Deck 9: Communicating With Patients and Co-Workers

Question 1

The nursing student addresses an 86-year-old patient by his first name at their initial meeting. To the patient, this behavior

A) is a sign of the nursing student's empathy for the patient.
B) could be interpreted as a lack of respect on the part of the student.
C) clearly indicates that the student feels comfortable working with the patient.
D) indicates that the student is establishing firm boundaries for the relationship.

Answer 1

B
Addressing an older adult by his first name by the nursing student may be interpreted as a lack of respect. Regarding therapeutic communication, positive regard implies respect and a willingness to work with the patient and communicate (through your actions) that the patient is a person worthy of caring about. Empathy is the ability to perceive the patient's needs, feelings, and situation accurately. Focus on the student nurse is incorrectly directed with the answer choices that discuss the student nurse's feeling comfortable working with the patient and the student nurse's establishing boundaries for the nurse-patient relationship.

Question 2

The nurse is working in the outpatient clinic when a patient who has been waiting to be seen for an hour yells, "What are you people doing? I'm sick and tired of waiting!" Which response is the most therapeutic, if made by the nurse?

A) "The doctor can only do so much."
B) "Would you like a magazine?"
C) "I can see that you are frustrated."
D) "You need to be quiet!"

Answer 2

C
Acknowledging the patient's frustration with "I can see that you are frustrated" indicates that the nurse is listening and that the message has been received. Stating "The doctor can only do so much" is defensive and minimizes the patient's issue. Asking "Would you like a magazine?" is a change of subject that discounts the patient's feelings and is likely to irritate the patient further. Stating "You need to be quiet!" shows a total disregard for the patient's frustration.

Question 3

Laura, a nurse manager, is meeting with the staff, which consists of nurses from the Veteran, Baby Boomer, Generation X, and Millennial generations. Which of the following is the best approach to encouraging collaboration and feedback from everyone?

A) Ask for volunteers to form a committee to explore the issue.
B) Form a committee made up of at least one representative from each generation.
C) Form a committee primarily composed of experienced, older nurses.
D) Meet with each nurse individually to solicit feedback.

Answer 3

B
Forming a committee made up of representatives from each generation is more likely to result in more collaborative and meaningful discussions. Asking for volunteers to form a committee would likely result in one generation being primarily represented and does not encourage collaboration among the generations. Forming a committee of experienced, older nurses, discriminates against other generations and experience. Meeting with each nurse does not encourage collaboration because it does not allow staff members to interact.

Question 4

The nurse is caring for a 64-year-old woman 4 hours after knee replacement. Although she rates her pain at 6 out of 10, she refuses pain medication and tells the nurse, "I can deal with it." Which of the following is the nurse's best response?

A) "OK, that's your decision."
B) "You're just being stubborn."
C) "OK, I'll come back later."
D) "What is your concern?"

Question 5

When considering the creation of an environment for emotional support in a therapeutic relationship, the primary focus of the nurse should be

A) removing stressors that cause anxiety and fear.
B) developing a trusting relationship.
C) encouraging the patient to become independent.
D) allowing the patient to be in control of medical decision-making.

Question 6

When preparing for patient teaching what should the nurse do first?

A) Assess the learner's needs.
B) List key points to be presented.
C) Collect the teaching materials.
D) Think about how the skill can be done at home.

Question 7

The nurse is preparing to assess a newly admitted Chinese patient. Which of the following would be most appropriate to assess first?

A) Pain
B) Language barrier
C) Family support
D) Religious preference

Question 8

A nurse has a plan for teaching the patient about a newly diagnosed disease. On entering the room the nurse realizes that the patient is blind. What considerations for communication should the nurse be aware of?

A) Tone, pitch, inflection, and intensity affect how messages are communicated.
B) Messages are clearer when verbal communication and nonverbal cues are opposite.
C) Verbal communication must be understood within the context of a patient's culture, gender, and age.
D) Facial expressions and eye contact are characteristics of verbal communication.

Question 9

A patient scheduled for surgery has a severe level of anxiety. Which action, if taken by the nurse, would be most appropriate at this time?

A) Providing teaching about the upcoming surgery and what to expect
B) Telling the patient that there is nothing to worry about
C) Calling the patient's family and demanding that they help out
D) Asking the patient about her concerns, feelings, and perceptions about the surgery

Question 10

Which statement, if made by the nurse, is an example of a communication technique that can facilitate communication?

A) "Yes, I agree with you."
B) "You need to talk to your doctor."
C) "I know just how you feel."
D) "What are you thinking about?"

Question 11

The physician orders a dose of morphine that the nurse considers excessive. The nurse should

A) administer the medication.
B) ask another nurse to administer the medication.
C) call the supervisor.
D) contact the physician.

Question 12

The nurse is caring for a patient 2 hours after a left above-the-knee amputation. The patient states, "My left leg is really hurting, and that medicine you gave me earlier didn't help." Which response is the most therapeutic, if made by the nurse?

A) "That's impossible!"
B) "You'll have to talk to your doctor."
C) "Keep your chin up."
D) "I will call your physician."

Question 13

The RN is educating the new RN on the primary focus of care when developing a therapeutic relationship with the patient. Which statement by the new RN indicates that teaching has been effective?

A) "Meeting the needs of the nurse is the primary focus."
B) "Medication administration is the primary focus."
C) "The patient's needs and problems is the primary focus."
D) "Self-care potential is the primary focus."

Question 14

The student nurse is listening to a lecture on therapeutic communication. Which statement indicates that teaching has been effective?

A) "The purpose of therapeutic communication is psychotherapy."
B) "The purpose of therapeutic communication is social communication."
C) "The purpose of therapeutic communication is to develop a trusting relationship."
D) "The purpose of therapeutic communication is emotional commitment to another."

Question 15

The student nurse is listening to a lecture on communication. Which statement indicates that the teaching has been effective?

A) "A communication blocker is silence."
B) "A communication blocker is eye contact."
C) "A communication blocker is advising."
D) "A communication blocker is clarifying."

Question 16

The RN has assigned the nursing assistant (NA) a task. The NA becomes angry and begins yelling at the RN. What is the best approach for the RN to take?

A) Tell the NA that you will let her leave early if she will do this for you.
B) Ignore her and reassign the task.
C) Meet with the NA to explore his or her feelings and the reason for resistance.
D) Call the nursing supervisor and report the NA for insubordination.

Question 17

The RN is documenting the patient's complaint of pain rated 6 on a scale of 0 to 10. Which chart entry would be the most appropriate, if made by the nurse?

A) Pt. complaining of pain. MD notified.
B) Pt complaining of pain rated at 6 on a scale of 0-10, states "My left leg is really hurting." Pt. grimacing, voice elevated. MD notified.
C) Pt. complaining of pain rated at 6 on a scale of 0-10. Appears to be in pain. MD notified.
D) Pt. complaining of pain rated 6. Wants more pain medication; appears to be drug-seeking. MD notified.

Question 18

A patient has just been informed by the physician that he will not be discharged today. The nurse brings in the patient's lunch tray and puts it on the overbed tray. The patient pushes it off onto the floor and shouts, "Get out of my room and leave me alone." The nurse's most therapeutic response would be

A) "Is there something wrong with your lunch tray?"
B) "You seem angry. Can you tell me about it?"
C) "Why are you angry? You seemed so much happier earlier today."
D) "I'll order you another lunch, and I'll be back when you're in a better mood."

Question 19

The nurse and patient are discussing the patient's perceptions and feelings related to the patient's illness. The patient is emotional and tearful and expresses feelings of hopelessness. During which phase of the nurse-patient relationship does the nurse interpret this patient to be in?

A) Pre-orientation
B) Orientation
C) Working
D) Termination

Question 20

The nurse is caring for a patient following painful radiation treatment for newly diagnosed cancer. Which question, if asked by the nurse in the orientation phase of the nurse-patient relationship, is most likely to elicit a meaningful response?

A) "Don't you love this weather?"
B) "How have things been going for you?"
C) "Tell me why you didn't stop smoking."
D) "Are you having any pain?"

Question 21

Before signing the verbal orders given earlier, the physician notifies the nurse of incorrectly wording the order. The physician requests the nurse to go back and insert the missing information. Which actions illustrate a lack of knowledge by the nurse? (Select all that apply.)

A) Use a black pen and insert the missing information.
B) Insist that the physician write a new order.
C) Write an addendum clarifying the order.
D) Toss the old order and write a new one.