Prep U chapter 20

Paramedics arrive in the emergency department with a victim of a motor vehicle collision. The paramedic reports the driver was restrained, the car was traveling about 30 miles per hour (48 Km/hour) , and the air bags were not deployed. The paramedic continues to report the car was struck from behind and that all individuals in the car were able to self-extricate. Which statement made by the nurse is verifying the report from the paramedic?

"All of the victims got themselves out of the car?"

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?"

The community health nurse is preparing a campaign to educate the public about heart health. Which forms of verbal communication will be effective? Select all that apply.

-Radio -Posters -Brochures -Television

A nurse is communicating the plan of care to a client who is cognitively impaired. Which nursing actions facilitate this process? Select all that apply.

-The nurse shows patience with the client and gives the client time to respond. -The nurse keeps communication simple and concrete. -The nurse maintains eye contact with the client.

A nurse is caring for an older adult client hospitalized following a hip fracture. Which actions made by the nurse will promote the development of a therapeutic relationship? (Select all that apply.)

-asking the client when the client would like to have the bed linens changed -encouraging the client to talk about the client's life

Which qualities in a nurse help the nurse to become effective in providing for a client's needs while remaining compassionately detached?

Empathy

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.

Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship?

Working phase

A client arrives at the emergency department after experiencing several black, tarry stools. The nurse will develop a cause and effect by:

asking the client if he or she has recently taken ferrous sulfate (iron) or bismuth subsalicylate.

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?

reviewing health changes

A nurse is interviewing a client for the establishment of long-term care insurance. During the interview, the nurse asks questions regarding the client's past medical history. The nurse is the:

sender.

The nurse is visiting a hospice client in his home. He is explaining the difficulties he is having with his home infusion pump. By making statements such as "I see" and "go on" during the conversation, the nurse is utilizing which therapeutic nurse-client communication technique?

Encouraging elaboration

When assessing a client's nonverbal communication, the nurse will assess which characteristic as the most expressive part of the body?

Facial expressions

In order to provide effective nursing care, the nurse should engage in what type of communication with the client and significant others?

Therapeutic communication

Nurses use social media to share ideas, develop professional connections, access educational offerings and forums, receive support, and investigate evidence-based practices. What is an example of the proper use of social media by a nurse?

A nurse uses a disclaimer to verify that any views expressed on Facebook are his or hers alone and not the employer's.

When documenting client care, the nurse understands that the most important reason for correct and accurate documentation is:

conveying information.

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:

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

A client with a cardiac dysrhythmia was recently prescribed metoprolol and is at a follow-up appointment at the cardiologist's office. The client tells the nurse, "I feel depressed, tired, and I have no desire to exercise." To determine a cause-and-effect relationship, the nurse should ask:

"Were you tired and depressed before starting the new medication?"

Nurses develop helping relationships with clients when caring for them. Which statements describe 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.

The nurse is collecting health data and avoids using closed-ended questions. Which are examples of closed-ended questions? (Select all that apply.)

-"Is there any chance you might be pregnant?" - "Does it hurt when I touch you here?" - "Are you ready to get out of bed?" - "Do you smoke cigarettes?"

A nurse is engaged in a nurse-client relationship. Which communication techniques would be important for the nurse to avoid? Select all that apply.

-False reassurance -Giving advice

A female nurse states the following to another nurse who is constantly forgetting to wash her hands between patients: "It looks like you keep forgetting to wash your hands between patients. It's really not safe for your patients. Let's think of some type of reminder we can use to help you remember." This communication is an example of what type of speech?

Assertive

Which of the following nurses most likely is the best communicator?

A nurse who easily developed a rapport with clients.

A nurse is caring for a client admitted to the hospital for dehydration. The physical findings consistent with the diagnosis include:

easy wrinkling of the skin and sunken eyes.

The term metacommunication is best defined as:

interpersonal bridge between verbal and nonverbal communication.

A client has just been given a diagnosis of cirrhosis of the liver. Which statements by the nurse should be avoided because they could impede communication? Select all that apply.

- "Your doctor knows best." - "Everything will be all right." -"Don't worry. You will be just fine in another day or two." -"Cheer up. Tomorrow is another day."

The nursing instructor is discussing communication with a student. The student identifies that a contract is made with the client during which phase of the nurse-client relationship?

Orientation phase

A nurse touches the client's hand while discussing his diagnosis. This action is a(an):

communication channel.

An experienced nurse is orienting a new nurse to the unit. The experienced nurse tells the new nurse that to be an effective caregiver, the new nurse needs to:

develop good communication skills.

A nurse communicating with a client states, "I will be changing your dressing, but we have plenty of time to talk first." She is already wearing sterile gloves and a mask and is busy working with her back to the client. The nurse is conveying a (an)

incongruent relationship.

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 person-centered or helping relationship is characterized by an unequal sharing of information.

When caring for a psychiatric client, a formal contract is made with the client during which phase of the nurse-client relationship?

Orientation phase

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

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:

evaluating the client's nonverbal response to the findings.

When communicating with clients nurses need to be very careful in their approach. This is particularly true when communicating using:

medical terminology.

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

A nurse gives a speech on nutrition to a group of pregnant women. What is the speech itself known as?

Message

Each of the following facilitates a therapeutic nurse-client relationship except:

closed-ended questions.

Nurses must take into considerations factors that influence communication when communicating with patients. Which examples accurately reflect communication that considers these variables? (Select all that apply.)

-A nurse checks a patient's occupation for clues on how this will affect communication but avoids stereotyping the person. -A nurse uses simple language and demonstrations to explain a procedure to a preschooler. -A nurse takes into consideration a patient's culture when planning how far away to sit when communicating.

Carl Rogers (1961) studied the process of therapeutic communication. Through his research, the elements of a "helpful" person were described. They include all of the following except which choice?

Analysis

A student nurse is attempting to improve her communication skills. Which therapeutic communication skill is appropriate?

Control the tone of the voice to avoid hidden messages.

The client recently immigrated from Mumbai, India. The client was just admitted to the nurse's unit postoperatively following gallstone removal. The client does not speak the dominant language. When using the hospital's interpretive services, which is most important?

Speak directly to the client.

When the nurse communicates with a newly admitted client, the nurse must pay particular attention to nonverbal behaviors. The nurse considers which characteristic as nonverbal communication?

The client's tone of voice

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:

allow the client to set the pace.

A nurse is on his lunch break in the hospital cafeteria and sits at a table near a group of physicians eating their lunch. The nurse recognizes one of the physicians as being in charge of his clients. The nurse witnesses the physician point at the nurse and state, "That guy needs to get fired." The best response by the nurse would be to:

ask to speak to the physician in private and address any disrespectful remarks or behaviors.

The mother of a toddler is deciding if she wants to allow her child to receive the recommended immunizations. The clinic nurse responds, "If you don't immunize your child you are jeopardizing the health of other children." What type of approach does this response indicate?

guilt inducement or approval/disapproval

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:

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

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:

sit at the bedside and allow the client to explain the statement