ADN 001 PrepU Ch 8
When communicating with a client, the nurse uses reflection for which purpose?
To have the client elaborate on thoughts and feelings
A client is diagnosed with diabetes. The client's adult child offers to serve as an interpreter, because the client does not speak the dominant language. Which is the best action for the nurse to take?
contact a professional interpreter
The nurse is performing an admission interview with a new client diagnosed with acute coronary syndrome. For the nurse to obtain information and allow the client free verbalization, which question would elicit the most information?
"Could you tell me more about how you are feeling right now?"
A nurse is discussing cataract treatment with a client. Which statement by the nurse would be most therapeutic?
"Have you ever thought of laser surgery?"
A nurse is asking a colleague about a situation. Which statement demonstrates assertive communication?
"I think there is a better way to handle this."
The child of a client who just died in a hospice unit arrives and asks, "May I please stay and sit at the bedside? I really wanted to be here so my dad would not die alone." Which statement made by the nurse best demonstrates the use of empathy?
"I will close the door so you can spend some quiet time at the bedside."
A client reports to a primary care physician with aggravated chest pain. The physician orders a stress test. The client tells the nurse that the client does not want to take the test and would prefer instead to continue taking medication a little longer. Understanding that the client is anxious, what is the most appropriate response by the nurse?
"Tell me more about how you are feeling."
A nurse states the following to another nurse who is constantly forgetting to wash hands between clients: "It looks like you keep forgetting to wash your hands between clients. It's really not safe for your clients. 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
A nurse is completing a health history on a client who has a hearing impairment. Which action should the nurse take first to enhance communication?
Assess how the client would like to communicate
A nurse is discharging a client and thus terminating the nurse-client relationship. Which action should the nurse perform in this phase?
Examine goals of the relationship to determine whether they were achieved
The nurse observing an interaction between a mother and daughter appropriately identifies the interaction as which communication zone?
Intimate
It is important for the nurse to empathize with the client to develop a positive, therapeutic relationship. What is a characteristic of empathy?
It is important for the nurse to empathize with the client to develop a positive, therapeutic relationship. What is a characteristic of empathy?
A nurse is caring for a client who sustained head trauma. The client is in a medically induced coma and on mechanical ventilation. The client's parent is at the bedside in tears. The parent states, "I just want my child to know I am here." To address the needs of the parent and the client, what would be the nurse's most appropriate response?
Place a chair next to the bed and encourage the parent to hold the client's hand.
The nurse is reporting to an oncoming nurse about the care of a client using the SBAR format. The nurse informs the oncoming nurse that the client should continue to have neurological checks every 2 hours and the nurse should report any alterations to the health care provider. In which section should this information be relayed?
Recommendation
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
Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship?
Working phase
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 touches the clients hand while discussing the clients diagnosis. The action is:
A communication channel
What nursing care behavior by the nurse engenders a client to trust the nurse?
A nurse answers the client's questions about an upcoming test in a calm gentle voice while making eye contact with the client.
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?
Empathy
When assessing a client's nonverbal communication, the nurse should assess which aspect as being the most expressive?
Facial expressions Explanation: The face is the most expressive part of the body
A nurse is engaged in a nurse-client relationship. Which communication techniques would be important for the nurse to avoid?
False reassurance and giving advice
The nurse should consider which client aspect as nonverbal communication?
The client's tone of voice
The nurse meets with the client to teach self-administration of low molecular weight heparin. During the initial part of the training the client shakes the head and asks the nurse to repeat the instructions. What action demonstrates that the nurse has assessed the client's communication abilities?
The nurse faces the client, speaks slowly and clearly, and demonstrates the procedure using a needleless syringe.
Which statement accurately describes the concept of feedback as it pertains to the process of communication?
The sender and the receiver use one another's reactions to produce further messages.
Clarification involves
asking a follow-up question about a statement made by the client to clear up some point that the nurse is not sure about or to elicit more specific details.
false reassurance
dismissing the patient's concerns in order to minimize uncomfortable feelings, can cause false hope
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.
Encouraging elaboration involves
making simple statements that indicate active listening and comprehension on the part of the nurse and that prompt the client to continue talking. This technique helps the client to describe more fully the concerns or problems under discussion.
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. Although the unit may have been busy, it is best to listen to the client express feelings.
A nurse enters the client's room and states, "Hello, Mr. Alonso. My name is Anthony Bader. I will be your registered nurse today. I will be providing your nursing care and will be with you until 3:30 PM. If you need anything, please call me on my phone or put your light on." The nurse then gives the client a printed card with this information. In the helping relationship, which phase does this represent?
Orientation phase
termination phase
the nurse and client acknolwedge that they have met the goals of the the initial agreement or that the client would be better served by another nurse or health care provider
Nurses attempting to complete that 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 base.
Conversation skills used in therapeutic communication include
Controlling the tone of ones voice to avoid hidden messages
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 Explanation: Nonverbal communication refers to the use of body language, such as gestures, facial expressions, posture, space, appearance, body movement, touch, voice tone and volume, and rate of speech.
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:
involve the child's stuffed animal in the educational session.
The nurse make a contract with the client during which phase of the nurses client relationship?
Orientation phase
When caring for a psychiatric client, a nurse would make a formal contract with the client during which phase of the nurse-client relationship?
Orientation phase
orientation phase
he nurse and client establish the tone and guidelines for the relationship
Communication Zones
intimate (0-18in) personal (18in-4ft) social (4-12ft) public (12-25ft)
When communicating with clients, nurses need to be very careful in their approach. This is particularly true when communicating using:
medical terminology To effectively educate and communicate, the nurse take care to limit medical jargon.
Reflection and restatement involve
the nurse repeating back to the client a comment made by the client to ensure that the nurse has correctly heard or understood the client.
Nurses use social media to share ideas, develop professional connections, access educational offerings and forums, receive support, and investigate evidence-based practices. Which is an example of the proper use of social media by a nurse?
A nurse uses a disclaimer to verify that any views the nurse expresses on Facebook are the nurse's alone and not the employer's.
A client has cancer, but the significant other does not want the client to know the diagnosis. The nurse demonstrates sensitivity to the significant other and works with the couple to achieve desired outcomes. What kind of behavior is the nurse exhibiting?
Empathy
The nurse is visiting a hospice client in the client's home. The client is explaining difficulties with a home infusion pump. By making statements such as "I see" and "go on" during the conversation, the nurse is using which therapeutic nurse-client communication technique?
Encouraging elaboration
A nurse who is caring for newborn infants delivers care by utilizing the sense that is most highly developed at birth. Which example of nursing care achieves this goal?
The nurse gently strokes the baby's cheek to facilitate breastfeeding. Explanation: The sense most highly developed at birth would be the sense of neurological reflex. The nurse gently stroking the baby's cheek to have the baby turn toward the stroke is a developmental reflex.
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 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 user. To foster effective communication, the nurse should:
remain honest, open, and frank.
Which quality in a nurse helps the nurse to become effective in providing for a client's needs while remaining compassionately detached?
Empathy Explanation: Empathy refers to intuitive awareness of what the client is experiencing. It helps the nurse perform activities and remain emotionally neutral
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?
False reassurance Explanation: False reassurance minimizes the client's concerns and feelings and is providing assurance not based on fact. Rescue feelings occur when a nurse feels a strong urge to personally try to fix the client or family member's problem. The nurse is not giving advice or being moralistic in this scenario.
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:
aggressive.
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. In this case, the nurse plays the role in the process of communication of the:
sender
A nurse is attempting to calm an infant in the nursery. The nurse responds to the highest developed sense by:
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.
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 the nurse has not performed wound care on a complex wound in the past. Using effective intrapersonal communication, this nurse should:
tell oneself to "remain calm" and remember that the nurse was trained to perform this skill. Explanation: Intrapersonal communication, or self-talk, is communication within a person. This communication is crucial because it affects the nurse's behavior and can enhance or detract from positive interactions with the client and family. Understanding the importance of intrapersonal communication can also help the nurse work with clients and families whose negative self-talk affects their health and self-care abilities. Speaking directly to the client, a UAP, or charge nurse is interpersonal communication, not intrapersonal.
