Taylor PrepU Chapter 8: Communication
An evening shift nurse is caring for a client scheduled for a colon resection in the morning. The client tells the nurse that the client is afraid of waking up during surgery. The best response by the nurse is to:
ask why the client thinks the client will wake up during surgery.
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 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?
"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 70-year-old client had a cholecystectomy 4 days ago. The client's daughter tells the nurse, "My mother seems confused today." Which question would be best for the nurse to ask to assess the client's orientation?
"What day of the week is it?"
The nurse takes into consideration factors that influence communication when communicating with clients. Which situations accurately reflect communication that considers these variables? Select all that apply.
-A nurse uses simple language and demonstrations to explain a procedure to a preschooler. -A nurse checks a client's occupation for clues on how this will affect communication but avoids stereotyping the person. -A nurse takes into consideration a client's culture when planning how far away to sit when communicating.
A nurse is planning care for an adult client with severe hearing impairment who uses sign language and lip reading for communication and who has a new diagnosis of cancer. Which nursing action is most appropriate when establishing the plan of care for this client?
Arrange for a sign language interpreter when discussing treatment.
Which is a skill appropriate to use in therapeutic communication?
Control the tone of the voice to avoid hidden messages.
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
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 has been caring for a client who had a myocardial infarction 2 days ago. During the morning assessment, the nurse asks the client how the client feels. Which scenario warrants further investigation?
The client stares at the floor and states, "I feel fine."
The nurse is using nonverbal communication when caring for a group of clients. Which situation reflects nonverbal communication? Select all that apply.
The nurse is maintaining eye contact when changing a client's dressing. The nurse has a smile when being thanked for caring for a family member. The nurse is using a quiet tone of voice.
Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship?
Working phase
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 attempting to complete an 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 pace.
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.
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:
is unacceptable and breaches the client's confidentiality rights.
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.
Which nurse would most likely be the best communicator?
A nurse who easily develops a rapport with clients
Which is a characteristic of a person-centered or helping relationship?
An unequal sharing of information
When assessing a client's nonverbal communication, the nurse should assess which aspect as being the most expressive?
Facial expressions
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 non-therapeutic communication?
False reassurance
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?
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
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 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.
A nurse is asking a colleague about a situation. Which statement demonstrates assertive communication?
"I think there is a better way to handle this."
A nurse is obtaining a history from an adult female client. When the nurse asks how many times the client has been pregnant, the client answers, "I have four kids." Which statement, made by the nurse, seeks clarification of the original question?
"I understand you have four kids; how many times have you actually been pregnant?
In which situation would the SBAR technique of communication be most appropriate?
A nurse is calling a physician to report a client's new onset of chest pain.
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?
"I know this is hard for you. Is there any way I can help?"
The nurse is collecting health data and avoids using closed-ended questions. Which are examples of closed-ended questions? Select all that apply.
"Does it hurt when I touch you here?" "Do you smoke cigarettes?" "Are you ready to get out of bed?" "Is there any chance you might be pregnant?"
A nurse is interviewing a client who has come to the clinic for a follow-up visit. The nurse notices the client does not make eye contact and speaks while looking down. How should the nurse respond?
Assume a position at eye level with the client and continue with the interview.
Which statements describe the qualities of a helping relationship? Select all that apply.
The helping relationship is built on the client's needs, not on those of the helping person. A helping relationship is dynamic. A helping relationship is purposeful and time limited.
A nurse is preparing to provide discharge instructions to a postpartum client regarding infant care. Before beginning the education session, the nurse should:
eliminate as many distractions as possible.
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.
During an admission intake assessment, a nurse uses open-ended questions to gather information. An example of an open-ended question is:
"Why did your physician send you here to be admitted?"
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?
"You're worried about how you will tolerate the pain associated with labor."
Each of the following facilitates a therapeutic nurse-client relationship except:
closed-ended questions.
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 communicating the plan of care to a client who is cognitively impaired. Which nursing actions facilitate this process? Select all that apply.
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 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
