Week 5: Communication and Collaboration
Stacy phones the healthcare provider. Which statement represents the recommendation?
"Can I have a prescription for a stronger pain medication?"
Drag and drop each nurse's statement to match the appropriate element of professional communication.
"Hello, Ms. Smith. My name is Jessica and I will be your nurse today. How are you feeling?" Courtesy "Ms. Smith, we have received your laboratory results. It seems that you are not healing well from your surgery." Trustworthy "Ms. Smith, this morning I accidently gave you the wrong medication. I have notified your provider and will monitor you closely." Autonomy
Julian returns to the client's room 30 minutes later to find that the client is tearful and states, "I am worried about having this surgery. What if something bad happens? Who will take care of my children?" Which response by Julian is therapeutic?
"This must be a difficult time for you. Would you like to talk more about this?"
When caring for a client who is hearing-impaired, which techniques may improve communication? Select all that apply.
-Allow the client time to process the information and respond. -Keep communication short, simple, and direct. -Assess the need for adaptive equipment, such as a hearing device.
Review the following interaction, then answer the question. Nurse: As a hair stylist, how do you avoid exposure to COVID-19? Client: I wear a mask and gloves at work. I wash my hands all the time. Nurse: You work with customers all day and you wear gloves and a mask. You wash your hands very frequently. Client: Yes, I wash my hands so much that the skin peels. Nurse: That sounds painful. Client: It is. I have tried different soaps, but nothing helps. Nurse: I have such dry skin on my hands from all the hand washing. I find that lotion helps. What therapeutic communication technique is Iryna using with this client? Select all that apply.
-asking relevant questions -paraphrasing -self disclosure -sharing empathy
What are elements of professional appearance? Select all that apply.
-avoid strong smelling perfume -follow uniform requirements -clean and well groomed
Which are aspects of nonverbal communication? Select all that apply.
-eye contact -sounds -gestures -appearance -personal space
What are the characteristics of a therapeutic nurse-client relationship? Select all that apply.
-purposeful -goal directed -boundaries
What are the reasons for effective communication in healthcare? Select all that apply.
-reduce errors -meets clinical standards of care -improves client outcomes increases client satisfaction meets legal standards
Review the following interaction, then answer the question. (Nurse makes eye contact with the client.) Nurse: Your hair looks very pretty today. Client: Thank you! I just got it cut last week. (A few minutes of silence passes while the client looks at herself in the mirror.) Client: I would love to do your hair for you one day. Nurse: If my hair gets any grayer, I may take you up on that offer. What therapeutic communication technique is Iryna using with this client? Select all that apply.
-sharing observations -active listening -sharing humor -using silence
Click to select all the cues that alert the nurse to be aware of communication needs.
-speaks polish -understands some English but speaks very little -been deaf since childhood -vision has deteriorated
What are elements of professional demeanor? Select all that apply.
-warm and friendly -confident -good listening skills -clear voice
Which clients may benefit from motivational interviewing? Select all that apply.
1. Client who has asthma and does not want to rehome their cat to prevent an attack 2. Client who is obese and does not think they have time to exercise 3. Client who recently had a heart attack and does not want to reduce fat intake
Drag and drop the element of professional communication to match its description.
1. Courtesy: Nurses say hello and goodbye to clients and knock on doors before entering. 2. Trustworthy: Nurses display consistency, reliability, honesty, competence, and respect. 3. Autonomy: Nurses are self-directed and independent in accomplishing goals and advocating for others.
Match each phase of the therapeutic relationship to the correct description.
1. Orientation : Begins when the nurse and client meet for the first time. 2. Termination : Marks the end of the relationship as it exists for the predefined purpose. 3. Preinteraction : Begins when the nurse starts preparation for the initial interaction with a client. 4. Working : Begins as the nurse and client collaborate as partners in promoting the client's health.
Select the correct zone of personal space to match the example provided.
1. Personal distance - The nurse is teaching a client how to choose low-sodium foods from a menu. 2. Social distance - The nurse is talking to the client's daughter about the diagnosis. 3. Personal distance - The nurse is sitting in a chair at the client's bedside. 4. Social distance - The nurse is giving a report to the oncoming shift. 5. Intimate distance - The nurse is feeding the client who has had a stroke. 6. Intimate distance - The nurse is assisting the client with toileting.
The nurse is working with a client who was involved in a motor vehicle accident last year and has been suffering from chronic pain. Match the client scenario with the phase of the therapeutic relationship.
1. Preinteraction : The nurse reads the client's chart before the first meeting to determine what interventions have been done to assist the client. 2. Working : The nurse asks what medications help to relieve the pain and suggests some alternative treatments, including massage and distraction. 3. Orientation : The nurse meets with the client and notes that they are both from Illinois. The nurse assures the client that the goal is to help them feel better. 4. Termination : The nurse provides the client with a list of items discussed and refers the client to a specialist for assistance. The nurse ends the session.
Match the healthcare professional to the role they play.
1. Speech therapist: Specializes in improving swallowing after a stroke 2. Physical therapist: Assists the client with a broken leg to use crutches properly 3. Registered dietitian: Teaches about a heart-healthy diet following a heart attack 4. case manager: Coordinates discharge to home with home health services 5. social worker: Provides community referrals to a support group 6. healthcare provider: Prescribes medication to treat an infection 7. RN: Delivers bedside care to the client based on identified needs
Which strategies implemented by the nurse would facilitate safe client transfer from the medical-surgical unit to the intensive care unit (ICU)? Select all that apply.
1. The nurse should allow time to answer any questions the ICU nurse has before transitioning the client. 2. The nurses from both departments should meet face-to-face to discuss the client's transition. 3. The nurse should use a standardized communication tool to provide information to the ICU nurse.
Motivational interviewing focuses on exploring and resolving ______ related to ________ motivation toward ______ unhealthy behaviors.
1. ambivalence 2. decreased 3. changing
Rachel enters the room to perform an assessment while waiting for Ms. Simpson's daughter to arrive. The client reports that she is in pain and feeling nauseous. The nurse decides to _______with the teaching session. Rachel is aware that ______ is important in this situation.
1. delay 2. timing
Non-therapeutic communication techniques ________ conversation and expression of feelings and causes _______ responses or behaviors in others.
1. discourage 2. negative
Which communication techniques are considered non-therapeutic? Select all that apply.
1. false reassurance 2. disapproving
Click to select all the cues that Julian is demonstrating a professional appearance and demeanor.
1. friendly and smiling 2. scrubs are clean and neatly pressed 3. shoes are clean 4. name tag is visible
Based on the client's facial expression, select the corresponding communication barrier.
1. hearing impaired or confused 2. lonely 3. frightened/anxious 4. angry/confrontational 5. sad/withdrawn 6. flirtatious
Review the following interaction, then answer the question. Client: Seriously! I need the TV fixed. Nurse: What did you do to it? Client: I did not do anything to it. Nurse: You did not do anything to it. Client: Why do you not believe me? Nurse: Of course, I believe you. Why wouldn't I believe you? What non-therapeutic communication techniques is Jeffery using with this client? Select all that apply.
1. parroting 2. defensive response 3. asking for explanation
Julian communicates with the charge nurse today. Julian: "Hi! I'm ready to receive the report." Charge Nurse: "It would be nice if you could be on time." Julian: "I'm sorry to keep you here longer. It won't happen again." Charge Nurse: "It better not! I have a family too, you know." Julian: "I'm wrong. You are correct."
1. passive 2. aggressive
Rearrange the stages of the therapeutic relationship into the correct order.
1. planning and starting the process before the purposeful interaction with the client begins 2. meeting, creating rapport, and establishing trust through honesty and empathy 3. mutual problem solving to accomplish therapeutic goals 4. separating from the formal therapeutic relationship
Nurses use communication throughout the nursing process. Place the communication statements in the correct order based on the nursing process.
1. the nurse asks the client if they have had any past surgeries 2. the nurse analyzes the client's responses and determines that the client is afraid to have surgery 3. the nurse talks with the client to establish mutual goals 4. the nurse teaches the client about the pain management plan after surgery 5. the nurse asks the client if they have any questions
Select the correct letter of the AIDET® communication technique to match the nurse-client interaction.
A: "Good afternoon, Ms. Philips." I: "My name is Anna. I am a registered nurse working in the surgery department." D: "Your procedure is scheduled for 3 p.m. The surgeon will be here to speak with you very soon." E: "Your surgery will take about 1 hour. You will wake up afterward in the recovery room. I will be there to take care of you." T:"Thank you for trusting us with your care. I will be back with the surgeon in 30 minutes."
Match the word of the acronym to the timely and accurate communication technique.
Acknowledge: Greet the client by name while making eye contact and smiling Introduce: Provide your name, skill set, professional certification, and experience. Duration: Give an accurate time expectation for procedures, medications, and discharge. Explanation: Provide instructions about what to expect next, answer questions, and let the client know how to contact you. Thank you: Show appreciation to the client for choosing your hospital or for their communication and cooperation.
Which are appropriate to share with the client? Select all that apply.
All choices are correct
When Stacy returns to the nurses' station, she overhears the night shift nurse mention that Stacy is a new graduate and probably not capable of caring for such a complicated client. When the nurse sees that Stacy has overheard the comment, the nurse groans and walks away. What action should Stacy take first?
Approach the nurse privately and ask to speak about the comment.
What is the evidence of effective communication between Julian and the client?
As the client leaves the preoperative area to go into the operative room, Julian thanks the client for her trust and cooperation.
For each statement, click to specify if it represents an assertive response, a passive response, or an aggressive response.
Assertive: -"As much as I would love to help, unfortunately, I have a lot of work to get through today." -"I disagree with you. This is how I see the situation." -"I feel offended by your statement." -"Next time, I would appreciate it if you were on time for the report." aggressive: -"I cannot help you today. You always ask for favors at the last minute." -"You are always late. What is the problem?" passive: -"I am pretty busy today, but I can do the project for you." -"It is OK that you were late. I cared for clients until you got here."
Below is an example of an ISBAR communication between a registered nurse and a healthcare provider. Which statement represents the "recommendation" in ISBAR?
Can I get a prescription for another pain medication that may help to better relieve Mr. Smith's pain?
For each client-nurse interaction, click to specify if the nurse is displaying empathy or not displaying empathy.
Empathy: -The nurse is caring for a client who recently experienced the loss of a newborn baby. The nurse sits at the bedside and holds the client's hand while the client quietly cries. -The nurse is caring for an injured client who is far from home with no support system. The nurse arranges for transportation home and grocery delivery to relieve the client's anxiety. Not empathy: -The nurse is caring for a client who is hospitalized on Thanksgiving Day. The client is tearful and missing their family on the holiday. The nurse responds, "Why are you crying? It's Thanksgiving Day!" -At the end of the shift, the nurse is caring for a client who has experienced stool incontinence. The nurse frowns when they realize this will delay leaving on time.
Select the correct non-therapeutic technique to match each statement.
Giving advice: "If I were you, I would take a leave of absence from work" Changing the subject: "It's time for your medications. We can talk about your concerns about discharge later." False reassurance: "I'm sure your test results will be normal." sympathy: "I'm so sorry for the loss of your father. You must be devastated." Disapproval: "You should not stop your cancer treatments." Defensive response: "We would never intentionally withhold your medication." Arguing: "How can you say that you are in pain? You are texting on your phone."
Below is an example of an ISBAR communication between a registered nurse and a healthcare provider. Which statement represents "identify" in ISBAR?
Good evening, Dr. Jones. This is Anna Patrick, RN, calling from St. Mary's Hospital medical-surgical unit about your client, Mr. Smith, in room 611.
Below is an example of an ISBAR communication between a registered nurse and a healthcare provider. Which statement represents the "background" in ISBAR?
He had a knee replacement two days ago and has been working with a physical therapist to use crutches.
Below is an example of an ISBAR communication between a registered nurse and a healthcare provider. Which statement represents "assessment" in ISBAR?
He reports his pain as 9/10 one hour after receiving the ordered pain medication. His temperature is normal, but his blood pressure, pulse rate, and respiratory rate are elevated. There are no signs of infection at his surgical incision.
Below is an example of an ISBAR communication between a registered nurse and a healthcare provider. Which statement represents the "situation" in ISBAR?
I'm doing well. Thank you for asking. Mr. Smith has reported severe pain in his left knee that is not relieved by the oral pain medication ordered.
A standardized communication tool used in healthcare to enhance quality care and client safety uses the acronym ISBAR. What does ISBAR stand for?
Identify, Situation, Background, Assessment, Recommendation
Click to specify if each action by the nurse indicates impaired verbal or impaired nonverbal communication.
Impaired verbal: -The nurse uses medical terminology to explain home care to Ms. Simpson. -The nurse's speech is rapid to allow Ms. Simpson to be home before it gets dark. -The nurse interrupts Ms. Simpson's daughter as she begins to ask questions. Impaired nonverbal: -The nurse touches Ms. Simpson's face without permission. -The nurse stands facing Ms. Simpson with her arms crossed.
Where is the best location for the hand-off report to occur?
Inside the client's room
Which statement best describes therapeutic communication?
It is a skill used to meet a client's expressed or unexpressed needs in a timely and respectful manner.
How does interprofessional collaboration improve health and wellness?
Leverages knowledge from multiple disciplines to improve the care of an individual
Click to identify whether each component of communication is verbal or nonverbal.
Nonverbal: -posture and gait -gestures -personal space -eye contact -appearance Verbal: -clarity and brevity -pacing -intonation -meaning
What is the most important characteristic of small group communication?
Organized and concise
For each nurse statement or action, click to specify if it is professional or unprofessional.
Professional: -"Alex, can you check Mr. Wong's blood sugar? He is in room 212." -"Good evening, Mr. Lopez. My name is Susie. I will be your registered nurse tonight." -Will brushes out his hair and pulls it back from his face before leaving for work. unprofessional: -"Good morning, John. We have not met before, but I am one of the nurses here." -"Justine, can you help me take care of the heart attack in room 126?" -Jacob got into a fight with his partner this morning before work. When asked to take the first admission, he snapped at the charge nurse. -"Oh sweetie, we will get your pain under control." -Lola prepares for work and realizes she does not have any clean scrubs, so she pulls out a dirty pair and sprays some perfume.
Select the letter from the acronym ISBAR to match the information communicated.
R: Recommend next action steps to assist the client. S: State the main reason for the communication. A: Give relevant assessment data that presents a clear picture of the client's current status. B: Provide any relevant background information that is needed to make decisions. I: Introduce yourself and identify your location and role in the care of the client.
Drag and drop the correct example to match its corresponding letter in the acronym of active listening skills.
S: Pull a chair close to the bedside and sit at an angle facing the client. U: Avoid a defensive position by uncrossing your arms and legs. R: Make your voice and posture communicate to the client that you are relaxed and comfortable. E: Maintain intermittent eye contact with the client to convey your willingness to listen. T: Use respectful and appropriate touch to convey empathy and compassion. Y: As you grow more confident in your communication abilities, trust your intuition, learn to individualize, and apply communication techniques.
The night shift nurse uses a standardized communication tool to provide hand-off information to Stacy. Drag and drop the correct letter of the ISBAR tool to match the statements.
S: The client's pain has been increasing over the past 4 hours. R: Continue to monitor the client's pain. You may need to contact the healthcare provider. B: The client had surgery two days ago and has a history of diabetes mellitus. A: The client's temperature, pulse, and blood pressure are elevated. The blood sugar level is normal. I: My name is Anna, RN. I have been caring for the client for the past 12 hours.
Ms. Simpson's daughter arrives and Rachel prepares to begin teaching. How should Rachel prepare for the education session?
Secure an authorized translator who can also perform sign language.
While Stacy is receiving the hand-off report, the physical therapist enters the room. What role does the physical therapist play in the client's recovery?
Teaching the client how to use a mobility device
Which family may benefit from motivational interviewing?
The family of a child recently diagnosed with diabetes mellitus and the family is concerned about changing their eating habits.
How do the phases of the nurse-client relationship compare to the nursing process?
The nurse is performing assessment during the orientation phase.
For each action taken by the nurse, drag and drop the corresponding client who would benefit from this action.
The nurse turns off the TV and faces the client when speaking. Client with hearing impairment The nurse announces entrance into the room and avoids the use of hand gestures when speaking. Client with vision impairment The nurse asks simple yes or no questions and uses visual aids when teaching. Client with aphasia The nurse uses simple sentences and avoids long explanations. Client with cognitive impairment The nurse provides a qualified interpreter when teaching. Client who only speaks Portuguese
Julian enters the client's room to find a nursing assistant helping the older client. Which action by the nursing assistant appears unprofessional?
The nursing assistant is calling the client "honey" instead of by name.
After providing education about medication compliance, Prisha thanks Mr. Lang and makes an appointment for him to return to the clinic in one month. What has Prisha accomplished?
The therapeutic relationship has terminated and a plan for the future was established.
For each statement, identify if the statement is therapeutic or non-therapeutic.
Therapeutic: -"The loss of a limb is a major change. Would you like to talk about how you are feeling?" -"You have been very courageous while fighting cancer. I believe you will find a way to face the surgery." -"You've told me that you are ready for discharge, but you still seem hesitant." -"Tell me more about the pain you are feeling." Non-therapeutic: -"Why have you never had a child?" -"You can't win them all."
What is the purpose of active listening?
To convey trust and respect to the client
The nurse is caring for a client who only speaks and reads Spanish. What action should the nurse take when communicating with this client?
Use an authorized interpreter to provide translation for the education.
A nurse is caring for a client who reports difficulty sleeping. Which response by the nurse is most appropriate?
You are having difficulty sleeping?"
A nurse is counseling a client about weight loss and suggests eliminating certain foods from the diet. The client refuses this advice stating, "But those are some of my favorite foods. I will not cut out those foods!" The nurse responds with, "You must cut out those foods or your health will continue to decline."
arguing
Review the following interaction, then answer the question. Nurse: What is wrong with you today? Client: I messed up the TV in my room. What non-therapeutic communication technique is Jeffrey using with this client?
asking for an explanation
Review the following interaction, then answer the question. Client: Yes, I've actually had to turn away customers. My schedule is so overbooked. Nurse: Thank you for making time to see us today. Tell me how it makes you feel to turn away customers. What therapeutic communication technique is Iryna using with this client?
asking relevant questions
Review the following interaction, then answer the question. Client: Can you call someone to fix my TV? Nurse: Let's go and see what the cafeteria is serving for lunch. What non-therapeutic communication technique(s) is/are Jeffrey using with this client? Select all that apply.
changing the subject
Making oneself available to clients in an unconditional manner demonstrates what communication technique by the nurse?
clarification
Review the following interaction, then answer the question. Nurse: How are you today? Client: I'm doing good, but it has been very busy at work lately. Nurse: You've been busy at work? What therapeutic communication technique is Iryna using with this client?
clarification
The nurse is educating a client and at the end of each sentence asks, "Okay?" The nurse's speech is rapid and explanations are lengthy. Which aspect of verbal communication is the nurse breaching?
clarity
A father is playing catch with his son. His son throws the ball high. The father says, "Come on son, that was a terrible throw."
disapproval
Prisha remembers her late grandfather who refused to take his medication and how her grandmother struggled to watch his health decline. She notices that Mr. Lang's partner is very concerned, so Prisha provides reassurance by touching Mr. Lang's partner's hand. Which characteristic of the therapeutic relationship is Prisha displaying?
empathy
Rachel finishes the teaching session and asks Ms. Simpson to repeat back how to care for her surgical site. Which part of the nursing process is Rachel performing?
evaluation
Review the following interaction, then answer the question. Client: I need it fixed now. I can't watch the news. Nurse: I'm sure it is just the batteries in the remote. Don't worry about it. What non-therapeutic communication technique is Jeffery using with this client?
false reassurance
What is the communication technique demonstrated by the nurse who selects a single topic or concept that the client has expressed to explore further?
focusing
After receiving the report, Stacy begins to assess the client, who states that pain is 9/10. The client requests additional pain medication, but there are no medications available at this time. Who should Stacy contact for assistance?
healthcare provider
Upon entering the exam room, Prisha states, "Hello, Mr. Lang. I saw that today is your birthday. Do you have any plans to celebrate?" This statement begins the orientation phase of the therapeutic relationship. This phase should include
informal communication that is friendly
Review the following interaction, then answer the question. Nurse: It must be frustrating for your TV to not be working when you want to watch the news. Let me see if I can help you.
jeffery is displaying empathy toward the client which is a therapeutic response
As Rachel prepares to provide discharge teaching, which level of communication is most appropriate?
one-on-one
What communication technique is demonstrated by the nurse? good morning hello! what would you like to talk about today
open-ended question
In which phase of the therapeutic relationship does building rapport occur?
orientation
Which communication technique involves repeating the client's exact statements word for word?
parroting
Tom says to Sally, "I'm not angry with you." Then Tom ignores Sally for the rest of the night.
passive response
John is talking to Tim and states, "Tim, you should quit your job if you are so unhappy."
personal opinion
Before assuming care, Julian receives a report of information from the nurse who is leaving the unit. Which phase of the therapeutic relationship is Julian entering with the client?
preinteraction
Clara reviews the client's medical record. Clara specifically wants to review the client's ethnicity and family form to determine any cultural needs to be addressed as part of dietary teaching. Additionally, Clara consults with the facility dietician for strategies to encourage family diet change. Which phase of the therapeutic relationship do Clara's actions demonstrate?
preinteraction
Prisha speaks to the healthcare provider and learns that Mr. Lang was recently diagnosed with a heart condition that requires daily medication. The provider explains that Mr. Lang was hesitant to take the drug and did not want to return to the clinic for monthly laboratory testing. Which phase of the therapeutic relationship does this represent?
preinteraction
Xavier Jones is talking with a family whose grandfather has just passed away. While answering questions and providing information, Xavier shares a story about his experience of losing his grandmother last year. What communication technique is Xavier using?
self-disclosure
Review the following interaction, then answer the question. Nurse: What exactly do you do for work? Client: I cut and style hair, mostly for brides and bridesmaids. Nurse: That sounds fun! Client: It is fun. I love my job, but yesterday I worked from 6 a.m. until 6 p.m. Nurse: That must have been an exhausting day. What therapeutic communication technique is Iryna using with this client?
sharing empathy
A student says to another student, "I'm sorry that you did poorly on the exam. I'm so worried that you won't pass this class."
sympathy
Click to select the cues that Prisha may need to establish a therapeutic relationship with Mr. Lang.
taking his medication inconsistently
What communication technique is demonstrated by the nurse?
touch
The content or main idea of what the client said is repeated by the nurse, allowing the client to continue or correct perceptions. Which communication technique is demonstrated by the nurse?
validation
In which phase of the therapeutic relationship, does the nurse encourage the client through self-exploration and use therapeutic communication to facilitate successful interactions?
working
Jeffery Phillips (pronouns he/him) is a registered nurse working in an assisted living facility. Today, he is caring for a resident that he has known for several months who seems agitated and angry. In which phase of the therapeutic relationship does this occur?
working
