Question 1

Which of the following statements by the nurse is an example of the therapeutic communication technique of offering self?

Accepted Answer

Offering self is a technique where the nurse offers their presence or availability to the patient. Option D clearly communicates that the nurse will stay with the patient until their family arrives, which shows the patient that the nurse is there for them and wants to provide comfort and support. Option A is an example of offering support but does not specifically offer the nurse's presence. Option B is an example of seeking clarification while option C is an example of promising to seek more information but does not offer the nurse's presence or availability.

Question 2

The nurse is providing care for a client who is newly diagnosed with chronic obstructive pulmonary disease (COPD).In this scenario,which action by the nurse would be considered an example of therapeutic communication?

Accepted Answer

A)Attentive or "mindful" listening is a therapeutic communication technique that involves listening and absorbing the content and feeling of what an individual is conveying, without selectivity. This technique requires paying attention to the client's total message, both verbal and nonverbal, and noting whether these communications are congruent. During attentive listening, the nurse focuses not on the nurse's own needs but rather on the client's needs. By asking appropriate questions about the client's medical history and carefully noting the client's responses, the nurse is engaging in attentive listening and thus in therapeutic communication.
B)Attentive or "mindful" listening is a therapeutic communication technique that involves listening and absorbing the content and feeling of what an individual is conveying, without selectivity. This technique requires paying attention to the client's total message, both verbal and nonverbal, and noting whether these communications are congruent. During attentive listening, the nurse focuses not on the nurse's own needs but rather on the client's needs. By asking appropriate questions about the client's medical history and carefully noting the client's responses, the nurse is engaging in attentive listening and thus in therapeutic communication.
C)Attentive or "mindful" listening is a therapeutic communication technique that involves listening and absorbing the content and feeling of what an individual is conveying, without selectivity. This technique requires paying attention to the client's total message, both verbal and nonverbal, and noting whether these communications are congruent. During attentive listening, the nurse focuses not on the nurse's own needs but rather on the client's needs. By asking appropriate questions about the client's medical history and carefully noting the client's responses, the nurse is engaging in attentive listening and thus in therapeutic communication.
D)Attentive or "mindful" listening is a therapeutic communication technique that involves listening and absorbing the content and feeling of what an individual is conveying, without selectivity. This technique requires paying attention to the client's total message, both verbal and nonverbal, and noting whether these communications are congruent. During attentive listening, the nurse focuses not on the nurse's own needs but rather on the client's needs. By asking appropriate questions about the client's medical history and carefully noting the client's responses, the nurse is engaging in attentive listening and thus in therapeutic communication.

Question 3

The nurse is providing care to a client who is diagnosed with hypertension.Which response by the nurse is an appropriate example of informational confrontation with the client?

Accepted Answer

A)An informational confrontation describes the visible behavior of another individual, whereas an interpretive confirmation expresses thoughts and feelings about behavior and draws inferences. Of the options provided, only the one that begins with "I noticed you rubbing your head and your eyes" is an example of an informational confrontation.
B)An informational confrontation describes the visible behavior of another individual, whereas an interpretive confirmation expresses thoughts and feelings about behavior and draws inferences. Of the options provided, only the one that begins with "I noticed you rubbing your head and your eyes" is an example of an informational confrontation.
C)An informational confrontation describes the visible behavior of another individual, whereas an interpretive confirmation expresses thoughts and feelings about behavior and draws inferences. Of the options provided, only the one that begins with "I noticed you rubbing your head and your eyes" is an example of an informational confrontation.
D)An informational confrontation describes the visible behavior of another individual, whereas an interpretive confirmation expresses thoughts and feelings about behavior and draws inferences. Of the options provided, only the one that begins with "I noticed you rubbing your head and your eyes" is an example of an informational confrontation.

Question 4

The nurse is caring for a school-age client who is scheduled to have major heart surgery the next morning.The nurse enters the room to administer a medication and finds the client crying.Which response by the nurse is most therapeutic?

Accepted Answer

Validation and acknowledgement of the client's emotions is important in establishing trust and therapeutic communication. The client needs to be reassured that it is okay to express their feelings and concerns. Option A may be helpful, but it does not address the client's emotions directly. Option B may create more anxiety for the client. Option C dismisses the client's feelings and denies them the opportunity to express their emotions.

Question 5

Which of the following situations is an example of countertransference in the group setting?

Accepted Answer

A)Countertransference occurs when leaders respond to group members because of reactions from earlier relationships. The leader who distrusts the group member because of similarities to his ex-wife is exhibiting countertransference. The scenario in which the members of a group place all blame on one person is an example of scapegoating. The scenario in which a group member reveres the leader because she reminds him of his mother is an example of transference. The scenario in which the group members become excessively caught up in group processes is an example of groupthink.
B)Countertransference occurs when leaders respond to group members because of reactions from earlier relationships. The leader who distrusts the group member because of similarities to his ex-wife is exhibiting countertransference. The scenario in which the members of a group place all blame on one person is an example of scapegoating. The scenario in which a group member reveres the leader because she reminds him of his mother is an example of transference. The scenario in which the group members become excessively caught up in group processes is an example of groupthink.
C)Countertransference occurs when leaders respond to group members because of reactions from earlier relationships. The leader who distrusts the group member because of similarities to his ex-wife is exhibiting countertransference. The scenario in which the members of a group place all blame on one person is an example of scapegoating. The scenario in which a group member reveres the leader because she reminds him of his mother is an example of transference. The scenario in which the group members become excessively caught up in group processes is an example of groupthink.
D)Countertransference occurs when leaders respond to group members because of reactions from earlier relationships. The leader who distrusts the group member because of similarities to his ex-wife is exhibiting countertransference. The scenario in which the members of a group place all blame on one person is an example of scapegoating. The scenario in which a group member reveres the leader because she reminds him of his mother is an example of transference. The scenario in which the group members become excessively caught up in group processes is an example of groupthink.

Question 6

The nurse is providing care to a client who is newly diagnosed with human immunodeficiency virus (HIV).Which statements by the nurse could inhibit the development of therapeutic communication with this client? Select all that apply.

Accepted Answer

A)Various obstacles to attentive listening can inhibit the development of therapeutic communication. Being concerned with oneself, assuming, and identifying are all common obstacles to attentive listening. In contrast, using open-ended questions and providing general leads-in are actions that enhance therapeutic communication.
B)Various obstacles to attentive listening can inhibit the development of therapeutic communication. Being concerned with oneself, assuming, and identifying are all common obstacles to attentive listening. In contrast, using open-ended questions and providing general leads-in are actions that enhance therapeutic communication.
C)Various obstacles to attentive listening can inhibit the development of therapeutic communication. Being concerned with oneself, assuming, and identifying are all common obstacles to attentive listening. In contrast, using open-ended questions and providing general leads-in are actions that enhance therapeutic communication.
D)Various obstacles to attentive listening can inhibit the development of therapeutic communication. Being concerned with oneself, assuming, and identifying are all common obstacles to attentive listening. In contrast, using open-ended questions and providing general leads-in are actions that enhance therapeutic communication.
E)Various obstacles to attentive listening can inhibit the development of therapeutic communication. Being concerned with oneself, assuming, and identifying are all common obstacles to attentive listening. In contrast, using open-ended questions and providing general leads-in are actions that enhance therapeutic communication.

Question 7

A nurse is providing teaching for an inpatient support group meeting.Which group behavior indicates that the teaching was effective?

Accepted Answer

If the group members appear relaxed and interested in the topic, it indicates that they are engaged and interested in the teaching. This suggests that the teaching was effective in capturing their attention and conveying important information. The other options all suggest some level of discomfort or avoidance, which would indicate that the teaching was not as effective.

Question 8

The nurse completes a teaching session on wound care for a client who will require dressing changes after discharge.The nurse then evaluates the effectiveness of the teaching session and determines that more education is required.Which statement by the nurse is appropriate in this situation?

Accepted Answer

Option A is an appropriate response as it acknowledges the need for clarification and provides an opportunity for the nurse to reinforce the necessary steps for proper wound care. Options B, C, and D are not appropriate as they are condescending, unhelpful, and may discourage the client from seeking further education or assistance.

Question 9

A nurse educator is teaching a group of students about therapeutic touch.In which situation is it appropriate to use therapeutic touch as a means of communication?

Accepted Answer

Therapeutic touch can be used to provide comfort and support in situations where the client is experiencing emotional distress or grief. It is important to obtain the client's consent and respect their cultural beliefs and personal boundaries when using therapeutic touch. In this scenario, the upset spouse may benefit from therapeutic touch as they cope with the loss of the client.

Question 10

The nurse is conducting a health history on a client who is being admitted to a medical-surgical unit for the treatment of chronic pain.The client is concerned about privacy and asks why it is necessary for the nurse to ask for private information and then document it in the medical record.Which response by the nurse is most appropriate?

Accepted Answer

The most appropriate response by the nurse is to explain that documentation decreases the likelihood that the client will have to repeat the private information to others who will care for them. It is important for healthcare providers to document a client's health history and other private information in the medical record to ensure continuity of care and to avoid repetition of information. This documentation is also protected under confidentiality laws to ensure that the client's privacy is maintained.

Question 11

Which of the following statements is true with regard to monopolizing in the group setting?

Accepted Answer

A)Monopolizing is the domination of a discussion by one member of a group. When this behavior occurs, a sense of resentment may develop within the group, and some members may direct their frustration and anger toward the group leader, whom they expect to do something to stop the monopolizer's behavior. Monopolizing behavior may be motivated by anxiety or a need for attention, recognition, and approval, although many compulsive talkers are unaware of their behavior and its effect on others. One useful strategy for dealing with monopolizing is to interrupt the monopolizer simply, directly, and supportively.
B)Monopolizing is the domination of a discussion by one member of a group. When this behavior occurs, a sense of resentment may develop within the group, and some members may direct their frustration and anger toward the group leader, whom they expect to do something to stop the monopolizer's behavior. Monopolizing behavior may be motivated by anxiety or a need for attention, recognition, and approval, although many compulsive talkers are unaware of their behavior and its effect on others. One useful strategy for dealing with monopolizing is to interrupt the monopolizer simply, directly, and supportively.
C)Monopolizing is the domination of a discussion by one member of a group. When this behavior occurs, a sense of resentment may develop within the group, and some members may direct their frustration and anger toward the group leader, whom they expect to do something to stop the monopolizer's behavior. Monopolizing behavior may be motivated by anxiety or a need for attention, recognition, and approval, although many compulsive talkers are unaware of their behavior and its effect on others. One useful strategy for dealing with monopolizing is to interrupt the monopolizer simply, directly, and supportively.
D)Monopolizing is the domination of a discussion by one member of a group. When this behavior occurs, a sense of resentment may develop within the group, and some members may direct their frustration and anger toward the group leader, whom they expect to do something to stop the monopolizer's behavior. Monopolizing behavior may be motivated by anxiety or a need for attention, recognition, and approval, although many compulsive talkers are unaware of their behavior and its effect on others. One useful strategy for dealing with monopolizing is to interrupt the monopolizer simply, directly, and supportively.

Question 12

The nurse is caring for an older adult client in a long-term care facility.Which behavior by the nurse conveys physical attending when communicating with this client?

Accepted Answer

Leaning toward the client during conversation is a nonverbal behavior that conveys physical attending. This demonstrates that the nurse is present and focused on what the client is saying, and it can also help the client hear better if they have hearing difficulties. Facilitating and taking action when needed, being concrete about actions that need to be taken during client care, and maintaining a proper social distance are all important behaviors for nurses, but they do not specifically convey physical attending.

Question 13

A novice nurse is working with a client who is admitted to a medical-surgical unit.The nurse is establishing a therapeutic relationship with the client by conveying empathy.Which statement by the nurse best exemplifies empathy?

Accepted Answer

The statement "You seem to be frightened by the procedure.Tell me how you are feeling." demonstrates empathy by showing the nurse's ability to understand and acknowledge the client's emotions and encourages the client to express them. The other statements do not convey empathy, and some may even invalidate the client's feelings.

Question 14

A nurse is caring for a client with cancer who is struggling with chronic pain.The nurse tells the client,"It is normal to feel frustrated about the discomfort." Which skill associated with the working phase of the nurse-client relationship does the nurse's statement best reflect?

Accepted Answer

The nurse's statement reflects the skill of respect, as he/she is acknowledging and validating the client's feelings about the pain. This helps to establish trust and rapport in the nurse-client relationship, which is important for effective communication and collaboration in addressing pain management.

Question 15

The nurse is caring for a client who received analgesic medication via central line to treat pain associated with cancer.After reassessing the client's response,which section of the PIE record will the nurse use when documenting the client's care?

Accepted Answer

A)The PIE documentation model groups information into three categories: problems (P), interventions (I), and evaluation (E)of nursing care. Reassessing the client's pain level after medication administration is considered evaluation and would be documented under "E." Interventions such as medication administration would labeled "I," whereas the problem statement would be labeled "P." Progress notes are not part of the identified labels of PIE charting.
B)The PIE documentation model groups information into three categories: problems (P), interventions (I), and evaluation (E)of nursing care. Reassessing the client's pain level after medication administration is considered evaluation and would be documented under "E." Interventions such as medication administration would labeled "I," whereas the problem statement would be labeled "P." Progress notes are not part of the identified labels of PIE charting.
C)The PIE documentation model groups information into three categories: problems (P), interventions (I), and evaluation (E)of nursing care. Reassessing the client's pain level after medication administration is considered evaluation and would be documented under "E." Interventions such as medication administration would labeled "I," whereas the problem statement would be labeled "P." Progress notes are not part of the identified labels of PIE charting.
D)The PIE documentation model groups information into three categories: problems (P), interventions (I), and evaluation (E)of nursing care. Reassessing the client's pain level after medication administration is considered evaluation and would be documented under "E." Interventions such as medication administration would labeled "I," whereas the problem statement would be labeled "P." Progress notes are not part of the identified labels of PIE charting.

Question 16

Use of flow sheets would be most appropriate during which phase of the nursing process?

Accepted Answer

Flow sheets are most appropriate during the implementation phase of the nursing process as they allow for the documentation of ongoing assessments and interventions. Flow sheets can help ensure a systematic approach to care and improve communication between healthcare team members.

Question 17

A nurse manager is educating staff nurses about the types and frequency of documentation required for clients being cared for in long-term care facilities.These requirements originate from which of the following laws and regulatory bodies? Select all that apply.

Accepted Answer

A)Long-term care facilities must comply with documentation requirements set forth in the Omnibus Budget Reconciliation Act (OBRA)of 1987 and the American Recovery and Reinvestment Act (ARRA)of 2009, as well as with regulations established by the Health Care Financing Administration (HCFA). The POMR is a system of medical recordkeeping, not a law or regulatory body. The Minimum Data Set (MDS)is an effort to establish standards for collecting standardized, essential nursing data for inclusion in computer databases. Although established under OBRA, the MDS is not a specific law or regulatory body.
B)Long-term care facilities must comply with documentation requirements set forth in the Omnibus Budget Reconciliation Act (OBRA)of 1987 and the American Recovery and Reinvestment Act (ARRA)of 2009, as well as with regulations established by the Health Care Financing Administration (HCFA). The POMR is a system of medical recordkeeping, not a law or regulatory body. The Minimum Data Set (MDS)is an effort to establish standards for collecting standardized, essential nursing data for inclusion in computer databases. Although established under OBRA, the MDS is not a specific law or regulatory body.
C)Long-term care facilities must comply with documentation requirements set forth in the Omnibus Budget Reconciliation Act (OBRA)of 1987 and the American Recovery and Reinvestment Act (ARRA)of 2009, as well as with regulations established by the Health Care Financing Administration (HCFA). The POMR is a system of medical recordkeeping, not a law or regulatory body. The Minimum Data Set (MDS)is an effort to establish standards for collecting standardized, essential nursing data for inclusion in computer databases. Although established under OBRA, the MDS is not a specific law or regulatory body.
D)Long-term care facilities must comply with documentation requirements set forth in the Omnibus Budget Reconciliation Act (OBRA)of 1987 and the American Recovery and Reinvestment Act (ARRA)of 2009, as well as with regulations established by the Health Care Financing Administration (HCFA). The POMR is a system of medical recordkeeping, not a law or regulatory body. The Minimum Data Set (MDS)is an effort to establish standards for collecting standardized, essential nursing data for inclusion in computer databases. Although established under OBRA, the MDS is not a specific law or regulatory body.
E)Long-term care facilities must comply with documentation requirements set forth in the Omnibus Budget Reconciliation Act (OBRA)of 1987 and the American Recovery and Reinvestment Act (ARRA)of 2009, as well as with regulations established by the Health Care Financing Administration (HCFA). The POMR is a system of medical recordkeeping, not a law or regulatory body. The Minimum Data Set (MDS)is an effort to establish standards for collecting standardized, essential nursing data for inclusion in computer databases. Although established under OBRA, the MDS is not a specific law or regulatory body.

Question 18

Four groups of nurses are attempting to determine which methods are most effective for teaching patients about proper self-care.Which of these groups is least likely to arrive at a successful decision in a timely manner?

Accepted Answer

A)Trial-and-error techniques are the most haphazard method for decision making. Managers and groups who use these techniques are typically seen as poor problem solvers, especially in a healthcare context. Use of pilot projects, scenario planning, or decision trees is more likely to result in successful decision making because these methods all involve proposal and analysis of various alternatives prior to taking action.
B)Trial-and-error techniques are the most haphazard method for decision making. Managers and groups who use these techniques are typically seen as poor problem solvers, especially in a healthcare context. Use of pilot projects, scenario planning, or decision trees is more likely to result in successful decision making because these methods all involve proposal and analysis of various alternatives prior to taking action.
C)Trial-and-error techniques are the most haphazard method for decision making. Managers and groups who use these techniques are typically seen as poor problem solvers, especially in a healthcare context. Use of pilot projects, scenario planning, or decision trees is more likely to result in successful decision making because these methods all involve proposal and analysis of various alternatives prior to taking action.
D)Trial-and-error techniques are the most haphazard method for decision making. Managers and groups who use these techniques are typically seen as poor problem solvers, especially in a healthcare context. Use of pilot projects, scenario planning, or decision trees is more likely to result in successful decision making because these methods all involve proposal and analysis of various alternatives prior to taking action.

Question 19

A nurse has just been hired as a medical information system (MIS)trainer at a hospital where an electronic medical record system is being installed.The nurse has been asked to assess the security of clients' medical records.According to HIPAA's Security Rule,which recommendations by the nurse will enhance security? Select all that apply.

Accepted Answer

HIPAA's Security Rule recommends assigning each staff member a unique username and password and installing a firewall to enhance security. Storing computer-generated worksheets in a locked vault and turning monitors away from view when unattended are additional security measures but not specifically mentioned in the Security Rule. Assigning each unit unique passwords is not as effective as assigning each staff member a unique username and password.

Question 20

What is the first phase in the therapeutic nurse-client relationship?

Accepted Answer

The first phase in the therapeutic nurse-client relationship is the preinteraction phase. This phase involves the nurse preparing for the initial meeting with the client, reviewing the client's medical history and chart, as well as any relevant information from healthcare providers. The nurse also reflects on their own biases and assumptions about the client to ensure that they approach the interaction with an open and non-judgmental mindset.

Quiz 38: Communication