Question 1

The nurse's first response in dealing with a conflict situation that involves a client is to&#10;A) understand the context of the situation.&#10;B) impose more controls on the client.&#10;C) gain a clear understanding of one's own personal response.&#10;D) encourage the client to discount statements made by the nurse.

Accepted Answer

Conflicts between nurse and client are not uncommon.The first step for the nurse is to gain a clear understanding of one's own personal response.No one is equally effective in all situations.The second step is to understand the context of the situation.Most interpersonal conflicts involve some threat to one's sense of control or self-esteem.Nurses have been shown to respond to the stress of not having enough time to complete their work by imposing more controls on the client,who then often reacts by becoming more difficult.Other situations,which may lead to conflict between the nurse and the client,include having statements discounted.

Question 2

A client on a psychiatric unit is found pacing the halls and angrily punching at the wall.The nurse's primary goal should be to&#10;A) assertively tell the client to stop the behavior.&#10;B) suggest that the client write in a journal to help relieve anxiety.&#10;C) speak in a loud voice in order to alert other staff members.&#10;D) maintain safety while helping the client.

Accepted Answer

The nurse should help the client own the angry feelings by getting the client to verbalize things that make him or her angry.Acknowledging a client's anger may prevent an expression of abusive ranting.It is essential that the nurse use empathetic statements or active listening to acknowledge the client's anger and maintain a nonthreatening demeanor before moving on to try to discuss the issue.The goal is to maintain safety while helping the client.Psychiatric clients can be unpredictable and at this point would not be likely to respond positively to a suggestion such as writing in a journal.Speaking assertively or in a loud voice may escalate the situation,and the client is already out of control.

Question 3

A nurse manager is educating nurses about the risk of violence experienced by nurses and social workers in their workplace when compared to other professionals.The nurse manager states that nurses and social workers are at

A) three times greater risk to experience violence in their workplace than are other professionals.
B) four times greater risk to experience violence in their workplace than are other professionals.
C) no greater risk to experience violence in their workplace than are other professionals.
D) two times greater risk to experience violence in their workplace than are other professionals.

Accepted Answer

Violence against health care workers is increasing.Nurses are at greater risk because of their close contact with clients.In fact,nurses and social workers are at three times greater risk to experience violence in their workplace than are other professionals.

Question 4

Which of the following are strategies the nurse should use when dealing with an angry client?&#10;A) Defuse hostility&#10;B) Avoid responding to a client's anger by getting angry&#10;C) Speak quickly and use a higher tone of voice&#10;D) Use empathy when communicating with the client&#10;E) Remain with the client

Accepted Answer

The nurse should defuse hostility by avoiding responding to a client's anger by becoming angry also.The nurse should use empathy in his or her communication.An angry client needs to have the nurse acknowledge both the issue and his or her feelings about that issue.Only then can the client begin to interact in a meaningful way.Empathy by the nurse may help defuse the situation.The nurse should deliberately begin to lower his or her voice and speak more slowly.When we get upset,we tend to speak quickly and use a higher tone of voice.If the nurse does the opposite,the client may begin to mimic him or her and thus calm down.The goal is to maintain safety while helping the client.Therefore,it may not always be appropriate to remain with the client because this may place the nurse in danger of physical harm.If the nurse feels in danger of physical harm,he or she should always maintain a space for safety and plan an exit.

Question 5

When working in situations that involve conflict,the nurse recognizes that which of the following is true in relation to conflict?&#10;A) Conflict always leads to impaired relationships.&#10;B) Conflict arises from compatible goals and needs.&#10;C) Most people experience conflict as a lack of discomfort.&#10;D) Conflict serves as a warning that something in the relationship needs closer attention.

Accepted Answer

Conflict has been defined as tension arising from incompatible goals or needs,in which the actions of one frustrate the ability of the other to achieve a goal,resulting in stress or tension.Conflicts in any relationship are inevitable: they serve as warning that something in the relationship needs closer attention.Conflict can lead to improved relationships.Conflict has been defined as tension arising from incompatible goals or needs.Most people experience conflict as discomfort.

Question 6

When interacting with the nurse,a client makes several condescending remarks directed toward the nurse.The nurse recognizes this behavior as an example of&#10;A) the use of humor.&#10;B) active listening.&#10;C) a verbal clue to anger.&#10;D) assertiveness.

Accepted Answer

Nonverbal clues to anger include grimacing,clenching jaws or fists,turning away,and refusing to maintain eye contact.Verbal clues by a client may,of course,include use of an angry tone of voice,but they may also be disguised as witty sarcasm or as condescending or insulting remarks.The client's remarks are condescending,not humorous.The client's remarks are verbal,not nonverbal.Use of condescending remarks is an example of passive-aggressive communication.

Question 7

The nurse is teaching an unlicensed assistive personnel (UAP)on potential approaches for dealing with difficult clients.The nurse recognizes that additional teaching is required when the UAP states&#10;A) &#34;I will be assertive by conveying my irritation toward the client's behavior.&#34;&#10;B) &#34;I will collaborate with staff so we all use the same uniform approach when responding to the client's demands.&#34;&#10;C) &#34;I will promote trust in the client by providing immediate feedback.&#34;&#10;D) &#34;I will explain to the client the limits of my role as an UAP.&#34;

Accepted Answer

Potential approaches for dealing with difficult clients include using a calm tone and avoiding conveying irritation.Potential approaches for dealing with difficult clients also include: working with staff so all use the same uniform approach to the client's demands; promoting trust by providing immediate feedback; and explaining the limits of one's role.

Question 8

A client yells,&#34;Take this mess away from here.How could anyone eat this food? What kind of place are you running here?&#34; The nurse uses skills of assertiveness to promote change that is focused on&#10;A) feelings.&#10;B) attitudes.&#10;C) behaviors.&#10;D) motivations.

Accepted Answer

Undesired behaviors,not feelings,attitudes,and motivations,are the focus for change.Feelings,attitudes,and motivations are not the focus for change.

Question 9

After fasting from 10 p.m.the previous evening,a client learns that the procedure has been cancelled.The client curses at the nurse and accuses the nurse of being incompetent.The nurse's best response would be

A) "You have no right to say that to me. You are nasty."
B) "I can understand that you're upset, but I feel uncomfortable when I am cursed at."
C) "Perhaps we shouldn't get so angry when things don't work out the way we think they should."
D) to leave the room and refuse to return to answer the call light when the client calls.

Accepted Answer

Assertive behaviors range from making a direct,honest statement about one's beliefs to taking a very strong,confrontational stand about what will and will not be tolerated in the relationship.Assertive responses contain "I" statements that take responsibility.This behavior is in contrast to aggressive behavior,which has a goal of dominating while suppressing the other person's rights.Aggressive responses often consist of "you" statements that fix blame on the other person."We" statements should be used only when the nurse actually means to look at an issue collaboratively.Thus,the statement,"Perhaps we both need to look at this issue a little closer." may be appropriate in certain situations.However,the statement,"Perhaps we shouldn't get so angry when things don't work out the way we think they should." is a condescending statement thinly disguised as a collaborative statement.What is actually being expressed is the expectation that both parties should handle the conflict in one way-the nurse's way.Some nurses were socialized to act passively.Passive behavior is defined as a response that denies our own rights in order to avoid conflict.

Question 10

The initial interpersonal strategy to help the client reduce strong emotion to a workable level involves&#10;A) talking the emotion through with someone.&#10;B) providing a neutral, accepting, interpersonal environment.&#10;C) taking action that might help the client come to terms with the emotional consequences.&#10;D) obtaining more information.

Accepted Answer

The initial interpersonal strategy used to help clients reduce strong emotion to a workable level is to provide a neutral,accepting,interpersonal environment.The second step in defusing the strength of an emotion is to talk the emotion through with someone.The third phase is to take action.The specific needs expressed by the emotion suggest actions that might help the client come to terms with the consequences of the emotion.This responsibility might take the form of obtaining more information or of taking some concrete risks to change behaviors that sabotage the goals of the relationship.

Question 11

When providing home health care to a client suffering from Alzheimer disease who fell and broke his hip 3 weeks ago,the nurse teaches the client's family correct use of the walker.This represents which stage of the nurse-caregiver relationship?

A) Worker-helper
B) Worker-worker
C) Nurse as manager; family as worker
D) Nurse as nurse for family caregiver

Accepted Answer

The answer of When providing home health care to a...

Question 12

A client yells at the nurse frequently and uses profane language.Which of the following is the most appropriate response by the nurse?&#10;A) Remain silent and do not respond&#10;B) Use an &#34;I&#34; statement when speaking to the client&#10;C) Tell the client, &#34;You make me angry.&#34;&#10;D) Ignore the behavior and walk away

Accepted Answer

The answer of A client yells at the nurse frequently...

Question 13

Which of the following is true about assertion communication?&#10;A) Components include the ability to say no and to ask for what you want.&#10;B) It includes a demonstration of deference to the demands of others.&#10;C) It consistently violates the needs of others.&#10;D) It includes the expression of only positive thoughts and feelings.

Accepted Answer

The answer of Which of the following is true about...

Question 14

A client states to the nurse in a hostile voice,&#34;I am sick of being poked at and stuck with needles.Go away and leave me alone.&#34; Which of the following is the best statement by the nurse?&#10;A) &#34;I am not surprised that you wish to be left alone.&#34;&#10;B) &#34;I'm so sorry you are feeling so upset.&#34;&#10;C) &#34;You feel vulnerable and depressed as a result of all these treatments.&#34;&#10;D) &#34;Okay, I will go away.&#34;

Accepted Answer

The answer of A client states to the nurse in...

Question 15

The nurse is caring for an intoxicated client who has been admitted to the emergency department.The client appears very angry and frequently shouts at the nurse and demands to see the physician.The best response by the nurse is to use

A) blaming.
B) empathy.
C) competition.
D) "I" statements.

Accepted Answer

The answer of The nurse is caring for an intoxicated...

Question 16

When a physician writes an order for the nurse to withhold life-saving treatment from a terminally ill client,the nurse is faced with two different choices,each supported by a different ethical principle.This type of conflict is known as

A) covert conflict.
B) overt conflict.
C) interpersonal conflict.
D) intrapersonal conflict.

Accepted Answer

The answer of When a physician writes an order for...

Question 17

The most effective problem-solving style for genuine resolution that creates a win-win situation is&#10;A) accommodation.&#10;B) avoidance.&#10;C) competition.&#10;D) collaboration.

Accepted Answer

The answer of The most effective problem-solving style for genuine...

Question 18

Which of the following best describes the goal of assertiveness?&#10;A) Offering responses that contain &#34;you&#34; statements&#10;B) Indirect communication&#10;C) Standing up for one's personal rights&#10;D) Ignoring the rights of others

Accepted Answer

The answer of Which of the following best describes the...

Deck 13: Resolving Conflicts Between Nurse and Client