaddling the child and gently stroking its head.
The nurse is performing an admission interview with a new client diagnosed with acute coronary syndrome. For the nurse to obtain information and allow the client free verbalization, which question would elicit the most information?
"Could you tell me more about how you are feeling right now?"
A nurse is obtaining a history from an adult female client. When the nurse asks how many times the client has been pregnant, the client answers, "I have four kids." Which statement, made by the nurse, seeks clarification of the original question?
"I understand you have four kids; how many times have you actually been pregnant?"
A nurse is completing a health history with a client being admitted for a mastectomy. During the interview the client states, "I do not know what to do. I am not sure if I really need this surgery." Which response by the nurse demonstrates active listening?
"You seem unsure. Tell me your concerns about your surgery."
What nursing care behavior by the nurse engenders a client's trust in the nurse?
A nurse answers the client's questions about an upcoming test in a calm gentle voice while making eye contact with the client.
Which nurse would most likely be the best communicator?
A nurse who easily develops a rapport with clients
A client, who was recently diagnosed with diabetes, has been coming to the emergency room every day for hyperglycemia. The client reports not being able to self-administer insulin injections. What strategy would best educate the client and improve the client's ability to self-administer insulin?
Demonstrate the proper method and have the client mimic the demonstration.
The nurse is providing care to an older adult client who has visual and hearing deficits. What action by the nurse is appropriate to help with communication?
Identify oneself by name and title with each entry into the client's room.
The nurse observing an interaction between a mother and her child appropriately identifies the interaction as which communication zone?
Intimate
A home care nurse discusses with a client when visits will occur and how long they will last. In what phase of the nurse-client relationship is this type of agreement established?
Orientation phase
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.
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."
The nurse is caring for a client at the end stage of life. The client is crying and states to the nurse, "I just cannot believe I am going to be leaving my children without a parent. I am not ready to go." What response by the nurse demonstrates the expression of empathy to the client?
"It sounds as though you are most concerned about how your children will feel."
A pregnant client presents to the emergency department with vaginal bleeding. A transvaginal ultrasound is performed, and the health care provider informs the client that there are normal fetal heart tones noted. The client begins to tear-up and has a worried appearance. To facilitate therapeutic communication, what statement would the nurse make after observing the client's nonverbal communication?
"Take your time and tell me how you are feeling. I have plenty of time to answer your questions and discuss any thoughts or feelings with you."
Which characteristics would indicate a professional relationship? Select all that apply.
An emphasis on addressing the client's needs in the current situation The relationship ending with goal achievement
A family has lost a member who was treated for leukemia at a nursing unit. The nurse provides emotional support to the family and counsels them to cope with their loss. Which quality should the nurse use in this situation?
Empathy
The nurse is communicating with a client who begins to cry. The nurse places a hand on the client's arm and sits quietly at the client's beside. What mode of communication is the nurse using to offer caring and comfort for the client?
Kinesthetic
The nurse will be caring a client who will soon be admitted to the medical unit. The nurse should establish a working relationship and discuss how communication will take place during what phase of the nurse-client relationship?
Orientation phase
A nurse who has been caring for a client for the past few days is preparing the client for discharge and termination of the nurse-client relationship. Which activity would the nurse be carrying out during this phase of the relationship?
Reviewing health changes
To provide effective nursing care, the nurse should engage in what type of communication with the client and significant others?
Therapeutic communication
A nurse suspects that a client may have a hearing problem. The nurse should attempt to consult:
an audiologist
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?"
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
