NURS 101 final communication powerpoint info, PREPU & glossary

In a nursing unit, the RN delegates nursing tasks to the nursing assistant. Keeping in mind the delegation guidelines, which of the following statements denotes the right direction for the nursing assistant? a. "Check the infusion rate." b. "Discontinue the IV solution." c. "Inspect the site for thrombophlebitis." d. "Dispose of the disconnected IV set."

d. "Dispose of the disconnected IV set."

incivility:

rude, intimidating, and undesirable behavior directed at another person

The nurse is caring for a very ill child with a large extended family. Members of the family repeatedly ask the same questions of the nurse and other healthcare team members. To effectively manage the accurate dissemination of information, which of the following should be the priority action by the nurse? a. Ask the family to identify a spokesperson to be the communicator with the team. b. Review policies to see who should be informed of the child's treatment plans. c. Ask team members to share information with the nurse instead of the family. d. Inform team members that only the parents should receive information.

a. Ask the family to identify a spokesperson to be the communicator with the team.

A psychiatric mental health facility is undergoing a change from paper-based health records to electronic records. What action should the nurse prioritize in order to ensure client rights are protected? a. Being vigilant to identify any potential threats to client confidentiality b. Educating clients and families about the potential benefits of the new system c. Teaching clients that they may lose the right to view their health records under the new system d. Ensuring clients know that they have the right to opt out of the proposed system

a. Being vigilant to identify any potential threats to client confidentiality

A woman has come to the clinic for her first prenatal visit. Which method would be the most effective way for the nurse to initiate data gathering for a health history? a. Conduct an interview in a private room to obtain her health history. b. Ask her some basic questions in the waiting room before taking her to the examining room. c. Wait until she is in the examining room and prepared for her physical examination. d. Ask her to complete a written questionnaire concerning her past and present status.

a. Conduct an interview in a private room to obtain her health history.

While caring for a client who has a problem related to digestion, a nurse has been referred by the primary care provider to be seen by a gastroenterologist. Which of the following parts of the client record should the nurse look at to see the recommendations made by the gastrointestinal specialist? a. Consultation b. Progress notes c. Laboratory reports d. Medical history

a. Consultation

A Spanish-speaking client is admitted to the Emergency Department with a urinary tract infection and is experiencing a stress response from hospitalization. What is the priority nursing intervention? a. Contact a translator. b. Collect a urine specimen. c. Administer broad-spectrum antibiotic. d. Begin taking a client history.

a. Contact a translator.

A nurse manager and the charge nurse have two employees who disagree with the accomplishment of client care. The manager determines a mutually agreed-upon time to discuss this situation with all the members involved. This activity is called what? a. Client protection b. Conflict resolution c. Problem solving d. Delegation

b. Conflict resolution

Nursing students are learning about the importance of therapeutic communication in their pediatric course. The nursing instructor identifies a need for further teaching when a student makes which statement? a. "It is good to sit, not stand when listening." b. "It is best to stoop to a child's level when listening." c. "It is best to stand when listening to a child to demonstrate knowledge." d. "It is good to lean forward when listening."

c. "It is best to stand when listening to a child to demonstrate knowledge."

In which of the following situations would the SBAR technique of communication be most appropriate? a. A nurse is explaining the process of bone marrow biopsy to a client who is scheduled for the procedure. b. A nurse is teaching a client about the benefits of smoking cessation and the risks of continuing to smoke. c. A nurse is calling a physician to report a client's new onset of chest pain. d. A nurse is facilitating a family meeting in order to coordinate a client's discharge planning.

c. A nurse is calling a physician to report a client's new onset of chest pain.

A client has lost mobility following a stroke. The nurse has established interventions that include providing direct care to the client, teaching, making referrals, and managing the case, to meet the goal. The next step is to a. Assist the family in obtaining equipment that would help the client to walk. b. Refer the client to physical therapy for ambulation exercise two times a week. c. Plan with the client how to incorporate the regimen into the client's activities of daily living. d. Instruct the client what he or she must do.

c. Plan with the client how to incorporate the regimen into the client's activities of daily living.

SBAR:

consistent, clear, structured, and easy-to-use method of communication between health care personnel; it organizes communication by the categories of: Situation, Background, Assessment, and Recommendations.

Which statement should the nurse use to describe to the parents why their child with leukemia is at risk for infections? a. "Abnormal platelets lead to bruising and bleeding." b. "There are an insufficient number of circulating white cells " c. "The number of red blood cells is inadequate for carrying oxygen." d. "Immature white blood cells are incapable of handling an infectious process."

d. "Immature white blood cells are incapable of handling an infectious process."

A nurse is interviewing a client for possible depression. Which client statement would most likely reflect clinical depression? a. "I've been sleeping fairly decently over the last few weeks." b. "I've been feeling sad and down for the last couple of days." c. "I've been much more focused at work and at home lately." d. "My life is worthless, and I don't know why I'm here."

d. "My life is worthless, and I don't know why I'm here."

The nurse is caring for a client whose spouse wishes to see the electronic health record. What is the appropriate nursing response? a. "I am sorry I can't access that information." b. "Let me get that for you." c. "The provider will need to give permission for you to review." d. "Only authorized persons are allowed to access client records."

d. "Only authorized persons are allowed to access client records."

A client has not had a bowel movement for 2 days and is feeling uncomfortable. The physician writes an order that states, "laxative of choice." How should the nurse proceed with this order? a. Ask the client what type of laxative he/she would like to have. b. Ask the client if he/she would prefer to have an enema administered. c. Give mineral oil because it does not require a physician's order. d. Ask the physician to prescribe a specific laxative.

d. Ask the physician to prescribe a specific laxative.

The family members of a dying patient are finding it difficult to verbalize feelings and show tenderness for the dying person. Which of the following nursing interventions should a nurse perform in such situations? a. Be a silent observer and allow the patient to communicate with the family members. b. Encourage conversations on the impending death of the patient. c. Encourage the patient's family members to spend time with the patient. d. Encourage the family members to express their feelings and listen to them in their frank communication.

d. Encourage the family members to express their feelings and listen to them in their frank communication.

An obese client is undergoing abdominal surgery. During the procedure a surgical resident states, "The amount of fat we have to cut through is disgusting." What is the best response by the nurse? a. Report the resident to the attending surgeon. b. Discuss concerns regarding the comments with the charge nurse. c. Ignore the comment. d. Inform the resident that all communication needs to remain professional.

d. Inform the resident that all communication needs to remain professional.

The nurse is assessing a client for changes in health condition. After listening to the client's lungs for adventitious breath sounds, the nurse also checks the client's latest white blood count (WBC) lab value. The nurse is gathering which type of data when looking up the lab value? a. Secondary b. Primary c. Subjective d. Objective

d. Objective

communication:

process of sharing information; process of generating and transmitting meanings

Narrative notes:

progress notes written by nurses in a source-oriented record

When recording data regarding the client's health record, the nurse mentions the analysis of the subjective and objective data, in addition to detailing the plan for care of the client. Which of the following styles of documentation is the nurse implementing? a. SOAP charting b. FOCUS charting c. PIE charting d. Narrative charting

a. SOAP charting

The nurse has selected a nursing diagnosis of "Impaired Home Maintenance" for an older adult client. What assessment data would evidence this diagnosis? a. The nurse observes unsafe conditions in the client's home. b. The nurse observes that the client is confused. c. The client lives with several extended family members. d. The client dislikes cleaning the home.

a. The nurse observes unsafe conditions in the client's home.

A physician orders ampicillin, 500 mg by mouth every 6 hours. This medication order is an example of: a. a standing order. b. an as-needed order. c. a stat order. d. a single order.

a. a standing order.

Calling the client by name and spending time with the client are examples of what? a. Positive regard b. Acceptance c. Empathy d. Values

a. Positive regard

patient record:

a compilation of a patient's health information; the patient record is the only permanent legal document that details the nurse's interactions with the patient

Focus charting:

a documentation system that replaces the problem list with a focus column that incorporates many aspects of a patient and patient care; the focus may be a patient strength or a problem or need; the narrative portion of focus charting uses the data (D), action (A), response (R) format

hand-off

a nurse's report to another nurse or health care provider about a patient's status and progress

ISBAR communication

a process for effective hand-off communication among health care professionals about a patient's condition, standing for Identity/Introduction, Situation, Background, Assessment, Recommendation, and Read back

A nurse has engaged a translator to help in communicating with a Vietnamese client. When asking questions of the client and obtaining answers, the nurse should: a. look at the client while asking questions and carefully listen to the client's response. b. take careful notes as the translator speaks. c. make sure that a family member is present at all times. d. record each session to avoid any later confusion or disputes over what was said.

a. look at the client while asking questions and carefully listen to the client's response.

The psychiatric nurse correctly identifies the client's form of communication as circumstantiality when the client does what? a. Fails to complete what the client is saying as if distracted. b. Provides long, irrelevant explanations when asked why the client abuses alcohol. c. Answers the question, "May we talk?" by responding, "Walk the walk." d. Repeats the phrase, "Mary had a little lamb," whenever feeling stressed.

b. Provides long, irrelevant explanations when asked why the client abuses alcohol.

health information exchange (HIE)

an electronic system that allows physicians, nurses, pharmacists, other health care providers, and patients to appropriately access and securely share a patient's vital medical information

horizontal violence:

anger and aggressive behavior between nurses or nurse-to-nurse hostility

progress notes:

any of a variety of methods of notes that relate how a patient is progressing toward expected outcomes

A 15-year-old client with type 1 diabetes has been noncompliant with his dietary regimen. When educating the teen, what is the most important thing the nurse can do to allow the teen to be in control and involved in the decision-making process? a. Praise the client often. b. Speak directly to the teen and consider his input in the decisions about care and education. c. Provide information and allow the teen to process and ask questions. d. Offer choices whenever possible.

b. Speak directly to the teen and consider his input in the decisions about care and education.

The nurse is obtaining physician orders which include a pulse pressure. The nurse is most correct to report which of the following? a. The difference between an apical and radial pulse b. The difference between the systolic and diastolic pressure c. The difference between an upper extremity and lower extremity blood pressure d. The difference between the arterial and venous blood pressure

b. The difference between the systolic and diastolic pressure

A nurse is performing a psychosocial assessment of the client. Which questions asked by the nurse can be identified as open ended? Select all that apply. a. "Is there something wrong with you?" b. "How did your problems begin?" c. "How can we help you?" d. "When was your last visit in the psychiatric facility?" e. "Are you feeling better today?"

b. "How did your problems begin?" c. "How can we help you?"

A 70-year-old female client had a cholecystectomy four days ago. The client's daughter tells the nurse, "My mother seems confused today." Which question would be best for the nurse to ask in order to assess the client's orientation? a. "Are you in a hospital?" b. "What day of the week is it?" c. "Is today the first day of the month?" d. "Is your name Evelyn?"

b. "What day of the week is it?"

A nursing student is preparing a presentation on client records and documentation. What information should the student include in the presentation? a. Clients should keep the original record at home in a fire proof safe. b. Communication is the primary purpose of client records. c. Physicians will not review nurse's documentation in the client's record. d. Nurses should not document progress notes in a client's record.

b. Communication is the primary purpose of client records.

change-of-shift report:

communication method used by nurses who are completing care for a patient to transmit patient information to nurses who are about to assume responsibility for continuing care; may be exchanged verbally in a meeting or audiotaped

interviewing techniques:

communication skills specifically designed to gather and validate information

intrapersonal communication:

communication techniques or self-talk to enhance positive interaction with the patient and family

interpersonal communication:

communication that occurs between two or more people with a goal to exchange messages

While observing a group of 9-year-old children at school, the nurse is concerned that one of the children is not cognitively developing according the Piaget's stage of concrete-operational thought processes. With which activity is the nurse concerned? a. Enjoys math instruction and decides to join the math club b. Believed that not turning in homework on time was acceptable, but has since decided it is not acceptable c. Arrives to class late from recess and apologizes to the teacher d. Does not understand the phrase "slow as molasses" when used by the teacher

d. Does not understand the phrase "slow as molasses" when used by the teacher

A nurse interviews a new client in the day room of the psychiatric unit. The nurse is wearing a jacket and a bag and frequently asks the client to repeat the last statement. The nurse's demeanor with the client is reflective of what? a. Unknowing b. Confidentiality c. Professionalism d. Lacking genuine interest

d. Lacking genuine interest

source-oriented record:

documentation system in which each health care group records data on its own separate form

problem-oriented medical record (POMR):

documentation system organized according to the person's specific health problems; includes database, problem list, plan of care, and progress notes

PIE charting:

documentation system that does not develop a separate care plan; the care plan is incorporated into the progress notes in which problems are identified by number, worked up using the problem (P)-intervention (I)-evaluation (E) format, and evaluated each shift

nonverbal communication:

exchange of information without the use of words

personal health record (PHR):

information sheets that contain the individual's medical history, including diagnoses, symptoms, and medications

empathy:

intellectually identifying with the way another person feels

helping relationship:

interaction that sets the climate of movement of the participants toward common goals

SOAP format:

method of charting narrative progress notes; organizes data according to subjective information (S), objective information (O), assessment (A), and plan (P)

bullying:

negative, often repetitive, disruptive behavior; also referred to as horizontal violence, lateral violence, and professional incivility

body language:

nonverbal communication

channel:

term used in communication theory to denote the medium selected to convey the message; the channel may target any of the receiver's senses

language:

prescribed way of using words; a means to express thoughts and feelings

Consultation:

process in which two or more individuals with varying degrees of experience and expertise deliberate about a problem and its solution

organizational communication:

process of communication that involves individuals and groups to achieve established goals

referral:

process of sending or guiding someone to another source for assistance

charting by exception (CBE)

shorthand method for documenting patient data that is based on well-defined standards of practice; only exceptions to these standards are documented in narrative notes

Nursing informatics:

specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice

aggressive behavior:

standing up for one's rights in a negative manner that violates the rights of others

group dynamics:

study of a group's characteristics and ways of functioning

Meaningful use:

the use of certified electronic health record technology to achieve health and efficiency goals, with a financial incentive from Medicare and Medicaid

Confer:

to consult with someone to exchange ideas or to seek information, advice, or instructions

feedback:

verbal and nonverbal evidence that the message is received and understood

Documentation:

written, legal record of all pertinent interventions with the patient—assessments, diagnoses, plans, interventions, and evaluations

A nurse receives an x-ray report on a newly admitted client suspected of having a fractured tibia. The nurse contacts the physician to report the findings. What role is the nurse engaged in? a. Caregiver b. Communicator c. Researcher d. Advocate

b. Communicator

Minimum data set:

a standard established by health care institutions that specifies the information that must be collected from every patient

A nursing instructor has assigned a student to care for a client of Asian descent. The instructor reminds the student that personal space considerations vary among cultures. What personal space preferences are important for the student to consider when caring for this client? a. People of Asian descent touch one another when sitting next to a familiar person. b. People of Asian descent prefer direct eye contact when communicating. c. People of Asian descent commonly stand close to one another when talking. d. People of Asian descent prefer some distance between themselves and others.

d. People of Asian descent prefer some distance between themselves and others.

A new graduate is working at a first job. Which statement is most important for the new nurse to follow? a. Document lengthy entries using complete sentences. b. Only document changes in the client's status. c. Use PIE charting even if it is not the institution's charting method. d. Use abbreviations approved by the facility.

d. Use abbreviations approved by the facility.

The nurse is caring for a patient who had a total laryngectomy and has drains in place. When does the nurse understand that the drains will most likely be removed? a. In 1 week when the patient no longer has serous drainage b. When the patient states that there is discomfort and requests removal c. When the drainage tube comes out d. When the patient has less than 30 mL for 2 consecutive days

d. When the patient has less than 30 mL for 2 consecutive days

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

d. eliminate as many distractions as possible.

Which phase of drug development is associated with continual evaluation of the drug? a. phase II study b. phase I study c. phase III study d. phase IV study

d. phase IV study

When preparing to transfer an older adult client back to the long-term-care facility where he has been for several years, it is the primary responsibility of the nurse to: a. discuss the return to familiar surroundings with the client. b. communicate to the next of kin so they are aware of the transfer. c. ensure that the current health state of the client is maintained. d. provide for the coordination and continuity of care by the health care providers.

d. provide for the coordination and continuity of care by the health care providers.

Discharge summary:

description of where the patient stands in relation to problems identified in the record at discharge; documents any special teaching or counseling the patient received, including referrals

noise:

factors that distort the quality of a message and interfere with the communication process

rapport:

feeling of mutual trust experienced by people in a satisfactory relationship

flow sheet

graphic record of abbreviated aspects of the patient's condition (e.g., vital signs, routine aspects of care)

When providing information about anorexia to a client, the nurse can ensure that the client can accurately comprehend the information by doing what? a. Giving the client ample opportunity to ask questions b. Presenting the information using language and terms the client will understand c. Being careful not to overload the client with too much information at one time d. Interacting with the client in a nonthreatening, respectful manner

b. Presenting the information using language and terms the client will understand

read back:

a process in which a nurse or other health care provider repeats a verbal order back to a physician to ensure that it was correctly heard and interpreted

variance report:

a report of any event that is not consistent with the routine operation of the health care agency that results in or has the potential to result in harm to a patient, employee, or visitor

cliché:

a stereotyped, trite, or pat answer

professionalism:

a way of being/commitment to secure the interests and welfare of those entrusted to one's care

The nurse is obtaining physician orders which include a pulse pressure. The nurse is most correct to report which of the following? a. The difference between an upper extremity and lower extremity blood pressure b. The difference between the systolic and diastolic pressure c. The difference between an apical and radial pulse d. The difference between the arterial and venous blood pressure

b. The difference between the systolic and diastolic pressure

Which data support a nursing diagnosis of impaired verbal communication? a. The presence of neologism, delusions, and anergia b. The presence of neologism, echolalia, and clanging c. Ambivalence, delusional thinking, and avolition d. Rapid pacing and running

b. The presence of neologism, echolalia, and clanging

When providing education to the parents of a client with conduct disorder, which is a valid teaching point? a. Act as the adolescent's advocate at school when the client is disruptive. b. Use 'I' language and express an emotion when setting limits. c. Tell the adolescent to go to their room as a consequence for using profanity. d. Provide reassurance that frequent sexual activity is normal in adolescence.

b. Use 'I' language and express an emotion when setting limits.

During family teaching, the daughter of a client with dementia mentions to the nurse that her mother distorts things. The nurse understands that the daughter needs further teaching about dementia when she makes which statement? a. "I turn off the radio when we are in another room." b. "I tell her reality, such as, 'That noise is the wind in the trees.'" c. "I tell her she is wrong, and then I tell her what is right." d. "I understand the misperceptions are part of the disease."

c. "I tell her she is wrong, and then I tell her what is right."

A homeless client in the public health clinic has a strong body odor and is wearing clothes that are visibly soiled. What nursing diagnosis would be most appropriate for the nurse to identify? a. Homelessness Syndrome related to lack of housing as evidenced by visibly soiled clothing b. Bathing Self-care Deficit related to lack of access to bathing facilities as evidenced by a strong body odor c. Impaired Impulse Control related to poor socioeconomic conditions as evidenced by visibly soiled clothing d. Inadequate Hygiene related to homelessness as evidenced by client's stink

b. Bathing Self-care Deficit related to lack of access to bathing facilities as evidenced

The nurse is caring for a client who experienced a crushing injury of the lower extremities. Which of the following symptoms is essential to be reported to the physician? a. Coolness b. Ischemia c. Pulselessness d. Pain

c. Pulselessness

The nurse is caring for an 88-year-old male admitted 2 days ago for dehydration. The nurse brings the client his breakfast tray and notes that the client appears to be having difficulty understanding what she is saying to him today. Which nursing action is most appropriate? a. Ask the client if he left his earplugs in his ears. b. Speak to the elderly client in a high-frequency tone of voice. c. Check the client's ear canals for cerumen. d. Use facial expressions and sign language to communicate.

c. Check the client's ear canals for cerumen.

The nurse manager for the psychiatric unit sees that there are major conflicts between the day and night shift staff. The nurse manager suggests that each shift put aside their differences for a time and determine a common major goal. Which of the following conflict resolution styles does the nurse manager display? a. Competing b. Avoiding c. Collaborating d. Smoothing

c. Collaborating

A client, who was hospitalized after a fall sustained while intoxicated, experienced alcohol withdrawal delirium during the hospitalization. A few days after the client's sensorium clears, the client tells the nurse that drinking helps to cope with anxiety related to a recent divorce. Which response by the nurse would help the client view the drinking more objectively? a. "Tell me about the last time you were under a lot of stress and drinking to cope." b. "I'm sure you must realize that sooner or later your drinking will kill you." c. "I hear defensiveness. You don't really believe what you're saying, do you?" d. "If the alcohol was helping you cope so well, you wouldn't be here, would you?"

a. "Tell me about the last time you were under a lot of stress and drinking to cope."

Which is an appropriately stated nursing intervention? a. Ambulate 30 ft. twice a day with assistance of a walker. b. Ambulate with assistance of a walker. c. Stand at bedside with assistance. d. Ambulate in the hall.

a. Ambulate 30 ft. twice a day with assistance of a walker.

The nurse manager in a critical care unit actively listens to his staff and engages the staff to offer decisions regarding problem solving and implementing these decisions. What type of managerial mindset does this manager exhibit? a. Collaborative mindset b. Action mindset c. Reflective mindset d. Analytical mindset

a. Collaborative mindset

A nurse hears a staff member giving incorrect information to the family of a client newly diagnosed with diabetes mellitus who is being discharged to home. The nurse wants to make sure the family has the proper information before the client is discharged. What should she do? a. Go into the room and correct the nurse so the family will be safe in providing home care. b. Go into the room, introduce herself to the family, and complete the discharge teaching. c. Have the nurse step outside of the room, discuss the situation, and use it as a learning opportunity. d. Have the nurse step outside of the room and tell her she's giving wrong information to the family.

c. Have the nurse step outside of the room, discuss the situation, and use it as a learning opportunity.

collaborative pathway

case management plan that is a detailed, standardized plan of care developed for a patient population with a designated diagnosis or procedure; it includes expected outcomes, a list of interventions to be performed, and the sequence and timing of those interventions

receiver (decoder):

term used in communication theory that specifies the person or object to which the message is directed

message:

term used in communication theory to denote the actual physical product of the source or encoder (e.g., a speech, interview, phone conversation, chart)