Deck 8: Communication and the Nurse Patient Relationship

Question 1

The nurse recognizes the patient who demonstrates communication congruency when the patient:

A) smiles and laughs while speaking of feeling lonely and depressed.
B) wrings her hands and paces around the room while denying that she is upset.
C) is tearful and slow in speech when talking about her husband's death.
D) states she is comfortable while she frowns and her teeth are clenched.

Answer 1

is tearful and slow in speech when talking about her husband's death.

Question 2

A nurse says to a patient, "I am going to take your TPR, and then I'll check to see whether you can have a PRN analgesic." In considering factors that affect communication, the nurse has:

A) used terminology to clearly inform the patient of what she is doing.
B) given information that is unnecessary for the patient to know.
C) used medical jargon, which might not be understood by the patient.
D) taken into consideration the patient's need to know what is happening.

Answer 2

used medical jargon, which might not be understood by the patient.

Question 3

To enhance the establishment of rapport with a patient, the nurse should:

A) identify himself by name and title each time he introduces himself.
B) share his own personal experiences so that the patient gets to know him as a friend.
C) act in a trustworthy and reliable manner; respect the individuality of the patient.
D) share information with the patient about other patients and why they are hospitalized.

Answer 3

act in a trustworthy and reliable manner; respect the individuality of the patient.

Question 4

An aspect of computer use in patient care in which the LPN may need to be proficient includes:

A) input of data such as requests for radiographs or laboratory services.
B) programming the computer to record data from primary care provider and other health care workers.
C) educating patients how to use hospital computers to access information such as discharge instructions or information relative to specific medications.
D) scheduling admissions, discharges, and nurse staffing to keep the unit at the best occupancy and utilization.

Question 5

The nurse can best ensure that communication is understood by:

A) speaking slowly and clearly in the patient's native language.
B) asking the family members whether the patient understands.
C) obtaining feedback from the patient that indicates accurate comprehension.
D) checking for signs of hearing loss or aphasia before communicating.

Question 6

When the patient says, "I get so anxious just lying here in this hospital bed. I have a million things I should be doing at home," the most empathetic response would be:

A) "I'd feel the same way you do. I know just what you're going through."
B) "It sounds like you're having a tough time dealing with this situation."
C) "It's always darkest before the dawn. Hang in there; it will get better."
D) "You sound pretty sorry for yourself. Why don't you look at the positives?"

Question 7

A patient with a nursing diagnosis of Sensory perception, disturbed auditory, would most appropriately require the nurse to:

A) obtain a sign language interpreter when a family member is unavailable.
B) speak slowly and distinctly, but not shout.
C) provide bright lighting without glare and orient frequently.
D) reorient frequently to time, place, staff, and events.

Question 8

When an office nurse asks the patient to repeat information that he has just given to the patient over the telephone, the nurse is:

A) testing the patient's intelligence and memory.
B) acting in a cautious way to avoid charges of negligence.
C) verifying that the patient understands the information.
D) saving the extra time it would take to mail the information.

Question 9

When the nurse is giving direction to a nursing assistant who is being delegated part of the patient care, the nurse's most effective direction would be:

A) "Do the morning care first on the patients in 205 and 206 who can't get out of bed."
B) "You take care of all the patients in 205 and 206. Let me know how you're doing and whether you need any help."
C) "Give the patient in 204A a shower after breakfast, and call me to check her feet before you get her dressed."
D) "Take the vital signs on all the patients in the lounge and tell me whether there are problems."

Question 10

A 67-year-old woman had major abdominal surgery yesterday. She has IV lines, a urinary catheter, and an abdominal wound dressing, and she is receiving PRN pain medication. The end of shift report that best conveys the patient status is:

A) "Doing great, was up in the chair most of the day. No complaints of pain or discomfort. Voiding adequately."
B) "Abdominal surgery yesterday, dressing is dry and intact, her IVs are on time and she's had pain meds twice. Vital signs stable."
C) "Abdominal dressing dry, IVs-800 mL left in #6; NS running at 125 mL/hr; urine output 800 mL this shift; had morphine 15 mg for pain at 8:00 AM and at 1:30 PM. She's comfortable now. Vital signs are stable, no fever."
D) "Unchanged since this morning. She wanted to know how soon she can have something to eat, so maybe you could check with her doctor this evening. Her husband has been visiting all day and will let you know if she needs anything."

Question 11

A Hispanic patient approaches the Asian nurse and, standing very close, touches the nurse's shoulder during their conversation. The nurse begins to step back to 18 to 24 inches, while smiling and nodding to the patient. This situation is most likely an example of:

A) the nurse's need to maintain a professional role rather than a social role.
B) a patient's attempt to keep the nurse's attention.
C) a nurse's need to establish a more appropriate location for conversation.
D) a difference in culturally learned personal space of the nurse and the patient.

Question 12

The nurse explains that the therapeutic nurse-patient relationship differs from the social relationship because:

A) a social relationship does not have goals or needs to be met.
B) the nurse-patient relationship ends when the patient is discharged.
C) the focus is mainly on the nurse in the nurse-patient relationship.
D) a social relationship does not require trust or sharing of life experiences.

Question 13

A nurse using active listening techniques would:

A) use nonverbal cues such as leaning forward, focusing on the speaker's face, and slightly nodding to indicate that the message has been heard.
B) avoid the use of eye contact to allow the patient to express herself without feeling stared at or demeaned.
C) anticipate what the speaker is trying to say and help the patient express herself when she has difficulty with finishing a sentence.
D) ask probing questions to direct the conversation and obtain the information needed as efficiently as possible.

Question 14

A 36-year-old woman who is in traction for a fractured femur that she received in an auto accident is found crying quietly. The nurse can best address this situation by saying:

A) "What's the matter? Why are you crying? Are you in pain?"
B) "Stop crying and tell me what your problem is."
C) "This could have been much worse. You're lucky no one was killed."
D) "You are upset. Can you tell me what's wrong?"

Question 15

The nurse has selected an outcome for the patient to eat all of the food on the breakfast tray each day. Assessing that the patient has eaten all of the breakfast, the nurse would give positive feedback by saying:

A) "Wow! That breakfast must have been pretty good."
B) "I like pancakes too. Everyone on the hall seemed to enjoy them."
C) "I hope you can keep all that breakfast down."
D) "Hurray! You finished your whole meal! What would you like for tomorrow?"

Question 16

To begin talking with a newly admitted patient about pain management, the nurse would most appropriately state:

A) "You look pretty comfortable. Are you having any pain?"
B) "Tell me about the pain you've been having."
C) "Is this pain the same as the pain you had yesterday?"
D) "Don't worry; this pain won't last forever."

Question 17

When the patient says, "I don't want to go home," the nurse's best therapeutic verbal response would be:

A) "I'm sure everything will be fine once you get home."
B) "You don't want to go home?"
C) "Doesn't your family want you to come home?"
D) "I felt like that when I had surgery last year."

Question 18

A patient asks the nurse, "What would you do if you had cancer and had to choose between surgery and chemotherapy?" The reply that can best help the patient is:

A) "If I were you, I would choose surgery and then consider chemo afterward."
B) "What solutions have you considered?"
C) "I would talk it over with my friends first."
D) "I don't know. I'm glad it isn't my decision."

Question 19

The nurse recognizes a verbal response when the patient:

A) nods her head when asked whether she wants juice.
B) writes the answer to a question asked by the nurse.
C) begins sobbing uncontrollably when asked about her daughter.
D) is moaning and restless and appears to be in pain.

Question 20

When a patient begins crying during a conversation with the nurse about the patient's upcoming surgery for possible malignancy, the nurse's most therapeutic response would be:

A) "Your surgeon is excellent, and I know he'll do a great job."
B) "Oh, dear, your gown is way too big, let me get you another one."
C) "Don't cry; think about something else and you'll feel better."
D) "Here is a tissue. I'd like to sit here for a while if you want to talk."

Question 21

The nurse is aware that the use of false reassurance is harmful to the nurse-patient relationship, because this communication block:

A) discounts the patient's stated concerns.
B) shows a judgmental attitude on the part of the nurse.
C) summarizes the patient's concerns and closes communication.
D) confuses the patient by giving information.

Question 22

While interviewing a Native American man for the admission history, the nurse should expect to:

A) wait patiently through long pauses in the conversation.
B) maintain eye contact with the patient.
C) give the patient permission to speak.
D) have another family member speak for the patient.

Question 23

When a nurse is conducting an assessment interview, the most efficient technique would be:

A) explaining the purpose of the interview.
B) excluding relatives and friends from the interaction.
C) telling the patient what data are already available.
D) asking closed questions to obtain essential information.

Question 24

To convey the intervention of active listening, the nurse would:

A) maintain eye contact by staring at the patient.
B) prompt the patient when the patient stops talking for a moment.
C) make a conscious effort to block out other sounds in the immediate environment.
D) write down remarks on a clipboard to facilitate later topics of conversation.

Question 25

A patient who has had a stroke is unable to speak clearly and has right sided hemiplegia. The nurse will design the approach to the assessment interview by:

A) asking questions and explaining procedures to the patient's daughter.
B) speaking slowly and giving the patient time to respond.
C) telling the patient he will get all necessary information from the daughter.
D) prompting the answers and finishing the sentences for the patient.

Question 26

The nurse is caring for a patient who has just had a mastectomy (breast removal). The patient expresses concern that her husband will no longer find her attractive because of her mastectomy. The nurse appropriately responds:

A) "You're concerned your husband will find you unattractive because of your mastectomy?"
B) "You're a beautiful woman; of course your husband will find you attractive after your mastectomy."
C) "Don't worry; when I had my mastectomy, my husband still found me very attractive."
D) "You should leave your husband immediately if he thinks you're unattractive after a mastectomy."

Question 27

An example of a nurse communicating with a patient using open-ended questions would be:

A) "Is your pain less today than it was yesterday?"
B) "Did you sleep all night without waking?"
C) "How many bowel movements have you had today?"
D) "What was your daughter's reaction to your desire for hospice?"

Question 28

When a patient states, "My son hasn't been to see me in months," the nurse's best verbal response is:

A) "Don't worry; I'm sure your son will visit."
B) "Your son hasn't been around much lately?"
C) "My son doesn't come to visit me either."
D) "How terrible that he doesn't visit you."

Question 29

The practical nursing student who is engaged in a therapeutic communication with a patient will have the most difficulty with the technique of:

A) closed questions.
B) restating.
C) using general leads.
D) silence.

Question 30

When the nurse enters the room, the patient is laughing out loud at something on TV. The patient stops and apologizes for the laughter, saying, "I guess I ought not be laughing at all since I am stuck here with two broken legs." The nurse can use evidence-based information when she responds:

A) "Laughter is nearly always a cover up for anxiety when facing a long rehabilitation."
B) "Long periods of laughter decrease the amount of oxygen available to your body for healing."
C) "Laughter in a hospital is often distracting and depressing to other patients nearby."
D) "Laughter truly is the best medicine as it has a positive effect on the immune system."

Question 31

When a patient states, "I don't feel like walking today," the nurse's most therapeutic verbal response would be:

A) "You have to walk today."
B) "You don't want to walk today?"
C) "I don't feel like walking today either."
D) "Why don't you want to walk today?"

Question 32

The nurse chooses to use touch in the nurse-patient relationship because touch:

A) can convey caring and support when words are difficult.
B) should be avoided because of problems of cultural misinterpretation.
C) is appropriate only in special circumstances, such as with young children.
D) is a nursing intervention of choice in almost all situations.

Question 33

A home health patient with a bleeding ulcer informs the nurse that she ate a bowl of chili with jalapenos. An inappropriate communication block with a judgmental tone by the nurse would be:

A) "Well, you have had this problem long enough to know what will happen-you certainly can't blame me!"
B) "I don't think that was a smart thing for you to do considering your ulcer."
C) "Well, you better watch your stool for evidence of blood so you can notify your primary care provider."
D) "Oh, poo! A bowl of chili every now and then won't make a lot of difference to your ulcer."

Question 34

When interacting with an older adult patient, the nurse would enhance communication by:

A) speaking slowly in order to allow the patient to process the message.
B) addressing him by his first name to encourage a therapeutic relationship.
C) standing in the doorway rather than entering the room to give the older adult patient more privacy.
D) speaking in simple sentences, as if to a child.

Question 35

When the nurse observes a resident in a long-term facility pounding his fists on his legs and grinding his teeth, the nurse will validate her perception of the patient's nonverbal expression of anger by:

A) documenting that the patient was agitated and appeared angry.
B) asking the male nursing assistant if it is his perception that the patient appears angry.
C) accessing the nursing care plan to ascertain if there is a nursing diagnosis relative to anger.
D) sitting down near the patient and saying, "You seem upset…can I help?"

Question 36

The nurse is aware that the purpose of therapeutic communication is to:

A) gather as much information as possible about the patient's problem.
B) direct the patient to communicate about his deepest concerns.
C) focus on the patient and the patient needs to facilitate interaction.
D) gain specific medical information and history of illness.

Question 37

The nurse is caring for a patient who states, "I tossed and turned last night." The nurse responds to the patient, "You feel like you were awake all night?" This is an example of:

A) open-ended question.
B) restatement.
C) reflection.
D) offering self.

Question 38

When the nurse makes the statement, "We can come back to that later-right now I need to know about when your symptoms started," the nurse is:

A) letting the patient know that topic of conversation was inappropriate.
B) setting limits on the expression of feelings.
C) refocusing the patient to the issue at hand when the conversation has wandered.
D) closing off the conversation by quickly getting to the point of the interview.

Question 39

A patient states, "I'm so worried that I might have cancer." The nurse responds, "It is time for you to eat breakfast." The nurse's response is an example of:

A) using clichés.
B) judgmental response.
C) changing the subject.
D) giving false reassurance.

Question 40

The nurse tells a patient, "For the last 2 days we have talked about whether to notify your daughter of your upcoming surgery in 2 days. You have indicated you do not want to be a burden to her, but you also would like to have her here. You may have to decide rather quickly because of the time constraint." The nurse is using the technique of:

A) focusing.
B) reflection.
C) restatement.
D) summarizing.

Question 41

When using the telephone to communicate with a primary care provider about a patient, the student nurse should have ready: (Select all that apply.)

A) current information relative to patient's condition change.
B) assessment of vital signs.
C) information on urinary output.
D) patient's social security number or hospital identification number.
E) medications received.

Question 42

In order to safeguard patient information when using a computer, the nurse should:

A) only use the computer located in the nurse's station.
B) wait until the end of the shift and document all information at one time.
C) use personal code words and abbreviations to disguise information.
D) change the computer password frequently.

Question 43

The nurse is caring for a patient who is concerned about living alone. The best response by the nurse is:

A) "Where have you considered living?"
B) "Why don't you live with your family?"
C) "I think you should live with your family."
D) "If you were my mom, I'd have you live with me."

Question 44

The nurse caring for a patient who is concerned about her 10-pound weight loss relative to her chemotherapy tells the patient, "Lucky you! Every cloud has a silver lining." The nurse's statement is an example of which type of communication block?

A) Defensive response
B) Asking probing questions
C) Using clichés
D) Changing the subject

Question 45

The nurse is caring for a patient with a diagnosis of lung cancer. The nurse states, "If I were you, I would have radiation therapy." The nurse's statement is an example of which type of communication block?

A) Inattentive listening
B) Giving advice
C) Using clichés
D) Defensive response

Question 46

When communicating with a hearing impaired patient, the nurse appropriately:

A) shouts repeatedly at the patient.
B) speaks directly into the patient's ear.
C) uses long, complex sentences.
D) uses short, simple sentences.

Question 47

The primary care provider informs the student nurse that he would like to give a telephone order. The best response by the student is:

A) document the telephone order on the primary care provider's orders.
B) ask another student to listen as a witness to the telephone order.
C) tape record the primary care provider giving the order to the student nurse.
D) ask the registered nurse to take the telephone order.

Question 48

When communicating with an aphasic patient, the nurse appropriately:

A) speaks quickly and shouts so the patient can hear.
B) assumes the patient can understand what is heard.
C) speaks to the patient's caregiver about the patient.
D) assumes the patient cannot understand what is heard.

Question 49

A nurse caring for a patient who fell off the roof while he was intoxicated asks the patient, "Why in the world were you on the roof when you had been drinking?" The nurse's statement is an example of which type of communication?

A) Changing the subject
B) Defensive response
C) Inattentive listening
D) Asking probing questions

Question 50

When communicating with a preschooler, the nurse should:

A) use abstract explanations.
B) use unfamiliar language.
C) use long, complex sentences.
D) consider the developmental level, using familiar words.

Question 51

The nurse will appropriately and deliberately use the closed question technique when the patient is: (Select all that apply.)

A) being asked for specific information.
B) extremely anxious and unfocused.
C) having difficulty expressing feelings.
D) confused.
E) angry and ranting about his lack of medical care.

Question 52

Pain is often conveyed through nonverbal communication. Two other common, nonverbally expressed emotions are _________________ and ______________.

Question 53

The characteristic that is representative of the nurse-patient relationship is that this relationship:

A) focuses on the nurse's ability to build rapport.
B) continues after discharge.
C) does not include humor.
D) focuses on the assessed patient health problems.

Question 54

When communicating with an adolescent, the nurse should be very sensitive to avoid:

A) asking embarrassing questions.
B) offering advice.
C) interrupting frequently.
D) using active listening.

Question 55

During the initial interview of a patient, the nurse should: (Select all that apply.)

A) assess the language capabilities of the patient.
B) use open-ended questions.
C) limit the interview to approximately 30 minutes.
D) assess comprehension abilities of the patient.
E) make the patient as comfortable as possible.
F) obtain the patient's medical history from the primary care provider.

Question 56

To elicit more information from a patient, the nurse should ask questions that require more than a one-word answer. This type of question is called _______.

Question 57

A nurse is delegating to a nursing assistant. The most appropriate form of this type of communication would be:

A) "Let me know if Mr. Jones' temperature is high."
B) "I need to know if Mr. Jones' blood pressure is elevated."
C) "Come and get me if Mr. Jones has a high heart rate."
D) "If Mr. Jones' heart rate is greater than 100, let me know."

Question 58

A patient tells the nurse that she dislikes the food that is served in the hospital. The nurse responds, "Our cooks work very hard; the food that is served is very good." The nurse's response is an example of the communication block of:

A) judgmental response.
B) giving advice.
C) defensive response.
D) using clichés.

Question 59

Behaviors that indicate to the patient that the nurse is inattentive to the patient's concerns are such activities as: (Select all that apply.)

A) turning back to straighten the bedside table while the patient is talking.
B) tapping feet or fingers.
C) sitting down in a chair near the bed with arms crossed.
D) leaving a hand on the door to go out.
E) nodding and asking for elaboration.

Question 60

The nurse is alert to avoid using blocks to effective communication that include: (Select all that apply.)

A) changing the subject.
B) using nonjudgmental remarks.
C) giving advice.
D) asking probing questions.
E) offering hope.
F) using clichés.

Question 61

The communication technique of __________ gives the caregiver the opportunity to ask and respond to questions.