Fundamentals of Nursing Ch 20 PrepU and NCLEX

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

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?

message

A nurse gives a speech on nutrition to a group of pregnant women. What is the speech itself known as?

"Have you ever thought of laser surgery?"

A nurse is discussing cataract treatment with a client. Which statement by the nurse would be most therapeutic?

asking the client if he or she has recently taken ferrous sulfate (iron) or bismuth subsalicylate

A client arrives at the emergency department after experiencing several black, tarry stools. The nurse will develop a cause and effect by:

"What questions do you have about the surgery?"

A client 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?

The working phase

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?

"Can you tell me why your physician sent you here to be admitted?"

During an admission intake assessment, a nurse uses open-ended questions to gather information. An example of an open-ended question is:

Therapeutic communication

In order to provide effective nursing care, the nurse should engage in what type of communication with the client and significant others?

"Do you have any questions about your cholecystectomy?"

The newly hired nurse is collecting assessment data for an upcoming surgical procedure from a client who speaks English as a second language. Which statement made by the newly hired nurse would indicate to the nurse educator that intervention is needed?

Interpersonal

The nurse and the physical therapist discuss the therapy schedule and goals for a client on a rehabilitation unit. What type of communication is occurring between the nurse and the therapist?

"Why did the health care provider prescribe this medication for you?"

The nurse faculty is observing a student nurse gather data from a client. Which question, if asked by the student, would indicate to the faculty that the student has a clear understanding of open-ended questions?

• "Is there any chance you might be pregnant?" • "Do you smoke cigarettes?" • "Are you ready to get out of bed?" • "Does it hurt when I touch you here?"

The nurse is collecting health data and avoids using closed-ended questions. Which of the following are examples of closed-ended questions? Select all that apply.

Kinesthetic

The nurse is communicating with a client who begins to cry. The nurse places her hand on the client's arm and sits quietly at the client's beside. What mode of communication is the nurse using to offer caring and comfort for the client?

Orientation phase

The nursing instructor is discussing communication with a student. The student identifies that a contract is made with the client during which phase of the nurse-client relationship?

• The nurse controls the tone of his or her voice so that it conveys exactly what is meant. • The nurse makes statements that are as simple as possible, gearing conversation to the patient's level. • The nurse takes advantage of any available opportunities to communicate information to patients in routine caregiving situations.

Which nursing actions would most likely help improve communications with patients and achieve a more effective helping relationship? (Select all that apply.)

have group members confront the dominant member to promote the needed team work

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:

Working phase

Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship?

• "Cheer up. Tomorrow is another day." • "Your doctor knows best." • "Don't worry. You will be just fine in another day or two." • "Everything will be all right."

A client has just been given a diagnosis of cirrhosis of the liver. Which statements by the nurse should be avoided because they could impede communication? Select all that apply.

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

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:

sits at the client's bedside and faces the client

A nurse enters a client's room to complete an admission history. The nurse will convey interest in the client's story if the nurse:

reviewing health changes

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 activity would the nurse be carrying out?

Identifying with the client's feelings

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?

Small-group communication

When attending a staff meeting, a nurse is participating in what type of communication?

The client stares at the floor and states, "I feel fine."

A nurse has been caring for a client who suffered a myocardial infarction 2 days ago. During the morning assessment, the nurse asks the client how he feels. Which scenario warrants further investigation?

involve the child's stuffed animal in the educational session

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:

Closed question

During an assessment of a newly admitted client the nurse asks the client 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?

Empathy

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?

orientation phase

A home care nurse discusses with a client when visits will occur and how long they will last. In what phase of the nurse-client relationship is this type of agreement established?

incongruent relationship

A nurse communicating with a client states, "I will be changing your dressing, but we have plenty of time to talk first." She is already wearing sterile gloves and a mask and is busy working with her back to the client. The nurse is conveying a (an)

aggressive

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:

swaddling the child and gently stroking its head

A nurse is attempting to calm an infant in the nursery. The nurse responds to the highest developed sense by:

allow the client to set the pace

A nurse is attempting to complete an admission database. While taking the history, the nurse notices the client appears uncomfortable and slightly tachypneic. The nurse should:

easy wrinkling of the skin and sunken eyes

A nurse is caring for a client admitted to the hospital for dehydration. The physical findings consistent with the diagnosis include:

"I know this is hard for you. Is there any way I can help?"

A nurse is caring for a client who is newly diagnosed with terminal cancer. The nurse enters the client's room and finds the client sitting in the dark crying. Which of the following statements conveys empathy on part of the nurse?

remain honest, open, and frank

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 abuser. To foster effective communication, the nurse should:

• The nurse shows patience with the client and gives the client time to respond. • The nurse maintains eye contact with the client. • The nurse keeps communication simple and concrete.

A nurse is communicating the plan of care to a client who is cognitively impaired. Which nursing actions facilitate this process? Select all that apply.

Sender

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. The nurse is the:

ask to speak to the physician in private and address any disrespectful remarks or behaviors

A nurse is on his lunch break in the hospital cafeteria and sits at a table near a group of physicians eating their lunch. The nurse recognizes one of the physicians as being in charge of his clients. The nurse witnesses the physician point at the nurse and state, "That guy needs to get fired." The best response by the nurse would be to:

intimate zone

A nurse is performing a wet to dry dressing change on a client's abdomen. During this intervention the nurse is communicating with the client in the:

tell herself to "remain calm" and remember that she was trained to perform this skill

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 she has not performed wound care on a complex wound in the past. Using effective intrapersonal communication, this nurse should:

eliminate as many distractions as possible

A nurse is preparing to provide discharge instructions to a postpartum client regarding infant care. Before beginning the education session, the nurse should:

"Sir, I understand this is uncomfortable but I assure you I am experienced with this task and would like to continue."

A client comes into the urgent care center to have sutures removed on his right arm. The nurse assesses the sutures and finds significant crusting along the suture line. The client indicates he didn't have time to get his sutures removed a week prior as directed. The nurse soaks the crust and attempts to remove the sutures. As the nurse attempts the suture removal, the client frequently pulls his arm away and tells the nurse, "you do not know what you are doing." In response, the nurse should answer:

"The needle causes discomfort or pain when it goes in, but I will be by your side throughout and will help you hold your position."

A client is scheduled for thoracentesis. The nurse assesses that the client appears anxious about the procedure and needs honest support and reassurance. What is the most appropriate response by the nurse to this client?

"All of the victims got themselves out of the car?"

Paramedics arrive in the emergency department with a victim of a motor vehicle collision. The paramedic reports the driver was restrained, the car was traveling about 30 miles per hour, and the air bags were not deployed. The paramedic continues to report the car was struck from behind and that all individuals in the car were able to self-extricate. Which statement made by the nurse is verifying the report from the paramedic?

• A nurse takes into consideration a patient's culture when planning how far away to sit when communicating. • A nurse uses simple language and demonstrations to explain a procedure to a preschooler. • A nurse checks a patient's occupation for clues on how this will affect communication but avoids stereotyping the person

Nurses must take into considerations factors that influence communication when communicating with patients. Which examples accurately reflect communication that considers these variables? (Select all that apply.)

Encouraging elaboration

The nurse is visiting a hospice client in his home. He is explaining the difficulties he is having with his home infusion pump. By making statements such as "I see" and "go on" during the conversation, the nurse is utilizing which therapeutic nurse-client communication technique?

Take note of the client's cues when choosing a position and act on these cues

Which guideline should a nurse use when choosing a position (location) in relation to a client during a verbal interaction?

A nurse who easily developed a rapport with clients

Which of the following nurses most likely is the best communicator?