139 Chapter 8 Questions
31. During the hospital admission interview, a client begins to cry when asked about number of pregnancies. Which communication technique would the nurse employ during this interaction? A. Use of silence B. Rescue feelings C. Offering reassurance D. Being moralistic
A Rationale: During an interaction where the client is crying, the nurse should use silence and give the client time to get control of the emotional response to continue the conversation. Rescue feelings and being moralistic are ineffective communication techniques. Offering reassurance might not be appropriate because the nurse does not yet know what is upsetting the client, and this could be false reassurance. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 194
7. A nurse is educating a home care client on how to administer a topical medication. The client is watching television while the nurse is talking. What might be the result of this interaction? A. The message will likely be misunderstood. B. The stimulus for communication is unclear. C. The receiver will accurately interpret the message. D. The communication will be reciprocal.
A Rationale: Noise, which is a factor that distorts the quality of a message, can interfere with communication at any point in the process. If the client is watching television, it is likely that the message from the nurse will be misunderstood. The communication will not be reciprocal. The stimulus or nurse is clear. The receiver, due to the noise, will inaccurately interpret the message. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Integrated Process: Communication and Documentation Reference: p. 173
5. 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? A. The nurse should ask appropriate questions to understand the reasons for the client's silence. B. The nurse should apologize for bothering the client, perform necessary assessments efficiently, and leave the room. C. The nurse should document the client's withdrawal and diminished mood in the nurse's notes. D. The nurse should ask the client whether the client feels afraid or angry.
A Rationale: Silence can have many meanings, and the nurse should attempt to identify the meaning of the client's silence in a tactful manner. Directly asking whether the client is angry or fearful is likely presumptuous and may harm rapport. The nurse should not make assumptions about the client's mood, nor should the nurse cease to engage with the client. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 178
4. The nurse enters 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 ask the client in this interaction? A. A yes or no question B. A directing question C. An open-ended question D. A reflective question
A Rationale: Sometimes a yes or no question is appropriate. In this case, the nurse may want to ask, "Do you feel short of breath?" or something similar. Directing questions and reflective questions follow up on earlier communication. An open-ended question may elicit the necessary assessment data, but a yes or no question accomplishes this goal more directly. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Communication and Documentation Reference: p. 196
26. The primary care provider is yelling at the nurse in the client's room because the client has not received an intravenous antibiotic. Which statement by the nurse demonstrates assertiveness? A. "Let's go to the nurses' station, and I will explain." B. "I have other clients and have been very busy today." C. "It's the fault of the previous nurse, who left it for me to do." D. "You should have written your order more clearly than you did."
A Rationale: The assertive response is to remove the conversation from the client's room and show respect for each other. The other responses are aggressive in being defensive or blaming. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Communication and Documentation Reference: p. 197
3. A nurse drafts an SBAR communication before contacting the primary care provider of a client whose condition has worsened suddenly. How should the nurse best conclude this communication? A. Ask the care provider to come and assess the client. B. Provide the client's most recent vital signs. C. Ask whether the care provider is familiar with this client. D. Provide the most likely diagnosis of the problem.
A Rationale: The final phase of an SBAR communication involves making a recommendation. In the case of a client whose condition is worsening, this may entail recommending that the primary care provider come to assess the client. Asking whether the care provider is familiar with the client should occur early in the communication. The nurse should provide assessment data and possible diagnoses in the background and assessment sections of the tool. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Communication and Documentation Reference: p. 185
24. Which action should the nurse first consider when attempting to become culturally competent? A. Assess own personal cultural beliefs and prejudices. B. Listen and understand the client's response. C. Avoid labeling any clients. D. Treat the client with respect and dignity.
A Rationale: The first step toward cultural competence requires a nurse becoming aware of own personal cultural beliefs and prejudices. After this is reviewed, a nurse can listen to the client and understand. A review of personal cultural beliefs allows the nurse to avoid labeling clients and treat each client with respect and dignity. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Understand Client Needs: Psychosocial Integrity Integrated Process: Nursing Process Reference: p. 181
20. A nurse pays a house visit to a client who is on parenteral nutrition. The client reports missing enjoying food with the client's family. What is the most appropriate response by the nurse? A. "Tell me more about how it feels to eat with your family." B. "You can sit with your family at meal times, even though you don't eat." C. "In a few weeks you may be allowed to eat a little, you may enjoy it then." D. "I know that you must be missing your favorite foods."
A Rationale: The nurse should help the client to verbalize feelings and cope with aspects of illness and treatment. Asking open-ended questions is most appropriate as the nurse encourages the client to express feelings. The other options block communication and are not appropriate. Telling the client that the client can sit with his family but must avoid eating does not consider the client's feelings. Informing the client that the client will be able to eat food in a few weeks changes the subject and stops communication. Stating that the client is missing the client's favorite dishes is empathic but does not help the client further verbalize feelings as does inviting the client to share more. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 196
1. A group of nurses is working together on a hospital task force focused on preventing infection. One nurse in the group continually argues with other members and attempts to block each step of the process. The nurse's behavior is causing frustration for the others and slowing their progress. Which attribute best describes this nurse's behavior in relation to group dynamics? A. Self-serving B. Task-oriented C. Maintenance D. Group-building
A Rationale: The nurse's behavior is best described as self-serving. Self-serving behavior advances the needs of individual members at the group's expense. Task-oriented behavior focuses on the work to be completed. Group-building or maintenance behavior focuses on the well-being of the people doing the work. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Communication and Documentation Reference: p. 181
15. Which nursing role is primarily performed during the working phase of the helping relationship? A. Counselor B. Manager C. Leader D. Researcher
A Rationale: The nursing roles of educator and counselor are primarily performed during the working phase of the helping relationship, when the nurse uses interpersonal skills to the fullest. Nurse managers help clients by managing the nurses who care for them, but this role is not specific to the working phase of the helping relationship. Nurses can have leadership ability when caring for clients at the bedside and while working in interdisciplinary teams, but this role is not the nurse's primary one during the working phase of the helping relationship. A research nurse is a nursing professional who works hard to help create, evaluate, and perfect new and old medications and treatments for various medical problems, but the role of researcher does not pertain to the working phase. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Understand Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Communication and Documentation Reference: p. 189
2. An older adult client has given medical power of attorney to an adult child. The adult child asks the nurse why a urine specimen was collected from the client earlier that morning. How can the nurse respond to the query? A. "We want to test the urine to make sure your parent does not have a urinary tract infection." B. "Your parent's health care provider ordered a urine culture and sensitivity test to rule out a urinary tract infection." C. "We want to do everything we can to get your parent healthy again." D. "Sometimes sick urine can make the whole person sick, and this might be causing the fever."
A Rationale: To communicate effectively, the nurse should avoid the use of jargon or abbreviations (e.g., "culture and sensitivity testing") that are unfamiliar to those outside the health care system. At the same time, accuracy is important, and vague and "dumbed-down" answers (e.g., "we want to do everything we can," "sick urine") are inappropriate. Explaining that the urine is being tested to rule out a urinary tract infection is accurate, specific, and understandable to the client's adult child. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 181
35. Which is an example of a closed question or statement? A. "How did that make you feel?" B. "Did you take those drugs?" C. "What has the health care provider discussed with you about your condition?" D. "Describe the type of pain you have."
B Rationale: A closed question or statement, such as "Did you take those drugs?" provides the receiver with a limited number of choices of possible responses and often can be answered by one or two words, such as "yes" or "no." When not used appropriately, closed-ended questions are a barrier to effective communication. The other options are open-ended questions, which allow for the client to provide additional information. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Understand Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Communication and Documentation Reference: p. 196
18. A nurse tells a client, "Are you going to get out of bed, or are you just going to sleep all day and night?" This is an example of which barrier to communication? A. Using comments that give advice B. Using judgmental or belittling language C. Using leading questions D. Using probing questions
B Rationale: A nurse making judgmental comments tends to impose the nurse's moral standards on the client. In this case, the nurse judges the client as being lazy, and the nurse's apparent hostility could end effective communication. Leading questions are usually open ended and allow for the client to finish a sentence or to provide direction in the form of oral communication. Probing questions are follow-up questions when a response is not fully understood or when answers are vague or ambiguous to obtain more specific or in-depth information. Comments that give advice provide guidance to the client. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 199
23. When documenting client care, the nurse understands that the most important reason for correct and accurate documentation is: A. reducing legal liability risks. B. conveying information. C. assisting in organization of care. D. noting the client's response to interventions.
B Rationale: Documentation of care in the client's record is most important for conveying information to other health care team members who are involved in the care of the client. The other answers are important reasons for accurate documentation but not as important as conveying information to other team members. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Understand Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Communication and Documentation Reference: p. 184
30. A nurse is conducting a health history. The client's spouse is answering the interview questions. What question would be appropriate to ask the client before proceeding with the remainder of the interview? A. "Why is your spouse answering the questions?" B. "Who manages health care-related issues in your family?" C. "Can you ask your spouse to leave the room?" D. "Do you have a hearing impairment preventing you from hearing the questions?"
B Rationale: In some cultures, the male is considered the head of the family and makes health care decisions and takes the role of answering questions related to health and medical care. It is important to establish who makes those decisions and to be respectful of the client's culture. It is best to take cues from the client. A client that is allowing another family member to answer questions may be doing so based upon the culture and roles in the family, it is important to clarify. Asking the spouse to leave the room or asking why the spouse is answering the questions can be insensitive and unprofessional. While asking about a hearing impairment may be appropriate, determining who makes the decisions is priority. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 181
14. Which action by the nurse would facilitate the nurse-client relationship during the orientation phase? A. Providing assistance to meet activities of daily living B. Introducing oneself to the client by name C. Designing a specific education plan of care D. Preparing for termination of the relationship
B Rationale: In the orientation phase of the nurse-client relationship, the nurse and client meet and learn to identify each other by name. It is especially important that the nurse introduce oneself to the client during this phase. Providing assistance to meet activities of daily living and designing a specific education plan of care would occur during the working phase. Preparing for termination of the relationship would occur in the termination phase. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Understand Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 188
9. The family of a client in a burn unit ask the nurse for information. The nurse sits with the family and discusses their concerns. What type of communication is this? A. Intrapersonal B. Interpersonal C. Organizational D. Focused
B Rationale: Interpersonal communication occurs among two or more people with a goal to exchange messages. Nurses spend most of their day communicating with clients, family members, and health care team members. Intrapersonal communication refers to self-talk. Organizational communication refers to the forms and channels of communication among members of organizations such as corporations, nonprofits (hospitals), or small businesses. Focused communication centers on active listening. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Understand Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 180
11. A nurse uses the SBAR method in a hand-off report to communicate to the health care team about the client. Which element should the nurse cover in the "B" section of the SBAR report? A. Vital signs B. Mental status C. Client request D. Further testing
B Rationale: SBAR stands for situation, background, assessment, and recommendations and provides a consistent method for hand-off communication that is clear, structured, and easy to use. Vital signs would fall under the category of situation, mental status: background, client request: assessment, further testing: recommendations. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Communication and Documentation Reference: p. 185
33. 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? A. Explain the importance of being able to control blood glucose levels with the injections. B. Demonstrate the proper method and have the client mimic the demonstration. C. Offer encouragement to boost the client's self-confidence. D. Refer to client to a diabetes educator and nutritionist.
B Rationale: The best strategy for this client is to demonstrate the proper administration and have the client mimic the demonstration to ensure the client is confident and knowledgeable on self-administration. Offering encouragement and explaining the importance of self-administration is important, but not the best method to ensure compliance. The client may or may not need to be referred to a nutritionist, and the nurse should be considered the diabetes educator. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies Integrated Process: Communication and Documentation Reference: p. 183
25. What is a violation(s) of the nurse's responsibility when using electronic communication? Select all that apply. A. The nurse wrote on a social media site, "Had a bad day at work. Need some support. Call me." B. The nurse posted on a social media site, "Psychotic mean client in Room 502 hit me," and, within 5 minutes, deleted the post. C. The nurse sent an email message to a client informing the client how to access a secured website to view the lab report. D. When a visitor inquired about a hospitalized client, the nurse, prior to answering, closed the computer monitor screen that was open to client data and could be seen by the visitor. E. The nurse accidentally texted a message about a new prescription for HIV medication to the wrong phone number.
B, E Rationale: Violations of the nurse's responsibility when using electronic communication are posting information about a client, even though the post was deleted, and texting information to a wrong phone number, even accidentally. The nurse writing on a social media site "had a bad day" and using the site for support is OK. Client information was not revealed. Sending an email message instructing a client on how to access a secure website is an appropriate means of electronic communication. Closing the computer monitor screen that could be seen by a visitor provides for confidentiality when a visitor asks a question of the nurse. Question format: Multiple Select Chapter 8: Communication Cognitive Level: Apply Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Communication and Documentation Reference: p. 178
22. A client comes to the clinic reporting abdominal pain. Which question would be most appropriate for the nurse to ask to facilitate the assessment? A. "Do you have sharp, stabbing pain?" B. "Is the pain associated with meals?" C. "What activities exaggerate the pain?" D. "Does the pain increase on palpation?"
C Rationale: "What activities exaggerate the pain?" is an open-ended question, because it gives the client an opportunity to express feelings and describe the pain. "Do you have sharp, stabbing pain?", "Is the pain associated with meals?", and "Does the pain increase on palpation?" are questions that can be answered with "Yes" or "No." These questions would be helpful later in the assessment to help focus on the client's statements. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Nursing Process Reference: p. 196
12. What is the goal of the nurse in a helping relationship with a client? A. To provide hands-on physical care B. To ensure safety while caring for the client C. To assist the client to identify and achieve goals D. To facilitate the client's interactions with others
C Rationale: A helping relationship exists among people who provide and receive assistance in meeting human needs. When a nurse and a client are involved in a helping relationship, the nurse assists the client to identify and achieve goals that allow the client's human needs to be met. The nurse does provide care, but that can be in a variety of ways, including hands-on physical care and help with communication. The nurse does ensure safety in providing care, but that is only an element of the nurse-client relationship. The nurse's job is not to facilitate client interactions with others but to provide nursing care to the client. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Understand Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Communication and Documentation Reference: p. 187
32. 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? A. "Would you like to discuss how long you have been using drugs?" B. "Have you reflected on what causes you to use heroine?" C. "Perhaps we can talk about your feelings some more." D. "I understand why you feel this way, it is difficult to kick an addiction."
C Rationale: Asking the client to talk more about feelings is therapeutic and could lead to helping the client make some decisions about how the drug use is impacting their life. All other responses are judgmental and non-therapeutic. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 196
29. The nurse is caring for a client whose cultural practices and beliefs regarding health care differ from the nurse's. In which manner can the nurse ensure health disparities are reduced and the client receives equitable care? A. Interview all clients in the same manner so as not to demonstrate bias or cultural insensitivity. B. Recognize that all cultures differ in communication styles and ask a family member to help facilitate the gathering of information. C. Adapt care to encourage a collaborative, client-centered relationship that ensures safe practice. D. Recognize the rules of personal space, eye contact, and body language may have an impact on perception of health care.
C Rationale: Culture and lifestyle do influence the communication process, understanding a client's culture allows the nurse to adapt nursing care to enable clients to collaborate and make decisions regarding health care. While understanding nonverbal communication is important in reducing communication barriers, it alone does not have an impact on health care. When the nurse interviews the client, the approach is based on cognitive function and understanding of the client and will vary with each client. Family members are not a viable source of facilitating communication and care because they have the same barriers as the client. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 181
19. A nurse is caring for a client who is visually impaired. Which action is a recommended guideline for communication with this client? A. Ease into the room without announcing your presence until you can touch the client. B. Speak in a louder voice to make up for the client's inability to perceive visual cues. C. Explain the reason for touching the client before doing so. D. Keep communication simple and concrete.
C Rationale: For clients who are visually impaired, the nurse should announce the nurse's presence in the client's room, identify self by name, speak in a normal tone of voice, explain the reason for touching the client before doing so, and indicate to the client when the conversation has ended and when the nurse is leaving the room. The nurse does not need to keep communication simple and concrete, as the client probably does not have an issue cognitively, the client is simply visually impaired. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 203
28. The nurse is completing an admission assessment with a client. The client looked down and became tearful when asked about feeling safe at home. How would the nurse respond to the nonverbal communication displayed by the client? A. "I am glad that you feel safe at home, everyone should feel safe at home." B. "Is someone abusing you at home? I need to report this to the police." C. "You seem upset. You are safe here and can talk to me confidentially." D. "Do you want me to call the police for you? You seem scared to be at home."
C Rationale: Nonverbal communication is the transmission of information without the use of words. In this situation, the lack of eye contact and tearfulness is a nonverbal message. The nurse should not ignore the nonverbal communication. It is important for the nurse to display empathy and establish trust with the client. Acknowledging the nonverbal communication and assuring the safety of the client is important. Asking if the client is being abused or stating that the client seems to be scared is making an assumption about the nonverbal communication, and there is no indication that the police should be called. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 177
8. A nurse gives a speech on nutrition to a group of pregnant clients. Within the model of the communication process, what is the speech itself known as? A. stimulus B. source C. message D. channel
C Rationale: The message is the actual physiologic product of the source. It might be a speech, interview, conversation, chart, gesture, memorandum, or nursing note. This communication process is initiated based on a stimulus. The sender or source of the message is a person or group who initiates or begins the communication process. The channel of communication is the medium the sender has selected to send the message. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Understand Client Needs: Health Promotion and Maintenance Integrated Process: Communication and Documentation Reference: p. 175
27. Which action by the nurse demonstrates respect for the client as an individual? A. The nurse is providing care to an older adult client and calls the client "Mom." B. The nurse is giving report to another nurse about "the gallbladder client." C. The nurse is administering medication to a client the nurse addressed as "Ms. Taylor." D. The nurse asks the aide to provide a bath for "the motor vehicle accident (MVA) client."
C Rationale: The nurse should address clients by their formal name, such as Ms. Taylor. Nurses should not address an older adult client as "Mom" or "Dad." This is not respectful. When referring to clients while addressing other health care workers, the nurse should use the client's formal name. The nurse should not refer to a client by the client's condition, such as "the gallbladder client" or "the MVA client." Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 189
13. The nurse is attempting to develop a therapeutic nurse-client relationship with a newly admitted client. Which expectation should the nurse have when developing the relationship? A. The relationship will occur spontaneously. B. The nurse and client will have a social relationship. C. The nurse is accountable for the outcome. D. The relationship is based on the needs of the nurse.
C Rationale: The person-centered or nurse-client relationship does not occur spontaneously, as do most social relationships. It occurs for a specific purpose with a specific person. The client shares information related to personal health problems, whereas the nurse shares information in terms of a professional role. The person-centered or nurse-client relationship is built on the client's needs, not on those of the helping person. The nurse is accountable for the outcome of the relationship. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Communication and Documentation Reference: p. 187
34. A nurse administers pain medication to a client. Which action should the nurse take to facilitate trust? A. Allow the client to vent about the pain. B. Share with the client a time the nurse was in pain. C. Return in 30 minutes for follow-up per previous communication with the client. D. Report pain medication administration to the nurse on the oncoming shift.
C Rationale: When a nurse repeatedly upholds commitments made to a client, it fosters foundational trust within the therapeutic relationship, such as returning to see if the pain is receding. Empathy, including allowing the client to vent, may be part of the therapeutic relationship, but in this case the nurse's behavior will instill trust. Reporting to the oncoming nurse is important for the record, but the client may not be aware this is happening. Sharing a time the nurse was in pain can take the focus off the client and place it onto the nurse. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 187
17. A client expresses worry about upcoming surgery. Which response by the nurse is a cliché? A. "Tell me what you are worried about." B. "Have you spoken to your family about your concerns?" C. "Do you want to cancel your surgery?" D. "Do not worry, everything will be fine."
D Rationale: A cliché is a stereotypical, trite, or pat answer. Most health care clichés suggest there is no cause for concern or offer false assurance. Clients tend to interpret the use of clichés as a lack of interest in what the client has said. The question in which the nurse asks the client about concerns is an open-ended question, which is therapeutic. Simply asking the client whether the client has spoken to family is a closed-ended question, although a supportive one because the nurse is asking for the client to discuss the concerns with a support network. Asking the client about a desire to cancel the surgery is clear and direct, and thus not a cliché. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 198
16. Which term describes a nurse who is sensitive to the client's feelings, but remains objective enough to help the client achieve positive outcomes? A. Competent B. Caring C. Honest D. Empathic
D Rationale: Empathy is identifying with the way another person feels. An empathic nurse is sensitive to the client's feelings and problems but remains objective enough to help the client work to attain positive outcomes. Nursing is a nurturing profession, and caring is the essential component of its holistic practice, especially with a critically ill client. Nurses are constantly faced with choices of actions that can be either honest or dishonest. Nursing competence is understood as the attainment of knowledge, intellectual capacities, practice skills, integrity, and professional and ethical values required for safe, accountable, and effective practice. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Understand Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 190
10. A nurse caring for client who is unconscious knows that communication is important even if the client does not respond. Which nonverbal action by the nurse would communicate caring? A. Making constant eye contact with the client B. Waving to the client when entering the room C. Sighing frequently while providing care D. Holding the client's hand while talking
D Rationale: Engaging a client's tactile sense, such as holding the client's hand while talking, is a form of nonverbal communication and is viewed as one of the most effective nonverbal ways to express feelings of comfort. Making constant eye contact and waving will not be perceived by an unconscious client. Sighing, if perceived by the unconscious client, would more likely be interpreted as frustration or condescension on the part of the nurse. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Reference: p. 195
21. 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. Sender B. Encoder C. Receiver D. Communication channel
D Rationale: The interpreter's role is that of a channel of communication, that is the medium or the carrier of the message. The interpreter conveys the message sent by the client to the nurse. The client is the sender and the encoder of the message. The nurse is the receiver of the message. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Understand Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Communication and Documentation Reference: p. 175
6. A nurse touches a client's hand to indicate caring and support. What channel of communication is the nurse using? A. Auditory B. Visual C. Olfactory D. Kinesthetic
D Rationale: The nurse is using a kinesthetic channel of communication. The channel of communication is the medium the sender has selected to send the message. The channel might target any of the receiver's senses. The channels are auditory (spoken words and cues), visual (sight, observations, and perceptions), and kinesthetic (touch). Olfactory is not one of the channels used in communication. Question format: Multiple Choice Chapter 8: Communication Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Caring Reference: p. 173