Question 1

The nurse is explaining a procedure to a 2-year-old child.Which is the best approach to use?
A)Showing the needles and bandages in advance
B)Telling the patient exactly what discomfort to expect
C)Using dolls and stories to demonstrate what will be done
D)Asking the child to draw pictures of what he or she thinks will happen

Accepted Answer

Some age-appropriate communication techniques for a 2-year-old child include storytelling and drawing.Showing the child needles or telling the child about discomfort would increase anxiety.Having a child draw what he expects does not explain what is going to happen.

Question 2

In establishing the nurse-patient relationship,personal self-disclosure by the nurse is useful for which of the following goals? (Select all that apply. )
A)To educate the patient
B)To build the therapeutic alliance
C)To encourage the patient's independence
D)To offer opinions that may influence the patient's decisions

Accepted Answer

Personal self-disclosure is used with caution and only in selected situations.Personal self-disclosure by the nurse is useful for the following goals: (1)to educate the patient, (2)to build a therapeutic alliance with the patient,and (3)to encourage the patient's independence.Barriers to therapeutic communication include giving an opinion,offering false reassurance,being defensive,showing approval or disapproval,stereotyping,and asking "Why?" The use of "why" questions causes increased defensiveness in the patient and hinders communication.

Question 3

The patient is admitted to the hospital with complaints of headache,nausea,and dizziness.She states that she has a final exam in the morning and needs to do well on it to pass the course,but she can't seem to get into it.She appears nervous and distracted,and is unable to recall details.She most likely is showing manifestations of _____ anxiety.
A)mild
B)moderate
C)severe
D)panic state of

Accepted Answer

Severe anxiety manifests as a focus on fragmented details,as well as headache,nausea,dizziness,inability to see connections between details,and poor recall.Mild anxiety manifests as increased auditory and visual perception,increased awareness of relationships,and increased alertness and ability to problem-solve.Moderate anxiety manifests as selective inattention,decreased perceptual field,focus only on relevant information,muscle tension,and diaphoresis.Panic state of anxiety manifests as an inability to notice surroundings,feelings of terror,and inability to cope with any problem.

Question 4

Which behavior should the nurse who is communicating with a potentially violent patient employ?
A)Sit closer to the patient.
B)Speak loudly and firmly.
C)Use slow,deliberate gestures.
D)Always block the door to prevent escape.

Accepted Answer

Make sure that gestures are slow and deliberate rather than sudden and abrupt.There is less chance for misinterpretation of the message,and slow,deliberate gestures are less threatening.Keep an adequate distance between yourself and the patient to reduce your risk of injury and to avoid making the patient feel pressured.Try to talk in a comfortable,reassuring voice.Position yourself closest to the door to facilitate escape from a potentially violent situation.Do not block the exit;if the patient feels unable to escape,this may cause a violent outburst.

Question 5

The patient is sitting at the bedside.He has not been eating and is just staring out of the window.The nurse approaches the patient and asks,"What are you thinking about?" What type of communication technique is this?
A)Restating
B)Clarification
C)Broad openings
D)Reflection

Accepted Answer

Broad openings encourage patients to select topics for discussion.They affirm the value of the patient's initiative.Restating is repeating a main thought that the patient has expressed.Clarification is attempting to put into words vague ideas or asking the patient to explain what he or she means.Reflection is directing back to the patient ideas,feelings,questions,or content.

Question 6

The patient is a 54-year-old man who has made a living as a construction worker.He dropped out of high school at age 16 and has been a laborer ever since.He never saw any need for "book learning," and has lived his life "my way" since he was a teenager.He has smoked a pack of cigarettes a day for 40 years and follows no special diet,eating a lot of "fast food" while on the job.He now is admitted to the coronary care unit for complaints of chest pain and is scheduled for a cardiac catheterization in the morning.Which of the following would be the best way for the nurse to explain why he needs the procedure?
A)"The doctor believes that you have atherosclerotic plaques occluding the major arteries in your heart,causing ischemia and possible necrosis of heart tissue."
B)"There may be a blockage of one of the arteries in your heart,causing the chest discomfort.He needs to know where it is to see how he can treat it."
C)"We have pamphlets here that can explain everything.Let me get you one."
D)"It's just like a clogged pipe.All the doctor has to do is 'Roto-Rooter' it to get it cleaned out."

Accepted Answer

To send an accurate message,the sender of verbal communication must be aware of different developmental perspectives as well as cultural differences between sender and receiver,such as the use of dialect or slang.

Question 7

The nurse is preparing to give an intramuscular injection to the patient in room 320.The patient care technician comes to the medication room and tells the nurse that the patient in room 316 is very angry with his roommate and is threatening to hit him.How should the nurse respond?
A)Tell the patient care technician to calm the patient down until she can get there.
B)Have the angry patient's roommate moved to another location.
C)Tell the angry patient to calm down until she can get there.
D)Tell the angry patient that he has to act civilized in the hospital,and that's that.

Accepted Answer

A potentially violent patient needs to be in an environment with decreased stimuli and to have protection from injury to self and against others.Encourage other people,particularly those who provoke anger,to leave the room or area.De-escalation is a skill that cannot be delegated to nursing assistive personnel (NAP).

Question 8

A patient tells the nurse,"I think that I must be really sick.All of these tests are being done." Which response by the nurse uses the specific communication technique of reflection?
A)"I sense that you are worried."
B)"I think that we should talk about this more."
C)"You think that you must be very sick because of all the tests."
D)"I've noticed that this is an underlying issue whenever we talk."

Accepted Answer

Reflecting is directing back to the patient ideas,feelings,questions,or content,validating the nurse's understanding of what the patient is saying,and signifying empathy,interest,and respect for the patient.Asking the patient to confirm your sense of his or her anxiety is "sharing perceptions." Stating that "we should talk about this more," that is,putting forth questions or statements to expand on a topic,is "focusing." Pointing out underlying issues or problems that occur repeatedly is known as "theme identification."

Question 9

The patient is admitted to the emergency department for trauma received in a fist fight.He states that he could not control himself.He says that his wife left him for another man.He thinks it was because he was always too tired after working to do things.He says he has to work,and there is nothing he could do to change things.He says that he feels trapped in his job,but he knows nothing else.What was the altercation with the other man probably a manifestation of?
A)Mild anxiety
B)Depression
C)Severe anxiety
D)Moderate anxiety

Accepted Answer

Symptoms of depression include apathy,sadness,sleep disturbances,hopelessness,helplessness,worthlessness,guilt,anger,fatigue,thoughts of death,decreased libido,ruminations of inadequacy,psychomotor agitation,verbal berating of self,spontaneous crying,dependency,and passiveness.Mild anxiety manifests as increased auditory and visual perception,increased awareness of relationships,increased alertness,and an increased ability to problem-solve.Moderate anxiety manifests as selective inattention,decreased perceptual field,focus only on relevant information,muscle tension,and diaphoresis.Severe anxiety manifests as a focus on fragmented details,headache,nausea,dizziness,an inability to see connections between details,and poor recall.

Question 10

Nonverbal communication incorporates messages conveyed by:
A)touch.
B)cadence.
C)tone quality.
D)use of jargon.

Accepted Answer

Nonverbal communication describes all behaviors that convey messages without the use of words.This type of communication includes body movement,physical appearance,personal space,and touch.Cadence,tone quality,and the use of jargon are all part of verbal communication.

Question 11

The patient is an elderly male who had hip surgery 3 days ago.He states that his hip hurts,but he does not like how the medicine makes him feel.He believes that he can tolerate the pain better than he can tolerate the medication.What would be the best response from the nurse?
A)Explain the need for the pain medication using a slower rate of speech.
B)Explain the need for the pain medication using a simpler vocabulary.
C)Explain the need for the pain medication,but ask the patient if he would like the doctor called and the medication changed.
D)Explain in a loud manner the need for the pain medication.

Accepted Answer

Suggesting,which is presenting alternative ideas for patient consideration relative to problem solving,can be effective in helping the patient maintain control by increasing the patient's perceived options or choices.Nurses often use elder-speak,which includes a slower rate of speech,greater repetition,and simpler grammar than normal adult speech,when caring for older adults.However,many older patients perceive this type of communication as patronizing.

Question 12

Verbal communication includes which of the following? (Select all that apply. )
A)Speech
B)Personal space
C)Body movement
D)Writing

Accepted Answer

Verbal communication includes both spoken word and written word.Nonverbal communication describes all behaviors that convey messages without the use of words.This type of communication includes body movement,physical appearance,personal space,and touch.

Question 13

In caring for patients of different cultures,it is important for the nurse to: (Select all that apply. )
A)use appropriate linguistic services.
B)display empathy and respect.
C)use accurate health history-taking techniques.
D)use patient-centered communication.

Accepted Answer

The following factors are essential in providing effective care for culturally and linguistically diverse patients: (1)use of appropriate linguistic services (e.g. ,interpreter or bilingual health care workers)and/or other communication strategies, (2)display of empathy and respect for culturally and linguistically diverse patients, (3)use of accurate health history-taking techniques for diagnostic and treatment purposes and health teaching,and (4)use of patient-centered communication behaviors,including participatory decision making.It also is helpful to speak plainly and to avoid mimicking a patient's accent or dialect.

Question 14

The patient is an elderly man who was brought to the hospital from an assisted-living community with complaints of anorexia and general malaise.The nurse at the assisted-living community reported that the patient was very ritualistic in his behavior and fastidious in his dress and always took a shower in the evening before bed.The patient became very angry and upset when the patient care technician asked him to take his bath in the morning.What does this behavior tell the nurse?
A)The patient is exhibiting anxiety because of a change in his rituals.
B)The patient is suffering from sensory overstimulation.
C)The patient is basically an angry person.
D)The patient has to follow hospital protocol.

Accepted Answer

Patients often become ritualistic and intent on performing activities a certain way.Anxiety develops as a result of a specific event or a general pattern of change.

Question 15

The nurse is assessing a patient who says that she is feeling fine.The patient,however,is wringing her hands and is teary eyed.The nurse should respond to the patient in which of the following ways?
A)"You seem anxious today.Is there anything on your mind?"
B)"I'm glad you're feeling better.I'll be back later to help you with your bath."
C)"I can see you're upset.Let me get you some tissue."
D)"It looks to me like you're in pain.I'll get you some medication."

Accepted Answer

When assessing a patient's needs,assess both the verbal and the nonverbal messages and validate them.In this case,if you see a patient wringing her hands and sighing,it is appropriate to ask,"You seem anxious today.Is there anything on your mind?" It is not enough to accept only the verbal message if nonverbal signals conflict,and it is inappropriate to jump to conclusions about what the nonverbal signals mean.

Question 16

When comparing therapeutic communication versus social communication,the professional nurse realizes that therapeutic communication:
A)allows equal opportunity for personal disclosure.
B)allows both participants to have personal needs met.
C)is goal directed and patient centered.
D)provides an opportunity to compare intimate details.

Accepted Answer

Therapeutic communication empowers patients to make decisions but differs from social communication in that it is patient centered and goal directed with limited disclosure from the professional.Social communication involves equal opportunity for personal disclosure,and both participants seek to have personal needs met.Nurses do not share with patients intimate details of their personal lives.

Question 17

The nurse is attempting to teach the patient and his family about his care after discharge.The patient and the family demonstrate signs of anxiety during the teaching session.The nurse should consider doing what?
A)Using more gestures or pictures
B)Focusing on the physical complaints
C)Getting another staff member to speak to the patient
D)Repeating information to the patient and the family at a later time

Accepted Answer

Remember that patients and their family members who are under stress often require repeated explanations.Increasing gestures and pictures is additional stimulation that may increase anxiety.Physical complaints should be acknowledged,but dwelling on them can also increase the patient's anxiety.Involving another staff member would cause a break in the continuity of care.

Question 18

The patient states,"I don't know what my family will think about this." The nurse wishes to use the communication technique of clarification.Which of the following statements would fit that need best?
A)"You don't know what your family will think?"
B)"I'm not sure that I understand what you mean."
C)"I think it would be helpful if we talk more about your family."
D)"I sense that you may be anxious about something."

Accepted Answer

The definition of clarification is attempting to put into words vague ideas or unclear thoughts of the patient to enhance the nurse's understanding,or asking the patient to explain what he or she means.Repeating main thoughts expressed by patients is known as "restating." Using questions or statements that help patients expand on a topic of importance is known as "focusing." Asking a patient to verify the nurse's understanding of what the patient is thinking or feeling is known as "sharing perceptions."

Question 19

A patient tells the nurse,"I want to die." Which response is the most appropriate for the nurse to make?
A)"Why would you say that?"
B)"Tell me more about how you are feeling."
C)"The doctor should be told how you feel."
D)"You have too much to live for to think that way."

Accepted Answer

Broad openings encourage the patient to select topics for discussion and indicate acceptance by the nurse and the value of the patient's initiative."Why" questions can cause defensiveness and can hinder communication.Saying you will inform the doctor leads the conversation away from the patient's feelings.Saying the patient has too much to live for is false reassurance and negates the patient's feelings.

Question 20

The nurse is about to go over the patient's preoperative teaching per hospital protocol.She finds the patient sitting in bed wringing her hands,which are sweaty,and acting slightly agitated.The patient states,"I'm scared that something will go wrong tomorrow." How should the nurse respond?
A)Redirect her focus to dealing with the patient's anxiety.
B)Tell the patient that everything will be all right and continue teaching.
C)Tell the patient that she will return later to do the teaching.
D)Give the patient antianxiety medication.

Accepted Answer

Anxiety interferes with comprehension,attention,and problem-solving abilities and thus interferes with the patient's care and treatment.To ensure the effectiveness of treatment,the nurse should try to help the patient understand the source of the anxiety.Ignoring the anxiety,medicating for it,and postponing the discussion are all inappropriate.

Quiz 3: Communication and Collaboration

The nurse is explaining a procedure to a 2-year-old child.Which is the best approach to use?

In establishing the nurse-patient relationship,personal self-disclosure by the nurse is useful for which of the following goals? (Select all that apply. )

Which behavior should the nurse who is communicating with a potentially violent patient employ?

The patient is sitting at the bedside.He has not been eating and is just staring out of the window.The nurse approaches the patient and asks,"What are you thinking about?" What type of communication technique is this?

The nurse is preparing to give an intramuscular injection to the patient in room 320.The patient care technician comes to the medication room and tells the nurse that the patient in room 316 is very angry with his roommate and is threatening to hit him.How should the nurse respond?

A patient tells the nurse,"I think that I must be really sick.All of these tests are being done." Which response by the nurse uses the specific communication technique of reflection?

Nonverbal communication incorporates messages conveyed by:

The patient is an elderly male who had hip surgery 3 days ago.He states that his hip hurts,but he does not like how the medicine makes him feel.He believes that he can tolerate the pain better than he can tolerate the medication.What would be the best response from the nurse?

Verbal communication includes which of the following? (Select all that apply. )

In caring for patients of different cultures,it is important for the nurse to: (Select all that apply. )

The nurse is assessing a patient who says that she is feeling fine.The patient,however,is wringing her hands and is teary eyed.The nurse should respond to the patient in which of the following ways?

When comparing therapeutic communication versus social communication,the professional nurse realizes that therapeutic communication:

The nurse is attempting to teach the patient and his family about his care after discharge.The patient and the family demonstrate signs of anxiety during the teaching session.The nurse should consider doing what?

The patient states,"I don't know what my family will think about this." The nurse wishes to use the communication technique of clarification.Which of the following statements would fit that need best?

A patient tells the nurse,"I want to die." Which response is the most appropriate for the nurse to make?

The nurse is about to go over the patient's preoperative teaching per hospital protocol.She finds the patient sitting in bed wringing her hands,which are sweaty,and acting slightly agitated.The patient states,"I'm scared that something will go wrong tomorrow." How should the nurse respond?