NSG 203 Ch.5

Which nursing role is primarily performed during the working phase of the helping relationship? a) Researcher b) Leader c) Manager d) Educator

d) Educator

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? a) Orientation phase b) Termination phase c) All of the above d) Working phase

a) Orientation phase

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 she has not performed wound care on a complex wound in the past. Using effective intrapersonal communication, this nurse should: a) tell herself to "remain calm" and remember that she was trained to perform this skill. b) inform the client that several nurses will be needed to care for this wound. c) ask the charge nurse to change her assignment. d) tell the unlicensed assistive personnel (UAP) to gather supplies and to prepare to cleanse and dress the wound.

a) tell herself to "remain calm" and remember that she was trained to perform this skill.

A nurse is asking a colleague about a situation. Which statement demonstrates assertive communication? a) "You always act like this." b) "I think there is a better way to handle this." c) "What is your problem with me?" d) "Why are you treating me this way?"

b) "I think there is a better way to handle this."

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? a) "Were these term births?" b) "I understand you have four kids; how many times have you actually been pregnant?" c) "How old are your children?" d) "All right, you have four children, is that correct?"

b) "I understand you have four kids; how many times have you actually been pregnant?"

Which best describes an element of the nurse-client relationship? a) conversation for mutual companionship, enjoyment and interaction b) The nurse self-discloses only what is necessary for the client's benefit. c) a conversation with the goal of forming a more intimate relationship d) sharing of life events and activities

b) The nurse self-discloses only what is necessary for the client's benefit.

During an admission intake assessment, a nurse uses open-ended questions to gather information. An example of an open-ended question is: a) "Can you tell me the medications you take on a daily basis?" b) "Are you allergic to any medications?" c) "Do you have and advanced directive or a living will?" d) "Can you tell me why your physician sent you here to be admitted?"

d) "Can you tell me why your physician sent you here to be admitted?"

A nurse is at the end of a busy shift on a medical-surgical unit. The nurse enters a room to empty the client's urinary catheter and the client says, "I feel like you ignored me today." In response to the statement, the nurse should: a) inform the client that the unit was very busy that day. b) smile at the client and apologize. c) ignore the statement and empty the urinary catheter. d) sit at the bedside and allow the client to explain the statement.

d) sit at the bedside and allow the client to explain the statement.

A nurse is caring for a client who is in delirium. The client tells the nurse that there are spiders on the wall and all over the room. What is the most appropriate response by the nurse to the client? a) "I know that you are frightened, but there are no spiders on the wall." b) "Do you want me to kill the spiders that are crawling on the wall?" c) "You are having a hallucination; there are no spiders on the wall." d) "I can see the spiders, but they are not going to harm you."

a) "I know that you are frightened, but there are no spiders on the wall."

A nursing instructor is discussing differences between nurse-client relationships and social relationships with a group of nursing students. Which statement is a characteristic of a person-centered or helping relationship? a) A person-centered or helping relationship is characterized by an unequal sharing of information. b) The person being helped in the person-centered or helping relationship is accountable for the outcomes of the relationship. c) A person-centered or helping relationship occurs spontaneously with random individuals. d) A person-centered or helping relationship is built on the needs of the helping person.

a) A person-centered or helping relationship is characterized by an unequal sharing of information. Explanation: A helping relationship is characterized by an unequal sharing of information. The client shares information related to personal health problems, and the nurse shares information in terms of a professional role. The helping relationship does not occur spontaneously and occurs for a specific purpose, with a specific person, and for a specific period of time. The person providing the assistance is professionally accountable for the outcomes of the relationship, and the relationship is built on the needs of the person being helped.

The nurse has engaged the services of an interpreter when interviewing a client who speaks a language that the nurse does not understand. The interpreter is functioning in which role during the communication process? a) Communication channel b) Sender c) Encoder d) Receiver

a) Communication channel

A student nurse is attempting to improve her communication skills. Which therapeutic communication skill is appropriate? a) Control the tone of the voice to avoid hidden messages. b) Use cliches to enhance a client's understanding of information. c) Be precise and inflexible regarding the intent of the conversation. d) Avoid the use of periods of silence.

a) Control the tone of the voice to avoid hidden messages.

Select all answer choices that apply. Which of the following are examples of nonprofessional involvement? (Select all that apply.) a) Discussing your recent breakup with your boyfriend with a patient who is also going through a difficult breakup. b) Asking a patient in hospice care to describe their relationship with various family members. c) Asking a patient if they would like to go out for dinner after they are discharged. d) Discussing today's weather forecast.

a) Discussing your recent breakup with your boyfriend with a patient who is also going through a difficult breakup. c) Asking a patient if they would like to go out for dinner after they are discharged.

Select all that apply Nurses on a hospital burn unit meet as a group to discuss procedures. Which statements accurately describe the functions of group dynamics? Select all that apply. a) If a group member dominates or thwarts the group process, the leader or other group members must confront her to promote the needed collegial relationship. b) In an effective group, power is used to "fix" immediate problems without considering the needs of the powerless. c) In an effective group, members support, praise, and critique one another. d) Effective groups possess members who elicit mutually respectful relationships. e) Ideally, the group will select a leader who alone uses her talents and interpersonal strengths to assist the group to accomplish goals. f) The group's ability to function at a high level depends on only the group leader's sensitivity to the needs of the group and its individual members.

a) If a group member dominates or thwarts the group process, the leader or other group members must confront her to promote the needed collegial relationship. c) In an effective group, members support, praise, and critique one another. d) Effective groups possess members who elicit mutually respectful relationships.

Select all answer choices that apply. A nurse is communicating the plan of care for a client who is unconscious. Which nursing actions best facilitate this process? Select all that apply. a) The nurse assumes the client can hear and discusses things that would ordinarily be discussed. b) The nurse raises environmental noises to help stimulate the client. c) The nurse does not use touch to communicate with the client. d) The nurse speaks with the client before touching him. e) The nurse is careful what is said in the client's presence since hearing is the last sense to go. f) The nurse speaks to the client in a louder than normal voice.

a) The nurse assumes the client can hear and discusses things that would ordinarily be discussed. d) The nurse speaks with the client before touching him. e) The nurse is careful what is said in the client's presence since hearing is the last sense to go.

A nurse is preparing to provide discharge instructions to a postpartum client regarding infant care. Before beginning the education session, the nurse should: a) eliminate as many distractions as possible. b) ask all visitors to leave the room. c) ask the client if she is able to read. d) ask the client's partner to leave the room to allow the client to focus.

a) eliminate as many distractions as possible.

A unit-based infection control task force was developed in an attempt to reduce catheter-acquired infections. The group consists of 10 team members. During the past three meetings, one person dominated the meeting and did not allow other members ample time to speak. The best way to address the team dysfunction is to: a) have group members confront the dominant member to promote the needed team work. b) pick a team leader who is not the dominant member. c) have group members issue a written warning to the dominant member. d) plan a meeting where the dominant person cannot attend.

a) have group members confront the dominant member to promote the needed team work.

Which action by the nurse will facilitate the nurse-client relationship during the orientation phase? a) introducing oneself to the client by name b) preparing for termination of the relationship c) providing assistance to meet activities of daily living d) designing a specific education plan of care

a) introducing oneself to the client by name

Several nurses on the same hospital unit communicate on the same social networking site. A nurse posts the following statement to the social networking page, "The lady in room 34 with heart failure was a train wreck!" This statement: a) is unacceptable and breaches the client's confidentiality rights. b) is acceptable because the client's name was not used. c) is unacceptable because the diagnosis of heart failure was listed. d) is acceptable because the hospital's name was not mentioned.

a) is unacceptable and breaches the client's confidentiality rights.

What is the goal of the nurse in a helping relationship with a client? a) to assist the client to identify and achieve goals b) to provide hands-on physical care c) to facilitate the client's interactions with others d) to ensure safety while caring for the client

a) to assist the client to identify and achieve goals

The nurse is caring for a client who speaks Chinese, and the nurse does not speak Chinese. An appropriate approach for communication with this client includes: a) using a caring voice and repeating messages frequently. b) writing messages for the client and offering him a dictionary for translation. c) avoiding the use of gestures or play-acting. d) speaking directly and loudly to the client.

a) using a caring voice and repeating messages frequently.

A newly graduated nurse tells the charge nurse about difficulty obtaining the client's cooperation in his care. What would be the charge nurse's most appropriate response? a) "The best way to obtain your client's cooperation is by following strict agency protocol." b) "The best way to obtain your client's cooperation is by first obtaining your client's trust." c) "The best way to obtain your client's cooperation is by being very firm with your instructions." d) "The best way to obtain your client's cooperation is by always maintaining a professional distance."

b) "The best way to obtain your client's cooperation is by first obtaining your client's trust."

A nurse is having problems communicating with a client. Which statement by the nurse would open up the most dialogue with the client? a) "Do you have pain when I move your arm this way? b) "You are back from therapy; tell me about it." c) "Would you like to get out of bed?" d) "Would you like an iced tea or juice with lunch?"

b) "You are back from therapy; tell me about it."

The nurse has entered a client's room and observes that the client is hunched over and appears to be breathing rapidly. What type of question should the nurse first implement in this interaction? a) A reflective question b) A yes/no question c) A directing question d) An open-ended question

b) A yes/no question

The nurse interviews a client during which step of the nursing process? a) Diagnosing b) Assessment c) Evaluation d) Planning

b) Assessment

Which qualities in a nurse help the nurse to become effective in providing for a client's needs while remaining compassionately detached? a) Kindness b) Empathy c) Sympathy d) Commiseration

b) Empathy

A nurse has been caring for a client who suffered a myocardial infarction 2 days ago. During the morning assessment, the nurse asks the client how he feels. Which scenario warrants further investigation? a) The client is sitting in a chair and states, "I feel a lot better than I did yesterday. b) The client stares at the floor and states, "I feel fine." c) The client looks at the nurse and states, "I am still not feeling my best." d) The client smiles at the nurse and states, "I cannot wait to go home."

b) The client stares at the floor and states, "I feel fine."

The nurse has entered a client's room after receiving a morning report. The nurse rapidly assessed the client's airway, breathing, and circulation and greeted the client by saying "Good morning." The client has made no reciprocal response to the nurse. How should the nurse best respond to the client's silence? a) The nurse should document the client's withdrawal and diminished mood in the nurse's notes. b) The nurse should ask appropriate questions to understand the reasons for the client's silence. c) The nurse should ask the client if he feels afraid or angry. d) The nurse should apologize for bothering the client, perform necessary assessments efficiently, and leave the room.

b) The nurse should ask appropriate questions to understand the reasons for the client's silence.

Which technique would a nurse employ when using listening skills appropriately? a) The nurse would stand close to the client and maintain eye contact. b) The nurse would listen to the themes in the client's comments. c) The nurse would not allow conversation to lapse into periods of silence. d) The nurse would try to avoid body gestures when listening to the client.

b) The nurse would listen to the themes in the client's comments. Explanation: The technique that a nurse would employ when using listening skills would be to listen to the themes in the client's comments. The nurse would not stand close to the client and maintain eye contact in all situations of listening. The nurse would possibly use positive body gestures and nonverbal communication when listening. The nurse could use periods of silence in therapeutic communication to allow the client to reflect

A nurse is caring for an older adult client. What strategy should the nurse include in order to facilitate effective communication? a) Use an authoritarian approach toward the client. b) Use active listening during communication. c) React only to the facts during conversation. d) React enthusiastically during conversation.

b) Use active listening during communication.

A pregnant female 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 on the study. When the nurse observes the client's facial expression, she is: a) identifying desired outcomes and a plan to meet them. b) evaluating the client's nonverbal response to the findings. c) gathering information necessary to treat the client. d) implementing the plan of care.

b) evaluating the client's nonverbal response to the findings.

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 abuser. To foster effective communication, the nurse should: a) consult with the social worker regarding inpatient drug rehabilitation. b) remain honest, open, and frank. c) ask the client for a urine specimen for urine drug abuse screening. d) ask if the client realizes the infection is a direct result of the drug abuse.

b) remain honest, open, and frank.

A 36-year-old client who underwent a hysterectomy 4 days ago says to the nurse, "I wonder if I'll still feel like a woman." Which response would Smost likely encourage the client to expand on this and express her concerns in more specific terms? a) "When did you begin to wonder about this?" b) "Do you want more children?" c) "Feel like a woman . . ." d) Remaining silent

c) "Feel like a woman . . ." Explanation: The best response of the options listed is the statement "Feel like a woman..." This response is a reflective comment, which allows the client to reflect and elaborate on her feelings. Remaining silent is a skill that is appropriate many times, but not the most appropriate in the situation at hand. Asking a yes/no question such as "Do you want more children?" does not encourage the client to reflect and elaborate on her feelings. The question "When did you begin to wonder about this?" does not direct the client in a direction for more reflection on her feelings.

A client comes into the urgent care center to have sutures removed on his right arm. The nurse assesses the sutures and finds significant crusting along the suture line. The client indicates he didn't have time to get his 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 his arm away and tells the nurse, "you do not know what you are doing." In response, the nurse should answer: a) "I am sorry this is hurting you but you are hurting my feelings." b) "You are the cause of the problem here. I do not have to tolerate this behavior and you are free to leave." c) "Sir, I understand this is uncomfortable but I assure you I am experienced with this task and would like to continue." d) "How would you know if I know what I am doing or not?"

c) "Sir, I understand this is uncomfortable but I assure you I am experienced with this task and would like to continue."

A nurse pays a house visit to a client who is on parenteral nutrition (PN). The client expresses that he misses enjoying food with his family. What is the most appropriate response by the nurse? a) "You can sit with your family at meal times, even though you don't eat." b) "I know that you must be missing your favorite foods." c) "Tell me more about how it feels to eat with your family." d) "In a few weeks you may be allowed to eat a little; you may enjoy then."

c) "Tell me more about how it feels to eat with your family." Explanation: The nurse should help the client to verbalize his feelings and cope with aspects of illness and treatment. Asking open-ended questions is most appropriate as the nurse encourages the client to express his feelings. The other options block communication and are not appropriate. Telling the client that he can sit with his family but must avoid eating does not consider the client's feelings. Informing the client that he will be able to eat food in a few weeks changes the subject and stops communication. Stating that the client is missing his favorite dishes devalues the client's feelings.

The nurse is conducting an assessment on a client and identifies a need for an interpreter. Which of the following is the best choice for an interpreter?" a) A fellow nurse who knows a few words of Spanish b) A family member c) A professional interpreter d) A friend who speaks both languages

c) A professional interpreter

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? a) Indifference b) Sympathy c) Empathy d) Pity

c) Empathy

A nurse is caring for a terminally ill client whose death is imminent. The nurse has developed a close relationship with the family. Which intervention is most appropriate? a) Tell the family to leave the client alone. b) Remain with the family but maintain silence. c) Encourage family discussions of feelings. d) Make decisions for the family in difficult situations.

c) Encourage family discussions of feelings.

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? a) Small-group b) Intrapersonal c) Interpersonal d) Organizational

c) Interpersonal Explanation: 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

A male client has always prided himself in maintaining good health and is consequently shocked at his recent diagnosis of diabetes. The nurse has asked the client, "How do you think your diabetes is going to affect your lifestyle?" The nurse has utilized which of the following interviewing techniques? a) Reflective question b) Closed question c) Open-ended question d) Validating question

c) Open-ended question

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: a) assertive. b) passive. c) aggressive. d) nurturing.

c) aggressive.

An evening shift nurse is caring for a client scheduled for a colon resection in the morning. The client tells the nurse she is afraid of waking up during surgery. The best response by the nurse is to: a) state "everyone is afraid of that." b) look directly at the client and state, "you are afraid of waking up during surgery." c) ask the client why she thinks she will wake up during surgery. d) ask the surgeon to come to the bedside to reassure the client.

c) ask the client why she thinks she will wake up during surgery.

An older adult client is advised to undergo a 12-lead ECG assessment. The client seems to be anxious because this is the first time he is undergoing such a procedure. What explanation should the nurse provide to the client? a) "You should lie still when the ECG is recorded; otherwise, the recording may be wrong." b) "Try not to be anxious; the test will give information about your heart to the doctor to guide treatment." c) "The procedure is of very short duration; it will take only 20 minutes to finish." d) "The ECG electrodes are painless and will record electrical activity of the heart."

d) "The ECG electrodes are painless and will record electrical activity of the heart."

A nurse is attempting to complete an admission database. While taking the history, the nurse notices the client appears uncomfortable and slightly tachypneic. The nurse should: a) tell the client to rest and allow a family member to answer. b) ask questions as quickly as possible. c) use only open-ended questions. d) allow the client to set the pace.

d) allow the client to set the pace.

Each of the following facilitates a therapeutic nurse-client relationship except: a) reflection. b) rephrasing. c) active listening. d) closed-ended questions.

d) closed-ended questions.

The client is an 18-month-old in the pediatric intensive care unit. He is scheduled to have a subgaleal shunt placed tomorrow, and his mother is quite nervous about the procedure. The nurse feels for the mother and tells her that the surgeon "has done this a million times. Your son will be fine." This is an example of what type of nontherapeutic communication? a) rescue feelings b) being moralistic c) giving advice d) false reassurance

d) false reassurance

A nurse is providing care to a 3-year-old child admitted with a diagnosis of infectious diarrhea. The nurse needs to insert an intravenous catheter in order to administer prescribed intravenous fluids. In an attempt to foster communication, the nurse should: a) ask the child's parents to leave the room while the nurse and child talk. b) provide both verbal and written information to the child. c) show the child the intravenous catheter and explain how it works. d) involve the child's stuffed animal in the educational session.

d) involve the child's stuffed animal in the educational session.

A nurse is attempting to calm an infant in the nursery. The nurse responds to the highest developed sense by: a) offering the neonate infant formula. b) softly humming a song near the neonate. c) staring into the neonate's eyes and smiling. d) swaddling the child and gently stroking its head.

d) swaddling the child and gently stroking its head. Explanation: Touch is the most highly developed sense at birth. Tactile experiences of infants and young children appear essential for the normal development of self and awareness of others. It has also been found that many older people long for touch, especially when isolated from loved ones because of hospitalization or long-term care facility care. Vision, taste, and hearing are not as fully developed as touch in the neonate