Communication and Interpersonal Skills

When interacting with clients, the nurse aide should remember that A. more than half of all communication is nonverbal. B. picture boards are not considered an accurate way to communicate. C. speaking is the most reliable way to communicate. D. clients lose the ability to communicate as they get older.

A: Research has shown that 58% of all communication is nonverbal. It includes tone and pitch of voice, eye contact, facial expressions, body position, gestures, and touch. To realize how powerful nonverbal communication can be, think of all the ways that simple concepts like "Yes" or "Really" can be said or even expressed nonverbally.

Which of the following is an acceptable way for the CNA to cope with feelings of anger and frustration? A. Ask your supervisor for time to talk about your feelings. B. Refuse to care for a difficult resident until your mood improves. C. Tell several staff members over lunch. D. Call your best friend on the way home and vent.

A: At some point in time, every health care professional becomes frustrated by a challenging client or situation. Do not dismiss your feelings. It is important for you to find a safe outlet for expressing your concerns. Remember the laws about client confidentiality and avoid comments to co-workers and friends. Supervisors are experienced and can offer perspectives and suggestions. Remember that working with clients can be challenging but also rewarding.

If you are unsure of the steps of a task that the nurse told you to do, you should A. ask the nurse to clarify the instructions. B. do the best possible job and hope it is adequate. C. ask the patient how the task is usually done. D. ask another CNA to do the job so you won't get in trouble.

A: Clarification is an important part of communication. If you receive a message that you don't understand, ask the speaker to explain. Simply say, "I'm not sure what you said about..." or "I don't feel clear about..." It is always good to repeat back the instructions so the speaker knows you understand them. It can be dangerous to give any client care if you're uncertain about how to perform a task.

If a client says, "God is punishing me," or asks, "Why me?" how should the nurse aide respond? A. Listen and ask questions to learn more. B. Talk about a time you felt the same way. C. Reply, "God doesn't punish people." D. Make humorous remarks to relieve tension.

A: Good communication includes active listening. This means giving a client your undivided attention and discerning the meaning of the person's message. It is safe to respond, "I don't know. How can we help you?" Do not discourage conversation. Engage the client by asking more questions such as "Why do you think that?" or "Tell me more." The client is in an active thought process. Do not offer solutions. Just be available to listen and reflect.

How can the nurse aide BEST help a client who is not accepting a loss? A. Encourage the client to talk about the loss. B. Leave the client to grieve privately. C. Convince the client to accept the loss. D. Discourage group activities until the client is ready.

A: Moving through the loss and grief process is an individual experience. Each person recovers at a different rate. The best way to help a grieving client is to be available to listen and provide support. Encourage the client to talk about the loss and share some memories. Being around others may also be helpful for the client, but do not decide what is best for the person. Consider asking a social worker, grief counselor, or clergy member to assist the client.

A confused client asks a nurse aide what day it is. The nurse aide should A. point to the date on a calendar and say the date. B. ignore the request because the client is already confused. C. explain that memory loss is natural and the date is not Important. D. provide the date and then quiz the client later.

A: Provide and repeat information to help clients understand their surroundings. To keep a client oriented, use the person's name frequently. Information such as date and time are reinforced with calendars and clocks. Seasonal decorations are also helpful.

A female resident calls the nurse aide and says, "Someone spilled water on my bed." The nurse aide observes a wet area on the pad, directly underneath the resident. The nurse aide should A. change the linens and make a mental note to offer the bedpan more often. B. remind the resident to ask for a bedpan when she needs one. C. tell the resident that she has obviously urinated in bed. D. ask the nurse to get an order for an indwelling catheter.

A: Respond to the situation with kindness and respect. Never embarrass or blame a resident. Don't ask a resident to do more than she is capable of. Try to determine the cause of the incident, then develop a plan that will help the resident remain healthy and safe. When a resident has an episode of incontinence, consider the possibilities. Does the resident have a bladder infection? Is the person confused? Was she dreaming? Is she on a regular toileting schedule? Has she consumed too many fluids? Was her call light nearby? Use good communication to ask questions and find the best solution for the resident.

To BEST communicate with a client who is totally deaf, the nurse aide should A. write down information for the client to read. B. avoid eye contact with the client. C. smile frequently and speak loudly. D. allow the client to initiate communication.

A: The first thing to do when working with a deaf client is to find out how the client prefers to communicate. This will lower the client's level of anxiety. Start by writing to introduce yourself and ask questions. Always maintain eye contact so the client knows you are communicating with him or her. If the client prefers to lip read, speak normally. Bear in mind that smiling interferes with natural speaking. Adding gestures is acceptable and can increase the client's understanding.

1. To communicate clearly with a client who has hearing loss, what should you do? A. Look directly at the client when you speak. B. Stand behind the client when you speak. C. Speak in a loud and slow manner. D. Speak in a high-pitched tone of voice.

A: When speaking to clients who are deaf, do several things. First, make sure that there is adequate lighting. Second, stand directly in front of the client and maintain eye contact. Next, talk a little slower so the client can adjust to your speaking style. Add gestures. If the client seems confused, write or draw pictures.

The nurse aide finds a resident sobbing. What is the best thing for the nurse aide to say to the person? A. "Crying doesn't solve anything." B. "Please stop crying. It upsets the others." C. "Cheer up. Let's go to the activity room." D. "You seem sad. Can you tell me about it?"

D: Emotions are a natural part of life. They must be acknowledged before they can be understood. Do not ignore or minimize how another person feels. Let the person talk about what happened and why the person feels the way he or she does. By sitting quietly and listening, you validate the person's emotions and allow him or her to find solutions or meanings. Don't offer a quick solution to avoid your own discomfort.

Mrs. Smith, your patient, tells you that her hearing aid is missing. What do you do? A. Tell her she will be fine without it for the day. B. Immediately report it to the nurse. C. Let her borrow her roommate's extra hearing aid. D. Call the family for a replacement.

B: After learning about any missing object, first do a complete search. Check drawers, linens, pockets, and all nearby areas. Often these items are simply misplaced. If you fail to locate the missing item, report the loss to the nurse and complete any forms. This will relieve you of responsibility. If the item is found, notify the nurse. Do not contact the family; doing this is not within the scope of care for a nurse aide.

A male resident has just been admitted to the facility. The nurse aide should A. do whatever the charge nurse says. B. introduce him to his roommate. C. announce his arrival at dinner. D. say nothing until he has settled in.

B: Any transition can cause anxiety. A new resident has to make many adjustments: new people, new schedules, and a new environment. As a direct caregiver, the nurse aide is in the best position to help a new resident become comfortable by introducing him to his roommate and helping him start becoming familiar with his surroundings.

A resident complains that his children never visit. The aide should A. remind him that his children have busy lives. B. listen quietly as he talks about his feelings. C. tell him that they will probably come soon. D. find other lonely residents for him to talk to.

B: Good communication aims for mutual understanding. If a client complains or seems angry, often there is another emotion present. The client may actually be sad, disappointed, or feeling abandoned. Spending a few minutes listening can lead to understanding of the person's true feelings. Reflect back what you are hearing and ask gentle questions. The client may be relieved and ready to talk about solutions.

After you've had to complete several assignments that a co-worker didn't do, what is the best approach? A. Warn the other team members. B. Ask the co-worker if there was a reason. C. Post an anonymous sign in the break room. D. Leave a note on the supervisor's desk.

B: Healthy communication depends on one's willingness to discuss all topics, even if they can be difficult. Don't assume the other person has negative intentions. Start the conversation in a nonthreatening way: "I notice that you haven't been able to finish your work. Is something the matter?" This lets the other person know that you are aware of the problem while allowing the person to respond without being defensive. If the behavior continues, you can say, "I'm having a hard time finishing my own work. I'll have to let the supervisor know."

How should you communicate with a client who only speaks and understands a foreign language? A. Listen and say nothing. B. Use picture boards and gestures. C. Ask the nurse for a different assignment. D. Speak more slowly to increase understanding.

B: Many facilities have clients who don't speak or understand English. Laws are in place to protect client rights. Check the policies of your facility to learn the proper procedures for assisting speakers of other languages. Find out if interpreters are available. Otherwise, employ simple adaptations such as picture boards and gestures.

An example of negative body language is A. touching the resident's shoulder as you're talking. B. putting your hands on your hips. C. smiling and maintaining eye contact. D. leaning toward the resident to communicate.

B: Negative body language can be powerful and cancel the meaning of your words. Putting your hands on your hips, crossing your arms, or making a "steeple" with your fingers can each create a communication barrier between you and others. Remember that over half of all communication is nonverbal. Use gestures to offer support, not to push others away.

A visitor enters the room while the nurse aide is changing the client. How SHOULD the nurse aide respond? A. "Hi, come on in. We're almost done." B. "Would you please wait in the lobby?" C. "Stay on the other side of the curtain." D. "Can't you knock?"

B: The client is entitled to complete privacy when receiving care. Close the door before starting care. If a visitor enters the room or fails to knock, quickly redirect that person to another area. Tell the person that you will get him or her once you are finished. Consider putting a sign on the door to let others know they may not come in while you're giving care.

When communicating with the client's family, the nurse aide SHOULD A. try to mediate the family's problems. B. listen to their concerns and offer support. C. offer advice about the client's medical treatment. D. compare the client's progress with that of other residents.

B: The nurse aide should always be able to offer support to the client and his or her family. However, the role of the nurse aide does not include providing medical recommendations. Listen to the family's concerns and tell them you will report those concerns to the nurse. Never offer medical advice on your own or discuss other clients, even if asked.

You are assigned to care for a new resident, but you don't know what to call her. You should introduce yourself and then A. call her "Dear" or "Honey" to be friendly. B. ask her what name she would like to be called by. C. call her by her first name. D. ask a family member what name to call her.

B: When a new resident enters the facility, it is appropriate to first address the person formally, such as "Ms. Smith" or "Mr. Jones." After you introduce yourself and start providing care, you can ask the client which name he or she prefers. Many older people choose to be addressed by their formal name. Others may be more comfortable with a first name. Using pet names such as "Honey" is not respectful.

The nurse aide asks a resident how she feels, and she replies, "Fine." Still, the nurse aide suspects the resident is in pain because A. the resident often mixes up language. B. the resident is dependent on analgesics. C. the resident is grimacing. D. the resident has a high tolerance for pain.

C: Nonverbal communication can help you understand a resident's condition. Facial expressions such as grimacing, frowning, or tight lips can indicate pain. Moaning or becoming completely silent are signs of discomfort. Rubbing or holding a part of the body are involuntary actions that tell you where the resident hurts. When a resident's words do not match his or her actions, look for nonverbal cues that can help you determine how to assist the resident.

If you are not sure how to use a piece of equipment , you should A. do the best you can. B. find a different way to complete the task. C. ask the nurse for instructions. D. not use the equipment.

C: Open and honest communication among all team members helps everyone accomplish more. Sometimes instructions aren't clear or you aren't familiar with a device or technique. Ask for help in a direct way. Listen attentively. Questions are a good way to clarify. Repeat instructions to make sure you understand. After performing the task, take the time to review the steps to reinforce the lesson.

A nurse aide is caring for a client who answers every question by nodding and saying "Yes." How should the nurse aide handle this behavior? A. Ask a family member to translate for the client. B. Speak loudly when providing care. C. Determine if the client is able to understand. D. Immediately inform the nurse of the client's odd behavior.

C: When a client always responds the same way to all questions or conversations, take the time to determine whether the person understands what is being said. Is the client able to hear? Does the person have expressive aphasia? Can he or she understand English? Is he or she trying to please the nurse aide? Once you know the reason, you can adapt your care to the client.

Which is the best way to talk to a resident with a visual impairment? A. Turn on all the lights to enhance the resident's remaining vision. B. Touch the resident before you start talking. C. Announce your presence when entering the room. D. Speak loudly and use exaggerated mouth movements.

C: When communicating with a client who has a visual impairment, speak in a natural tone and volume. Loss of vision does not mean loss of hearing. However, never assume that the client can recognize your voice. Always identify yourself when entering the client's room. If others are present, introduce them. Turn off the television and minimize distractions. Use normal language; there is no need to avoid words like "see" or "look." Speak directly to the client. Be sure to let the person know when you are leaving the room.

Active listening is important because A. it doesn't require any effort. B. it eliminates the need to ask questions. C. it provides time to plan a response. D. it prevents misunderstandings.

D: Active listening can build relationships and solve problems by eliminating judgment and keeping communication open. When using active listening, be relaxed and attentive. Block out distractions. Use nonverbal cues such as eye contact and leaning toward the speaker. Don't interrupt the speaker. Be open and try to understand the speaker's point of view. Ask thoughtful questions to learn more. The goal is to reach a common understanding and agreement.

When communicating with a nonverbal resident, the nurse aide should do all of the following EXCEPT A. reaching the resident's eye level for better interaction. B. asking the family if there are facial expressions or gestures that have meaning. C. remembering that nonverbal residents are often able to understand. D. providing routine care while assuming the resident has no way to communicate.

D: Being nonverbal does not mean being unable to communicate. The resident may be intelligent and able to understand what others are saying. Often the resident can communicate through gestures or facial expressions. Picture or word boards can be useful communication tools. Asking questions with yes-or-no answers, such as "Are you in pain?" allow the resident to respond. The resident's family may also be able to provide methods to increase understanding.