week 2- nurse client relationship

Congruent communication

the verbal and nonverbal aspects of the message match

A nurse enters the client's room and begins the process of establishing a nurse-client relationship. The nurse introduces oneself and informs the client how long the nurse will be caring for the client. What additional statement does the nurse need to communicate with the client? -"I have been a nurse for 5 years on this unit." -"I know that you will feel better in a short time here." -"Let me know if you have concerns regarding your care." -"I am here to meet both of our needs."

"Let me know if you have concerns regarding your care."

When the preoperative client tells the nurse that the client cannot sleep because the client keeps thinking about the surgery, an appropriate reflection of the statement by the nurse is: -"You shouldn't be nervous. We perform this procedure every day." -"The thought of having surgery is keeping you awake." -"You have a great surgeon. You have nothing to worry about." -"It sounds as if your surgery is a pretty scary procedure."

"The thought of having surgery is keeping you awake."

A nurse has developed strong rapport with the wife of a client who has been receiving rehabilitation following a debilitating stroke. The wife has just been informed that her husband will be unlikely to return home and will require care that can only be provided in a facility with constant nursing care. The client's wife tells the nurse, "I can't believe it's come to this." How should the nurse best respond? -"What would help you accept that this is best for both of you?" -"Do you understand that everyone here has your husband's best interests at heart?" -"This must be very difficult for you to hear. How do you feel right now?" -"Why do you think that the care team has made this recommendation?"

"This must be very difficult for you to hear. How do you feel right now?"

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?" -"Do you check your blood pressure and pulse before you take your medication?" -"Have you tried exercising at all in the last week or two?" -"Tell me about the foods you are eating."

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

The nurse is collecting health data and avoids using closed-ended questions. Which are examples of closed-ended questions? Select all that apply. -"What sorts of things do you do for fun?" -"Do you smoke cigarettes?" -"Are you ready to get out of bed?" -"What plans do you have after you are discharged?" -"Is there any chance you might be pregnant?"

-"Do you smoke cigarettes?" -"Are you ready to get out of bed?" -"Is there any chance you might be pregnant?"

The nurse enters a client's room after receiving a morning report. The nurse rapidly assesses the client's airway, breathing, and circulation and greets the client by saying "Good morning." The client makes no reciprocal response to the nurse. How should the nurse best respond to the client's silence? -The nurse should apologize for bothering the client, perform necessary assessments efficiently, and leave the room. -The nurse should ask appropriate questions to understand the reasons for the client's silence. -The nurse should document the client's withdrawal and diminished mood in the nurse's notes. -The nurse should ask the client whether the client feels afraid or angry.

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

7 Keys of Active Listening

1. be attentive 2. ask open ended questions 3. ask probing questions 4. request clarification 5. paraphrase 6. be attuned to and reflect feelings 7. summarize

social space distance

4-12 feet

intimate space distance

6 inches

personal space distance

6 inches to 4 feet

Kinesics

Body language

Which is a skill appropriate to use in therapeutic communication? -Control the tone of the voice to avoid hidden messages. -Use cliches to enhance a client's understanding of information. -Be precise and inflexible regarding the intent of the conversation. -Avoid the use of periods of silence.

Control the tone of the voice to avoid hidden messages.

When assessing a client's nonverbal communication, the nurse should assess which aspect as being the most expressive? -Eye contact -Hand gestures -Posture -Facial expressions

Facial expressions

The client is an 18-month-old in the pediatric intensive care unit. The client is scheduled to have a subgaleal shunt placed tomorrow, and the client's mother is quite nervous about the procedure. The nurse tells the client's mother, "The surgeon has done this a million times. Your son will be fine." This is an example of what type of nontherapeutic communication? -Rescue feelings -False reassurance -Giving advice -Being moralistic

False reassurance

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? -Encouraging elaboration -Giving false reassurance -Giving information -Seeking clarification

Giving false reassurance

A nurse caring for an unconscious client knows that communication is important even if the client does not respond. Which nonverbal action by the nurse would communicate caring? -Sighing frequently while providing care -Waving to the client when entering the room -Making constant eye contact with the client -Holding the client's hand while talking

Holding the client's hand while talking

the 4 categories of client needs designated by The National Council of State Boards of Nursing

Psychosocial integrity Physiologic integrity Safe, effective care environment Health promotion and maintenance

2 types of touch

Task-oriented touch Affective touch

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

To assist the client to identify and achieve goals

the 4 roles of a nurse in a nurse-client relationship

caregiver educator collaborator delegator

Paralanguage

communicating through vocal sounds

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 -explaining the health consequences of refusing to undergo the prescribed treatment -recommending assessment of the client's cognitive capacity to make health care decisions -asking the client's family to discuss the importance of the prescribed treatment with the client

contacting the interprofessional care team to discuss alternative treatment options

a Therapeutic Nurse-Client Relationship is one that moves toward __________ _______

improved health

public space distance

more than 12 feet

Which is a component of the termination phase of the nurse-client relationship? -mutually planning the client's care -mutual agreement that the client's health problem has improved -identification of the client's health problems -accepting that a client has a potential for change

mutual agreement that the client's health problem has improved

The nurse encourages a client to participate in the communication process by using an opening remark based on observations and assessment. Which approach would be most effective for the nurse to use to promote trust? -probing -intrusive -interrogative -neutral

neutral

What is an example of positive body language? -tilt of head -arms crossed -rubbing nose -clenched jaw

tilt of head

what is the nonverbal form of communication that is a tactile stimulus produced by making personal contact

touch

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? -Obtain the client's attention by calling out the client's first name. -Remove the COVID protection face mask while speaking with the client. -Identify oneself by name and title with each entry into the client's room. -Speak in a loud voice over the volume of the television set.

Identify oneself by name and title with each entry into the client's room.

Phases of the nurse-client relationship

introductory working terminating

nursing 5 rights of delegation

right person right task right circumstance right communication/ instruction right supervision/ evaluation

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." -"You seem unsure, please let me know if you decide to postpone the surgery until you are no longer unsure." -"I understand your confused, what do you think you should do?" -"I understand you are not sure about having the surgery. Why do you think you really do not need the surgery?"

"You seem unsure. Tell me your concerns about your surgery."

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.

A palliative care nurse possesses numerous skills that have enhanced the nurse-client relationship and communication in the past. One of these skills that has benefited previous clients is affective touch. Before using this technique, the nurse must consider: -the institutional policies. -the client's prognosis. -the client's diagnosis. -the client's culture.

the client's culture.

Proxemics

use/relationship of space in communication