Ch 21 Communicator
A client has been recently diagnosed with type 1 diabetes mellitus. He is seen in the emergency room every day with high blood sugar. The client apologizes to the nurse for bothering them every day, but he cannot give himself insulin injections. What should the nurse's response be?
"Has someone taught you how to take them?"
A nurse is discussing cataract treatment with a client. Which of the following statements by the nurse would be most therapeutic?
"Have you ever thought of laser surgery?"
A nurse visits a female victim of sexual assault for the fourth visit. The client expresses that she is unable to cope with the trauma. Even though the assault occurred quite some time ago, she feels as if it just happened yesterday. What is the most appropriate response by the nurse?
"Tell me more about the aspects that makes you feel as if it happened yesterday."
A client reports to the primary health care facility with complaints of chest pain. After the investigations and initial treatment, the client anxiously inquires if he had a heart attack. What should be the nurse's reply?
"The physician wants to monitor you and control your pain."
When the preoperative patient tells the nurse that he cannot sleep because he keeps thinking about the surgery, an appropriate reflection of the statement by the nurse is
"The thought of having surgery is keeping you awake."
When documenting patient care, the nurse understands that the most important reason for correct and accurate documentation is which of the following?
Conveyance of information
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 is caring for a client with myasthenia gravis. The client is having difficulty forming words and his tone is nasal. Which of the following is an effective communication strategy for this client?
Repeat what the client has said to verify the meaning.
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 of the following activities would the nurse be carrying out?
Reviewing health changes
Which of the following activities takes place during the working phase of the nurse-patient relationship? Select all that apply.
• The patient genuinely expresses his or her concerns to the nurse. • The patient participates actively in the relationship.
Care provided to a patient following surgery and until discharge represents which phase of the helping relationship?
Working phase
The nurse has arranged to start an IV line for a client with pancreatitis. The nurse notes that the client appears anxious about the procedure. Which of the following is the most appropriate response by the nurse to decrease the client's anxiety?
"I will start an IV that will add fluids directly to the blood stream."
A nurse pays a house visit to a client who is on total parenteral nutrition. The client expresses that he misses enjoying food with his family. What is the most appropriate response by the nurse?
"Tell me more about how it feels to eat with your family."
A female client reports to her primary care physician with aggravated chest pain. The physician orders a stress test. The client tells the nurse that she doesn't want to take the test and feels she should instead continue with the 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 has developed strong rapport with the wife of a patient 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 patient's wife tells the nurse, "I can't believe it's come to this." How should the nurse best respond?
"This must be very difficult for you to hear. How do you feel right now?"
A client comes to the clinic complaining of abdominal pain. Which question would be most appropriate for the nurse to ask initially to facilitate the assessment?
"What activities exaggerate the pain?"
A nurse is assessing a patient's nutritional intake prior to admission based upon information that indicates the patient has lost 10 pounds over the last 2 months. An appropriate therapeutic communication technique to gain information is which of the following?
"What factors have contributed to your weight loss over the last few months?"
A patient scheduled to have hip replacement surgery states, "I am so scared of the surgery and of the anesthetic." What is the best response by the nurse?
"What questions do you have about the surgery?"
A nurse is examining a 3-year-old child with conjunctivitis. During the examination, the child starts crying and refuses to sit still. Which of the following statements is appropriate for the nurse tell the child?
"Would you like to see my flashlight?"
In which of the following situations would the SBAR technique of communication be most appropriate?
A nurse is calling a physician to report a patient's new onset of chest pain.
The nurse has entered a patient's room and observes that the patient is hunched over and appears to be breathing rapidly. What type of question should the nurse first implement in this interaction?
A yes/no question
An elderly patient who has had a colostomy for over 10 years states, "I won't need any teaching about colostomies. I understand how to change the bag and care for my colostomy, but I'm not sure how to best clean my stoma?" What does this statement indicate?
An incongruent relationship
A nurse has drafted an SBAR communication before contacting the primary care provider of a patient whose condition has worsened. How should the nurse best conclude this communication?
Ask the care provider to come and assess the patient.
A nurse is asking a client health-related questions during a medical assessment. The client has developed lesions on the skin and warts around the mouth. Which of the following factors affect oral communication?
Attention and concentration
In the provision of care and the establishment of the therapeutic relationship, the nurse must first
Be aware of one's own personality
During an assessment of a newly admitted patient the nurse asks the patient many questions. The nurse begins the assessment by asking, "How many times have you been hospitalized this year for your back pain?" This is an example of which type of question?
Closed question
When caring for a patient, nursing care will be most effective when the nurse-patient interactions are focused on which of the following circumstances?
Common understanding
A nurse touches the patient's hand while discussing his diagnosis. This action is a(an)
Communication channel
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?
Communication channel
A student nurse is attempting to improve her communication skills. Which of the following is an appropriate therapeutic communication skill?
Control the tone of the voice to avoid hidden messages.
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
Which qualities in a nurse help the nurse to become effective in providing for a client's needs while remaining compassionately detached?
Empathy
A nurse is caring for a terminally ill client whose death is imminent. The nurse has developed a close relationship with the family. Which of the following is the most appropriate intervention?
Encourage family discussions of feelings.
When communicating with patients nurses need to be very careful in their approach. This is particularly true when communicating using
Medical terminology
While assessing a client, the nurse notices that the client seems to be distracted from the questions being asked. The nurse attempts to identify factors that may be affecting the communication. Which of the following would the nurse identify as an internal influencing factor?
Experience
When assessing a patient's nonverbal communication, the nurse will assess which of the following as the most expressive part of the body?
Facial expressions
Communication is the
Heart of nursing
It is important for the nurse to empathize with the client to develop a positive, therapeutic relationship. Which of the following is the characteristic of empathy?
Identifying with the client's feeling
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?
Neutral
During an annual performance review with an employee, the nurse manager does not maintain eye contact and seems concerned about the time and the next appointment. This use of communication is considered
Nonverbal
Mr. Edmondson has always prided himself in maintaining good health and is consequently shocked at his recent diagnosis of type 2 diabetes. The nurse has asked Mr. Edmondson, "How do you think your diabetes is going to affect your lifestyle?" The nurse has utilized which of the following interviewing techniques?
Open-ended question
A nurse enters the patient's room and introduces himself stating, "Hello, Mr. Alonso. My name is Anthony Bader. I will be your registered nurse today. I will be providing your nursing care and I will be with you until 3:30 PM. If you need anything, please call me on my phone or put your light on." He then gives the patient a printed card with this information. In the helping relationship, what does this represent?
Orientation phase
When caring for a psychiatric patient, a formal contract is made with the patient during which phase of the nurse-patient relationship?
Orientation phase
A group of nursing students are working together on a presentation for their clinical instructor. One student in the group participates by arguing and attempting to block each step of the process of creating this presentation. The student's behavior is causing frustration for the group of students and slowing their progress. Which of the following best describes the role this individual student is playing in relationship to the group dynamics?
Self-serving
Which of the following guidelines should a nurse use when choosing a position in relation to a patient during a verbal interaction?
Take note of the patient's cues when choosing a position and act on these cues.
The nurse has entered a patient's room after receiving morning report, rapidly assessed the patient's airway, breathing, and circulation and greeted the patient by saying "good morning." The patient has made no reciprocal response to the nurse. How should the nurse best respond to the patient's silence?
The nurse should ask appropriate questions to understand the reasons for the patient's silence.
A nurse and an elderly client with chronic back pain are in the working phase of the nurse-client relationship. Which of the following activities occur in the working phase?
The nurse tries to avoid retarding the client's independence.
When the nurse communicates with a newly admitted patient, the nurse must pay particular attention to nonverbal behaviors. The nurse considers which of the following as nonverbal communication?
The patient's tone of voice
A dialysis nurse is teaching a patient to care for the dialysis access that was inserted in the patient's right arm. The nurse assesses the patient'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 patient's hospitalization. What phase of the working relationship is best described in this scenario?
The working phase
In order to provide effective nursing care, the nurse should engage in what type of communication with the patient and significant others?
Therapeutic communication
A nurse is caring for an elderly client. What strategy should the nurse include in order to facilitate effective communication?
Use active listening during communication.
