Deck 24: Communication

Question 1

Which of the following statements best reflects the client's positive feedback to the nurse's question,"Do you understand how to check your blood sugar?"
1) Nodding affirmatively
2) "I test it 4 times a day."
3) "Yes,I understand how to do it."
4) Demonstrating a fingerstick to the nurse

Answer 1

4
Feedback is the message the receiver returns.It indicates whether the receiver understood the meaning of the sender's message.Demonstrating the technique is the best way to show the nurse an understanding of the process.The other options either nonverbally or verbally indicate understanding;they are not as conclusive as showing understanding.

Question 2

There are a number of variables that may influence the client's communication with the health care team.Which of the following is an example of an interpersonal variable?
1) Postoperative discomfort
2) An extremely warm room
3) A talkative roommate
4) A loud television

Answer 2

1
Interpersonal variables are factors within both the sender and receiver that influence communication.An example of an interpersonal variable is postoperative discomfort.An extremely warm room is an example of an environmental variable that may affect communication.A talkative roommate is an example of an environmental variable that may affect communication because of the lack of privacy and distraction.Noise,such as a loud television,is an example of an environmental variable that may affect communication.

Question 3

In using communication skills with clients,the nurse evaluates which response as being the most therapeutic?
1) "Why don't you stick to the special diet?"
2) "I noticed that you didn't eat lunch.Is something wrong?"
3) "I think you need to find another physician that's better than this one."
4) "We can't continue talking about your problems;it's time for your bath."

Answer 3

2
The nurse who is sharing an observation,"I noticed that you didn't eat lunch.Is something wrong?" is using the most therapeutic response.Sharing observations often helps the client communicate without the need for extensive questioning,focusing,or clarification."Why don't you stick to the special diet?" is an example of a nontherapeutic response.It is asking for an explanation."Why" questions can cause resentment,insecurity,and mistrust."I think you need to find another physician that's better than this one." is not a therapeutic response.It is giving a personal opinion.Changing the subject,"We can't continue talking about your problems;it's time for your bath," is not therapeutic.

Question 4

The client tells the nurse that he understands most of the information but still has questions concerning the medication after the nurse has provided the client with information regarding the treatment plan for the diagnosis the.This response is an example of:
1) Referent
2) Receiver
3) Channel
4) Feedback

Question 5

The nurse is aware of the client's zones of personal space when planning interactions.The zone of personal space and touch that extends the greatest amount from an individual is the:
1) Social zone
2) Personal zone
3) Consent zone
4) Vulnerable zone

Question 6

When a nurse tells an advanced nurse practitioner that her client is "slipping a little" in reference to hemodynamic pressures,The nurse is using:
1) Brevity
2) Relevance
3) Pacing and control.
4) Connotative meaning

Question 7

A helping relationship is being established between nurse and client.In addressing the client,the nurse should:
1) Use the client's first name
2) Touch the client right away to establish contact
3) Sit far enough away from the client's personal space
4) Always knock and pause before entering the client's room

Question 8

A client is admitted for a CAT scan (diagnostic test)of the cranium.As the nurse explains this diagnostic test,the client moves away from the nurse.This is an example of what influencing factor in communication?
1) Gender
2) Environment
3) Space and territoriality
4) Sociocultural background

Question 9

Discussing the client's follow-up dietary needs immediately after the surgery when the client is experiencing discomfort is an error in:
1) Pacing
2) Intonation
3) Timing and relevance
4) Denotative meaning

Question 10

When working with a client with aphasia,the nurse may attempt to enhance communication by:
1) Using visual cues
2) Speaking loudly
3) Using open-ended questions
4) Communicating through a speech therapist

Question 11

The nurse will often display empathy in communication with clients.Of the following responses by the nurse,which one best conveys empathy?
1) "Good morning.How did you sleep last night?"
2) "I can understand your concern about learning to inject yourself."
3) "Do you mean you would like to talk to the new family nurse practitioner?"
4) "Can you describe to me what the pain in your abdomen feels like right now?"

Question 12

During the assessment phase of the nursing process,the nurse may uncover data that help to identify communication problems.An example of this information is:
1) Extreme dyspnea or shortness of breath
2) Urinary frequency and pain
3) Chronic stomach pain
4) Lack of appetite

Question 13

When reaching over the side rails to take a client's blood pressure,he draws back.To promote effective communication,the nurse should first:
1) Tell the client that the blood pressure can be taken at a later time
2) Rotate the nurses who are assigned to take the client's blood pressure
3) Continue to perform the blood pressure assessment quickly and quietly
4) Apologize for startling the client and explain the need for touching the client

Question 14

The nurse is in the process of conducting an admission interview with the client.At one point in the discussion,the client has provided information that the nurse would like to clarify.The nurse employs the technique of clarification as indicated by the response:
1) "I'm not sure that I understand what you mean by that statement."
2) "The ECG records information about your heart's electrical activity."
3) "Let's look at the problem you have had with your medication when you were home."
4) "What's your biggest concern related to your hospitalization at the moment?"

Question 15

Throughout the nursing process communication is used.During the evaluation phase,communication is specifically used by the nurse to:
1) Delegate activities to other staff members
2) Validate the client's health and wellness needs
3) Acquire both verbal and nonverbal client feedback
4) Document expected outcomes and planned interventions

Question 16

Communication involves both active listening and body language working together.The nurse actively listens to the client and:
1) Sits facing the client
2) Keeps the arms and legs crossed
3) Leans back in the chair away from the client
4) Avoids eye contact as much as is physically possible

Question 17

"I've never told anyone this information about my son," is an example of a parent:
1) Identifying problems
2) Building trust
3) Clarifying roles
4) Revealing

Question 18

The faculty member is reviewing a process recording with the student nurse.The student has been working with a client who has had an amputation of the lower left leg and is emotionally fragile.The student receives positive feedback from the faculty member for the following response made to the client:
1) "Why are you so upset today?"
2) "I'm sure that everything will be all right."
3) "You shouldn't cry.The wound will heal soon."
4) "It must be very difficult to have this happen to you."

Question 19

When dealing with toddlers or preschoolers what communication technique may be used most effectively?
1) Using analogies to explain health-related ideas
2) Allowing manipulation of equipment to be used
3) Moving quickly and minimizing contact to avoid distress
4) Focusing on what other children on the unit may have been doing

Question 20

In working with a client who is newly diagnosed with diabetes mellitus,the nurse provides feedback to the client on her progress in learning the treatment regimen.Of the following,the nurse demonstrates the use of therapeutic communication by stating:
1) "I believe that you have come a long way in learning how to manage your care."
2) "It didn't look like you were ever going to be able to get the injection technique."
3) "Check your blood sugar unless you really want to come back to the hospital again."
4) "You don't appear to have any real interest in managing your daily dietary intake."

Question 21

The nurse recognizes that a client's sense of personal control is most therapeutically impacted when:
1) The client attends a self-help/support group
2) The nurse encourages the client to make menu selections
3) The client views a video on the use of a personal glucose monitor
4) The nurse provides instructions on a patient-controlled analgesic (PCA)pump

Question 22

Which of the following is the single most negative factor affecting a nurse's credibility?
1) Deficient technical skills
2) Unethical or illegal behavior
3) Lack of caring and empathy
4) Poor nurse-client communication

Question 23

Which of the following statements shows the best attempt by a nurse to overcome personal biases?
1) "So how does that make you feel?"
2) "Most people really like Dr.Jones."
3) "I know how that must frighten you."
4) "How much did the medication help your pain?"

Question 24

The nurse enters a client's room and finds her crying softly.The most therapeutic statement the nurse can make at this time is to ask:
1) "Are you alright?"
2) "Why are you crying?"
3) "What can I do to help you?"
4) "Is being hospitalized upsetting you?"

Question 25

Which of the following statements made by a nurse most reflects the best understanding of the effect assertiveness has on interpersonal communication?
1) "Can anyone help;I'm feeling overwhelmed today?"
2) "I think we need to tell the doctors to write more legibly."
3) "I will need some help with that complicated dressing change."
4) "You will need to do the admission assessments today because I'm so busy."

Question 26

The nurse is discussing discharge instructions with a client who was recently diagnosed with type 1 diabetes mellitus and is now taking insulin.The nurse recognizes this as an example of:
1) Nonverbal communication
2) Interpersonal communication
3) Intrapersonal communication
4) Transpersonal communication

Question 27

A nurse provides a brief but concise orientation to the use of the room's telephone and television to a newly admitted older client experiencing abdominal pain.The client's daughter later reports that her father attempted to call her but was never shown how to use the telephone.The most likely cause for the client's apparent lack of knowledge retention is:
1) Admission to the hospital has caused mild confusion that is not atypical in older clients
2) The pain was distracting him from focusing on the information when it was provided
3) He is experiencing forgetfulness regarding newly introduced nonessential information
4) The nurse did not take adequate time to explain the use of either the telephone or the television

Question 28

The nurse shares with a client diagnosed with bipolar disorder who is in the manic phase that,"The CNA will be in 20 minutes to complete your ADLs." This nurse-initiated communication will likely result in client confusion or noncompliance because:
1) The timing of the conversation was poorly chosen
2) The client was not actively involved in the decision-making process
3) The conversation relied on terms familiar only to health care providers
4) The nurse assumed that the client would accept the nursing assistant's help

Question 29

An older client who appears confused after discussing his new diagnosis of Parkinson's disease shares with the nurse that,"I didn't understand much of what you said." The nurse determines that the most likely cause of the client's failure to understand is that:
1) The conversation included unfamiliar medical terminology
2) The client is in denial concerning the diagnosis of Parkinson's disease
3) The nurse's choice of timing for the client education was poor
4) The etiology of the condition is too complicated for this client to understand

Question 30

Which of the following statements made by a nurse most reflects a poor understanding of trustworthiness regarding nurse-client communication in response to a client's report that,"I don't like the night shift nurse"?
1) "How can I meet your needs and expectations on dayshift?"
2) "Tell me more about why you dislike the night shift nurse."
3) "Can you give me an example of why you are dissatisfied?"
4) "The nurse on night shift has your well being in mind always."

Question 31

A close,effective nurse-client relationship impacts interpersonal communication most by facilitating:
1) Client education regarding health-related issues
2) The accurate interpretation of shared information
3) A free exchange of information between client and nurse
4) The client's expression of physical and emotional needs

Question 32

Which of the following nursing statements is the best example of the communication tool of clarification?
1) "Please say that again."
2) "I don't think I understand."
3) "What did you mean by that?"
4) "Can you give me an example?"

Question 33

The best communicator is the nurse who:
1) Thinks critically
2) Is a good listener
3) Is comfortable talking
4) Empathizes with the client

Question 34

Supporting a client by holding onto her elbow while accompanying her as she ambulates around the nursing unit is considered social touching and so would typically:
1) Be considered nonthreatening by the client
2) Not require the client's permission
3) Be viewed as therapeutic by the nurse
4) Not be needed unless the client was ataxic

Question 35

Mentally reviewing the steps of a complicated nursing procedure before entering the client's room is an example of:
1) Nonverbal communication
2) Interpersonal communication
3) Intrapersonal communication
4) Transpersonal communication

Question 36

The nurse can best detect that a client needs clarification of the information provided on a special diet by:
1) Asking the client frequently if they have any questions
2) Assessing the client's nonverbal cues that suggest confusion
3) Providing the client with written supportive materials on the diet
4) Requesting that the client rephrase the information in his or her own words

Question 37

The nurse sits on a chair alongside a client's bed to discuss the postoperative nursing care the client will receive.The therapeutic outcome of sitting beside the client is that:
1) The nurse-client relationship will be strengthened
2) The client will feel less threatened by the nurse's presence
3) The nurse can appear more relaxed during the conversation
4) The nurse and client will be equal participants in the conversation

Question 38

When meeting for the first time,the home health nurse smiles warmly and shakes the client's hand.The nurse-client relationship is in the:
1) Working phase
2) Orientation phase
3) Termination phase
4) Preinteraction phase

Question 39

The nurse observes a client with head bowed and hands folded seemingly in prayer.The nurse recognizes this as an example of:
1) Nonverbal communication
2) Interpersonal communication
3) Intrapersonal communication
4) Transpersonal communication

Question 40

Which of the following statements made by a nurse best reflects an understanding of the therapeutic value of perceived client control?
1) "The client was very interested in the information about support groups."
2) "The client fell right to sleep when I told her the procedure was canceled."
3) "Research has shown that clients are less stressed when told what to expect."
4) "I always include the client in on any decisions regarding their nursing care."

Question 41

The nurse identifies the nursing diagnosis risk for injury for a client who is unable to verbally communicate effectively.The primary risk for injury occurs because the client:
1) Lacks the ability to tell the staff what he or she needs
2) Cannot notify the staff when he or she has fallen
3) Is not able to effectively use the call bell to communicate
4) Displays impatience when needs are not met effectively

Question 42

Which of the following statements made by a nurse reflects a need for further instruction regarding communicating with the older adult client?
1) "Children and the elderly have the same communication barriers."
2) "If I tell him why he needs to know something,he'll usually listen."
3) "Hearing deficits can certainly make communication a challenge."
4) "I always try to have family around when I talk with an elderly client."