NUR 112 Unit 2 PREP-U
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 user. To foster effective communication, the nurse should:
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?"
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:
"Were you tired and depressed before starting the new medication?"
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:
"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?
Open-ended question
A male client has always prided himself in maintaining good health and is consequently shocked at his recent diagnosis of diabetes. The nurse has asked the client, "How do you think your diabetes is going to affect your lifestyle?" The nurse has utilized which of the following interviewing techniques?
an audiologist.
A nurse suspects that a client may have a hearing problem. The nurse should attempt to consult:
communication channel.
A nurse touches the client's hand while discussing his diagnosis. This action is a(an):
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?
A student nurse is attempting to improve their communication skills. Which therapeutic communication skill is appropriate? Control the tone of the voice to avoid hidden messages.
A student nurse is attempting to improve their communication skills. Which therapeutic communication skill is appropriate?
Working phase
Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship?
A student nurse is attempting to improve their communication skills. Which therapeutic communication skill is appropriate?
Control the tone of the voice to avoid hidden messages.
"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:
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?
Therapeutic communication
In order to provide effective nursing care, the nurse should engage in what type of communication with the client and significant others?
Identifying with the client's feelings
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 uses a disclaimer to verify that any views expressed on Facebook are his or hers alone and not the employer's.
Nurses use social media to share ideas, develop professional connections, access educational offerings and forums, receive support, and investigate evidence-based practices. What is an example of the proper use of social media by a nurse?
An RN is working on a medical-surgical unit with an experienced licensed practical/vocational nurse (LPN/LVN). Which tasks are appropriate for the RN to delegate to the LPN/LVN? (Select all that apply.)
Reinforce a post-surgical abdominal dressing. nsert a nasogastric tube in a client with absent bowel sounds. Administer oral aspirin and lisinopril to the client with hypertension.
is unacceptable and breaches the client's confidentiality rights.
Several nurses on the same hospital unit communicate on the same social networking site. A nurse posts the following statement to the social networking page, "The lady in room 34 with heart failure was a train wreck!" This statement:
"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 or question 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?
"Are you ready to get out of bed?" "Do you smoke cigarettes?" "Is there any chance you might be pregnant?" "Does it hurt when I touch you here?"
The nurse is collecting health data and avoids using closed-ended questions. Which are examples of closed-ended questions? (Select all that apply.)
"Could you tell me more about how you are feeling right now?"
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?
Recommendation
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 neurolgoical checks every 2 hours and the nurse should report any alterations to the health care provider. In which section should this information be relayed?
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?
needs reflective of the current situation relationship terminated with goal achievement
Which characteristic would indicate a professional relationship? Select all that apply.
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
Message
A nurse gives a speech on nutrition to a group of pregnant women. What is the speech itself known as?
"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?
"I think there is a better way to handle this."
A nurse is asking a colleague about a situation. Which statement demonstrates assertive communication?
sit at the bedside and allow the client to explain the statement.
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:
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:
A nurse is calling a physician to report a client's new onset of chest pain
In which of the following situations would the SBAR technique of communication be most appropriate?
"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:
"Feel like a woman . . ."
A client who underwent a hysterectomy 4 days ago says to the nurse, "I wonder if I'll still feel like a woman." Which response would most likely encourage the client to expand on this and express her concerns in more specific terms?
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?
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?
ask to speak to the night shift nurse in private and explain how the comment made her feel.
A graduate nurse has been working on a telemetry unit for 6 months. The nurse arrives at work in the morning and overhears a night shift nurse talking about the graduate nurse. The night shift nurse is heard saying, "That new nurse is only here to meet a doctor and get married." The best response by the new nurse would be to:
an 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:
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:
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:
Orientation phase
A nurse enters the client'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 client a printed card with this information. In the helping relationship, what does this represent?
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?
"You're worried about how you will tolerate the pain associated with labor."
A nurse is assessing vital signs on a pregnant client during a routine prenatal visit. The client states, "I know labor will be so painful, it sounds awful. I am sure I will not be able to stand the pain; I really dread going into labor." What is the best response from the nurse?
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:
pull the curtain dividing the two beds, maintain eye contact, and speak in a low, audible voice.
A nurse is caring for a client in a semi-private room. The nurse is preparing to discuss the medical treatment plan with the client. To best ensure privacy the nurse should:
"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 statement conveys empathy by the nurse?
"You said that you do not smoke, but you have an open package of cigarettes in your pocket."
A nurse is collecting a health history on a client. When asked about alcohol, tobacco, and drug use, the client states, "I quit smoking 10 years ago." However, the nurse observes an open package of cigarettes in the client's shirt pocket. What is the most appropriate response by the nurse?
The nurse maintains eye contact with the client. The nurse shows patience with the client and gives the client time to respond. 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.
assess how the client would like to communicate
A nurse is completing a health history on a client who has a hearing impairment. Which actions should the nurse take to first to enhance communication?
False reassurance Giving advice
A nurse is engaged in a nurse-client relationship. Which communication techniques would be important for the nurse to avoid? Select all that apply.
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:
Approach the client from the front. Use the client's name. Smile and maintain eye contact.
A nurse needs to complete an assessment and vital signs on a client who has Alzheimer's disease. How should the nurse approach this client to gain cooperation? (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:
Reinforce a post-surgical abdominal dressing. nsert a nasogastric tube in a client with absent bowel sounds. Administer oral aspirin and lisinopril to the client with hypertension.
An RN is working on a medical-surgical unit with an experienced licensed practical/vocational nurse (LPN/LVN). Which tasks are appropriate for the RN to delegate to the LPN/LVN? (Select all that apply.)
ask the client why she thinks she will wake up during surgery.
An evening shift nurse is caring for a client scheduled for a colon resection in the morning. The client tells the nurse she is afraid of waking up during surgery. The best response by the nurse is to:
recommend 40 mg of furosemide be administered because the client had improvement with past administration.
An experienced nurse has been working with a client with heart failure. The client's lungs were clear to auscultation during the morning assessment; however, the afternoon assessment revealed bibasilar crackles and tachypnea. The nurse calls to give SBAR report to the covering health care provider. In the final step of the report the nurse should:
A professional interpreter
The nurse is conducting an assessment on a client and identifies a need for an interpreter. Which of the following is the best choice for an interpreter?"
Trustworthiness
What quality do clients most value in nurses?
Facial expressions
When assessing a client's nonverbal communication, the nurse will assess which characteristic as the most expressive part of the body?
Orientation phase
When caring for a psychiatric client, a formal contract is made with the client during which phase of the nurse-client relationship?
medical terminology.
When communicating with clients nurses need to be very careful in their approach. This is particularly true when communicating using:
"The thought of having surgery is keeping you awake."
When the preoperative client 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 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 client's level. The nurse takes advantage of any available opportunities to communicate information to clients in routine caregiving situations.
Which nursing actions would most likely help improve communication with clients and achieve a more effective helping relationship? Select all that apply.
Empathy
Which qualities in a nurse help the nurse to become effective in providing for a client's needs while remaining compassionately detached?
"Were you tired and depressed before starting the new medication?"
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: