Question 1

The nurse is admitting a client to an inpatient psychiatric unit. The client is speaking wildly and is obviously very agitated. Which action by the nurse would be appropriate to calm the client?

Accepted Answer

A)Speaking in a soft, calm manner is the first step in attempting to soothe an excited client. The nurse's tone may calm the excited client. Using short sentences is a useful approach, but in the case of an excited client, the nurse would attempt to calm the client first. Isolating the client may be necessary if the client's behavior escalates to violence, but that is not evident here and is not the first choice of action. Giving a sedative is the last resort and is used only if the client is threatening to hurt self or others.
B)Speaking in a soft, calm manner is the first step in attempting to soothe an excited client. The nurse's tone may calm the excited client. Using short sentences is a useful approach, but in the case of an excited client, the nurse would attempt to calm the client first. Isolating the client may be necessary if the client's behavior escalates to violence, but that is not evident here and is not the first choice of action. Giving a sedative is the last resort and is used only if the client is threatening to hurt self or others.
C)Speaking in a soft, calm manner is the first step in attempting to soothe an excited client. The nurse's tone may calm the excited client. Using short sentences is a useful approach, but in the case of an excited client, the nurse would attempt to calm the client first. Isolating the client may be necessary if the client's behavior escalates to violence, but that is not evident here and is not the first choice of action. Giving a sedative is the last resort and is used only if the client is threatening to hurt self or others.
D)Speaking in a soft, calm manner is the first step in attempting to soothe an excited client. The nurse's tone may calm the excited client. Using short sentences is a useful approach, but in the case of an excited client, the nurse would attempt to calm the client first. Isolating the client may be necessary if the client's behavior escalates to violence, but that is not evident here and is not the first choice of action. Giving a sedative is the last resort and is used only if the client is threatening to hurt self or others.

Question 2

A nurse is teaching a client about a dressing change that should be done three times per day. The client is from a culture that is "present oriented." Based on this data, at which times should the nurse tell the client to perform the dressing changes?

Accepted Answer

A)For clients who are "present oriented," it is important to avoid fixed schedules. The nurse can offer a time range for activities and treatments, such as in the morning or after breakfast, and in the evening or before going to bed. Relating the dressing changes to regular daily activities would be a good approach for a client who is not focused on times of the day, such as 9 a.m., 3 p.m., and 9 p.m. It is not necessary for the dressing changes to be exactly 8 hours apart. Leaving it up to the client to change the dressing at any time as long as it is changed three times a day does not allow for any regularity in the dressing changes.
B)For clients who are "present oriented," it is important to avoid fixed schedules. The nurse can offer a time range for activities and treatments, such as in the morning or after breakfast, and in the evening or before going to bed. Relating the dressing changes to regular daily activities would be a good approach for a client who is not focused on times of the day, such as 9 a.m., 3 p.m., and 9 p.m. It is not necessary for the dressing changes to be exactly 8 hours apart. Leaving it up to the client to change the dressing at any time as long as it is changed three times a day does not allow for any regularity in the dressing changes.
C)For clients who are "present oriented," it is important to avoid fixed schedules. The nurse can offer a time range for activities and treatments, such as in the morning or after breakfast, and in the evening or before going to bed. Relating the dressing changes to regular daily activities would be a good approach for a client who is not focused on times of the day, such as 9 a.m., 3 p.m., and 9 p.m. It is not necessary for the dressing changes to be exactly 8 hours apart. Leaving it up to the client to change the dressing at any time as long as it is changed three times a day does not allow for any regularity in the dressing changes.
D)For clients who are "present oriented," it is important to avoid fixed schedules. The nurse can offer a time range for activities and treatments, such as in the morning or after breakfast, and in the evening or before going to bed. Relating the dressing changes to regular daily activities would be a good approach for a client who is not focused on times of the day, such as 9 a.m., 3 p.m., and 9 p.m. It is not necessary for the dressing changes to be exactly 8 hours apart. Leaving it up to the client to change the dressing at any time as long as it is changed three times a day does not allow for any regularity in the dressing changes.

Question 3

A female nurse is caring for a 21-year-old male client with a questionable gastrointestinal blockage. The healthcare provider prescribes an enema. Which reaction by the client would the nurse anticipate when planning care?

Accepted Answer

A)The nurse would anticipate that most young adult clients will be embarrassed by this procedure when the nurse and client are of different genders. When the client states that he would rather have his doctor perform the enema, he is probably motivated by embarrassment and acting on the assumption that the doctor is male. The nurse should approach the client beforehand to address the issue. Most clients would only experience annoyance, not fear, in relation to this procedure. Most clients in this age group would also be familiar with what an enema is, even if they have not had an enema themselves. The nurse would definitely not expect the client to request the presence of another individual in the room for this procedure.
B)The nurse would anticipate that most young adult clients will be embarrassed by this procedure when the nurse and client are of different genders. When the client states that he would rather have his doctor perform the enema, he is probably motivated by embarrassment and acting on the assumption that the doctor is male. The nurse should approach the client beforehand to address the issue. Most clients would only experience annoyance, not fear, in relation to this procedure. Most clients in this age group would also be familiar with what an enema is, even if they have not had an enema themselves. The nurse would definitely not expect the client to request the presence of another individual in the room for this procedure.
C)The nurse would anticipate that most young adult clients will be embarrassed by this procedure when the nurse and client are of different genders. When the client states that he would rather have his doctor perform the enema, he is probably motivated by embarrassment and acting on the assumption that the doctor is male. The nurse should approach the client beforehand to address the issue. Most clients would only experience annoyance, not fear, in relation to this procedure. Most clients in this age group would also be familiar with what an enema is, even if they have not had an enema themselves. The nurse would definitely not expect the client to request the presence of another individual in the room for this procedure.
D)The nurse would anticipate that most young adult clients will be embarrassed by this procedure when the nurse and client are of different genders. When the client states that he would rather have his doctor perform the enema, he is probably motivated by embarrassment and acting on the assumption that the doctor is male. The nurse should approach the client beforehand to address the issue. Most clients would only experience annoyance, not fear, in relation to this procedure. Most clients in this age group would also be familiar with what an enema is, even if they have not had an enema themselves. The nurse would definitely not expect the client to request the presence of another individual in the room for this procedure.

Question 4

A home health nurse is precepting a new nurse during a routine wound care visit. The new nurse is assessing the client's wound and notes that it is showing signs and symptoms of infection. The client's spouse asks the new nurse how the wound looks. The new nurse responds by stating, "It looks fine," but the new nurse's face indicates a different story. When evaluating the new nurse, the preceptor should note a need to work on which aspect of communication?

Accepted Answer

A)Congruence is adjusting one's tone of speech and facial expression to match one's spoken message. If a nurse's facial expression and words are not congruent, the client and family will often suspect that something is wrong. Credibility is the quality of being truthful, trustworthy, and reliable. Although the nurse's words in this situation may not be completely true, they do not necessarily reflect a larger problem with credibility. Timing means that a message is delivered when the client and family are capable of processing it fully and correctly. Clarity and brevity are characteristics involving preciseness and use of few words.
B)Congruence is adjusting one's tone of speech and facial expression to match one's spoken message. If a nurse's facial expression and words are not congruent, the client and family will often suspect that something is wrong. Credibility is the quality of being truthful, trustworthy, and reliable. Although the nurse's words in this situation may not be completely true, they do not necessarily reflect a larger problem with credibility. Timing means that a message is delivered when the client and family are capable of processing it fully and correctly. Clarity and brevity are characteristics involving preciseness and use of few words.
C)Congruence is adjusting one's tone of speech and facial expression to match one's spoken message. If a nurse's facial expression and words are not congruent, the client and family will often suspect that something is wrong. Credibility is the quality of being truthful, trustworthy, and reliable. Although the nurse's words in this situation may not be completely true, they do not necessarily reflect a larger problem with credibility. Timing means that a message is delivered when the client and family are capable of processing it fully and correctly. Clarity and brevity are characteristics involving preciseness and use of few words.
D)Congruence is adjusting one's tone of speech and facial expression to match one's spoken message. If a nurse's facial expression and words are not congruent, the client and family will often suspect that something is wrong. Credibility is the quality of being truthful, trustworthy, and reliable. Although the nurse's words in this situation may not be completely true, they do not necessarily reflect a larger problem with credibility. Timing means that a message is delivered when the client and family are capable of processing it fully and correctly. Clarity and brevity are characteristics involving preciseness and use of few words.

Question 5

The nurse is providing care for a client who is about to be discharged. The nurse is discussing the discharge orders with the client's primary healthcare provider. Which statement by the nurse is an appropriate example of using assertive communication?

Accepted Answer

A)The nurse who expresses concern because the client's blood pressure remains high even with new medication is being assertive, clear, and concise. Stating that the new medication is ineffective could be interpreted as an inflammatory remark by the provider. Asking whether the provider can talk about a client does not give the provider enough information. Saying the provider must do something about the client's blood pressure may cause the provider to become defensive.
B)The nurse who expresses concern because the client's blood pressure remains high even with new medication is being assertive, clear, and concise. Stating that the new medication is ineffective could be interpreted as an inflammatory remark by the provider. Asking whether the provider can talk about a client does not give the provider enough information. Saying the provider must do something about the client's blood pressure may cause the provider to become defensive.
C)The nurse who expresses concern because the client's blood pressure remains high even with new medication is being assertive, clear, and concise. Stating that the new medication is ineffective could be interpreted as an inflammatory remark by the provider. Asking whether the provider can talk about a client does not give the provider enough information. Saying the provider must do something about the client's blood pressure may cause the provider to become defensive.
D)The nurse who expresses concern because the client's blood pressure remains high even with new medication is being assertive, clear, and concise. Stating that the new medication is ineffective could be interpreted as an inflammatory remark by the provider. Asking whether the provider can talk about a client does not give the provider enough information. Saying the provider must do something about the client's blood pressure may cause the provider to become defensive.

Question 6

A young adolescent client is in the hospital preparing for major surgery for the removal of a tumor on the kidney. The client's mother tells the nurse that she doesn't want her child to receive narcotics for postoperative pain. What is the nurse's best response?

Accepted Answer

A)As a client advocate, the nurse should defend the need for effective pain medication by using assertive communication. Thus, the best response is for the nurse to tell the mother the truth about the client's pain and then explore the mother's objection to the drugs. Acceding to the mother's request is submissive communication and would not be in the best interests of the child. Telling the mother she does not have a choice is aggressive and untrue. Putting the child in the middle of the discussion is a divisive maneuver.
B)As a client advocate, the nurse should defend the need for effective pain medication by using assertive communication. Thus, the best response is for the nurse to tell the mother the truth about the client's pain and then explore the mother's objection to the drugs. Acceding to the mother's request is submissive communication and would not be in the best interests of the child. Telling the mother she does not have a choice is aggressive and untrue. Putting the child in the middle of the discussion is a divisive maneuver.
C)As a client advocate, the nurse should defend the need for effective pain medication by using assertive communication. Thus, the best response is for the nurse to tell the mother the truth about the client's pain and then explore the mother's objection to the drugs. Acceding to the mother's request is submissive communication and would not be in the best interests of the child. Telling the mother she does not have a choice is aggressive and untrue. Putting the child in the middle of the discussion is a divisive maneuver.
D)As a client advocate, the nurse should defend the need for effective pain medication by using assertive communication. Thus, the best response is for the nurse to tell the mother the truth about the client's pain and then explore the mother's objection to the drugs. Acceding to the mother's request is submissive communication and would not be in the best interests of the child. Telling the mother she does not have a choice is aggressive and untrue. Putting the child in the middle of the discussion is a divisive maneuver.

Question 7

The nurse is caring for a client who was admitted to the emergency department with abdominal pain. The client speaks very little English and requires an emergency appendectomy. The nurse has enlisted the hospital interpreter to explain the procedure and help with informed consent. When the interpreter arrives, which action by the nurse is appropriate?

Accepted Answer

A)An interpreter is an individual who mediates spoken or signed communication between people who use different languages without adding, omitting, distorting meaning, or editorializing. It is not the interpreter's responsibility to determine the dialect with which the client is most familiar. The nurse should direct all questions to the client, not the interpreter. The nurse should also avoid asking the client's family, especially a child or spouse, to help interpret.
B)An interpreter is an individual who mediates spoken or signed communication between people who use different languages without adding, omitting, distorting meaning, or editorializing. It is not the interpreter's responsibility to determine the dialect with which the client is most familiar. The nurse should direct all questions to the client, not the interpreter. The nurse should also avoid asking the client's family, especially a child or spouse, to help interpret.
C)An interpreter is an individual who mediates spoken or signed communication between people who use different languages without adding, omitting, distorting meaning, or editorializing. It is not the interpreter's responsibility to determine the dialect with which the client is most familiar. The nurse should direct all questions to the client, not the interpreter. The nurse should also avoid asking the client's family, especially a child or spouse, to help interpret.
D)An interpreter is an individual who mediates spoken or signed communication between people who use different languages without adding, omitting, distorting meaning, or editorializing. It is not the interpreter's responsibility to determine the dialect with which the client is most familiar. The nurse should direct all questions to the client, not the interpreter. The nurse should also avoid asking the client's family, especially a child or spouse, to help interpret.

Question 8

The nurse is sitting in on a meeting for clients on a behavioral health unit. Which of the following characteristics of the group indicate that the group is functioning effectively? Select all that apply.

Accepted Answer

A)Groups function most effectively when they listen to the ideas of all members, use group members' expertise, and have a positive atmosphere. In an effective group, members feel satisfied with their participation and time is well used-that is, the discussion focuses on the major decisions to be made, and members feel committed to these decisions and responsible for their implementation.
B)Groups function most effectively when they listen to the ideas of all members, use group members' expertise, and have a positive atmosphere. In an effective group, members feel satisfied with their participation and time is well used-that is, the discussion focuses on the major decisions to be made, and members feel committed to these decisions and responsible for their implementation.
C)Groups function most effectively when they listen to the ideas of all members, use group members' expertise, and have a positive atmosphere. In an effective group, members feel satisfied with their participation and time is well used-that is, the discussion focuses on the major decisions to be made, and members feel committed to these decisions and responsible for their implementation.
D)Groups function most effectively when they listen to the ideas of all members, use group members' expertise, and have a positive atmosphere. In an effective group, members feel satisfied with their participation and time is well used-that is, the discussion focuses on the major decisions to be made, and members feel committed to these decisions and responsible for their implementation.
E)Groups function most effectively when they listen to the ideas of all members, use group members' expertise, and have a positive atmosphere. In an effective group, members feel satisfied with their participation and time is well used-that is, the discussion focuses on the major decisions to be made, and members feel committed to these decisions and responsible for their implementation.

Question 9

A nurse is providing care to a client who is scheduled for a colonoscopy. The client requires a bowel prep prior to the diagnostic test. Which approach should the nurse use to facilitate the client's understanding of the procedure?

Accepted Answer

A)Good verbal communication incorporates simplicity, brevity, and completeness. Simplicity involves the use of commonly understood words rather than medical terminology. For example, the term "bowel prep" may be completely meaningless to the client, so telling the client that she needs to drink a gallon of laxative-like medication will get the point across better. Asking the client to repeat the information back in her own words gives the nurse a chance to evaluate whether the teaching has been successful. While intonation can modify the feeling and impact of a message, focusing on intonation is less important than using easily understood terminology. Speaking too slowly or too loudly could be interpreted by the client as patronizing or aggressive.
B)Good verbal communication incorporates simplicity, brevity, and completeness. Simplicity involves the use of commonly understood words rather than medical terminology. For example, the term "bowel prep" may be completely meaningless to the client, so telling the client that she needs to drink a gallon of laxative-like medication will get the point across better. Asking the client to repeat the information back in her own words gives the nurse a chance to evaluate whether the teaching has been successful. While intonation can modify the feeling and impact of a message, focusing on intonation is less important than using easily understood terminology. Speaking too slowly or too loudly could be interpreted by the client as patronizing or aggressive.
C)Good verbal communication incorporates simplicity, brevity, and completeness. Simplicity involves the use of commonly understood words rather than medical terminology. For example, the term "bowel prep" may be completely meaningless to the client, so telling the client that she needs to drink a gallon of laxative-like medication will get the point across better. Asking the client to repeat the information back in her own words gives the nurse a chance to evaluate whether the teaching has been successful. While intonation can modify the feeling and impact of a message, focusing on intonation is less important than using easily understood terminology. Speaking too slowly or too loudly could be interpreted by the client as patronizing or aggressive.
D)Good verbal communication incorporates simplicity, brevity, and completeness. Simplicity involves the use of commonly understood words rather than medical terminology. For example, the term "bowel prep" may be completely meaningless to the client, so telling the client that she needs to drink a gallon of laxative-like medication will get the point across better. Asking the client to repeat the information back in her own words gives the nurse a chance to evaluate whether the teaching has been successful. While intonation can modify the feeling and impact of a message, focusing on intonation is less important than using easily understood terminology. Speaking too slowly or too loudly could be interpreted by the client as patronizing or aggressive.

Question 10

Which of the following terms encompasses the way a group functions, communicates, sets goals, and achieves objectives?

Accepted Answer

A)Group dynamics, or group processes, are related to how a group functions, communicates, sets goals, and achieves objectives. Cohesiveness, commitment, and member behavior are all aspects of group dynamics.
B)Group dynamics, or group processes, are related to how a group functions, communicates, sets goals, and achieves objectives. Cohesiveness, commitment, and member behavior are all aspects of group dynamics.
C)Group dynamics, or group processes, are related to how a group functions, communicates, sets goals, and achieves objectives. Cohesiveness, commitment, and member behavior are all aspects of group dynamics.
D)Group dynamics, or group processes, are related to how a group functions, communicates, sets goals, and achieves objectives. Cohesiveness, commitment, and member behavior are all aspects of group dynamics.

Question 11

Which of the following barriers to communication involves asking a client for information chiefly out of curiosity rather than with the intent to assist the client?

Accepted Answer

A)Probing involves asking a client for information chiefly out of curiosity rather than out of a desire to assist the client. Probing often places clients in a defensive position and violates their privacy. Challenging refers to giving a response that makes clients prove their statement or point of view. Testing involves asking questions that make a client admit to something. Rejecting is refusing to discuss certain topics with a client. All four of these behaviors are barriers to effective nurse-client communication.
B)Probing involves asking a client for information chiefly out of curiosity rather than out of a desire to assist the client. Probing often places clients in a defensive position and violates their privacy. Challenging refers to giving a response that makes clients prove their statement or point of view. Testing involves asking questions that make a client admit to something. Rejecting is refusing to discuss certain topics with a client. All four of these behaviors are barriers to effective nurse-client communication.
C)Probing involves asking a client for information chiefly out of curiosity rather than out of a desire to assist the client. Probing often places clients in a defensive position and violates their privacy. Challenging refers to giving a response that makes clients prove their statement or point of view. Testing involves asking questions that make a client admit to something. Rejecting is refusing to discuss certain topics with a client. All four of these behaviors are barriers to effective nurse-client communication.
D)Probing involves asking a client for information chiefly out of curiosity rather than out of a desire to assist the client. Probing often places clients in a defensive position and violates their privacy. Challenging refers to giving a response that makes clients prove their statement or point of view. Testing involves asking questions that make a client admit to something. Rejecting is refusing to discuss certain topics with a client. All four of these behaviors are barriers to effective nurse-client communication.

Question 12

The nurse is caring for a young adult client after a cervical biopsy. The client has expressed anxiety about the results. The healthcare provider peeks into the client's room and says, "The biopsy is negative." The nurse later finds the client sobbing. Which response by the nurse is most appropriate?

Accepted Answer

A)The nurse does not know specifically what the client is upset about and should ask the client an open-ended question so she can talk. The healthcare provider, in delivering important news to the client, should have taken time to sit with her and discuss the test results. In telling the client that the test was negative, the provider did not clarify what "negative" actually meant. Using medical jargon without explanation can lead to misinterpretation by the client. Asking the client why she is crying about good news does not allow the client to express concern regarding the results. Asking the client what the provider told her assumes that she is crying because of what the provider said and does not allow her to express her concern in an open-ended manner. Saying that the test results are good in this case assumes that the client has misunderstood the results, which may be true but does not allow the client to express her concerns.
B)The nurse does not know specifically what the client is upset about and should ask the client an open-ended question so she can talk. The healthcare provider, in delivering important news to the client, should have taken time to sit with her and discuss the test results. In telling the client that the test was negative, the provider did not clarify what "negative" actually meant. Using medical jargon without explanation can lead to misinterpretation by the client. Asking the client why she is crying about good news does not allow the client to express concern regarding the results. Asking the client what the provider told her assumes that she is crying because of what the provider said and does not allow her to express her concern in an open-ended manner. Saying that the test results are good in this case assumes that the client has misunderstood the results, which may be true but does not allow the client to express her concerns.
C)The nurse does not know specifically what the client is upset about and should ask the client an open-ended question so she can talk. The healthcare provider, in delivering important news to the client, should have taken time to sit with her and discuss the test results. In telling the client that the test was negative, the provider did not clarify what "negative" actually meant. Using medical jargon without explanation can lead to misinterpretation by the client. Asking the client why she is crying about good news does not allow the client to express concern regarding the results. Asking the client what the provider told her assumes that she is crying because of what the provider said and does not allow her to express her concern in an open-ended manner. Saying that the test results are good in this case assumes that the client has misunderstood the results, which may be true but does not allow the client to express her concerns.
D)The nurse does not know specifically what the client is upset about and should ask the client an open-ended question so she can talk. The healthcare provider, in delivering important news to the client, should have taken time to sit with her and discuss the test results. In telling the client that the test was negative, the provider did not clarify what "negative" actually meant. Using medical jargon without explanation can lead to misinterpretation by the client. Asking the client why she is crying about good news does not allow the client to express concern regarding the results. Asking the client what the provider told her assumes that she is crying because of what the provider said and does not allow her to express her concern in an open-ended manner. Saying that the test results are good in this case assumes that the client has misunderstood the results, which may be true but does not allow the client to express her concerns.

Question 13

A nurse case manager spends the morning in a peer discussion and the afternoon in an ad hoc quality management committee meeting that is led by the hospital administrator. Which two types of groups has the nurse case manager participated in?

Accepted Answer

A)Primary groups are typically informal groups that communicate regularly in face-to-face interactions. The case manager's peer group would be considered a primary group. Secondary groups are larger, more impersonal, and goal-oriented. The quality management committee would be classified as a secondary group. All of the other options-camaraderie, information, work, administrative, support, and governance-are functions of groups, not group types.
B)Primary groups are typically informal groups that communicate regularly in face-to-face interactions. The case manager's peer group would be considered a primary group. Secondary groups are larger, more impersonal, and goal-oriented. The quality management committee would be classified as a secondary group. All of the other options-camaraderie, information, work, administrative, support, and governance-are functions of groups, not group types.
C)Primary groups are typically informal groups that communicate regularly in face-to-face interactions. The case manager's peer group would be considered a primary group. Secondary groups are larger, more impersonal, and goal-oriented. The quality management committee would be classified as a secondary group. All of the other options-camaraderie, information, work, administrative, support, and governance-are functions of groups, not group types.
D)Primary groups are typically informal groups that communicate regularly in face-to-face interactions. The case manager's peer group would be considered a primary group. Secondary groups are larger, more impersonal, and goal-oriented. The quality management committee would be classified as a secondary group. All of the other options-camaraderie, information, work, administrative, support, and governance-are functions of groups, not group types.

Question 14

The nurse is caring for a client who is having difficulty understanding the dressing changes that need to be completed in the home as part of postdischarge wound care. The client asks the nurse to demonstrate the procedure again and allow the client's spouse to perform the procedure while the nurse watches. What is the most likely outcome of this assertive request by the client?

Accepted Answer

A)The client used assertive communication to ensure that the dressing changes would be performed correctly, which will likely result in appropriate healing of the client's wound. No information is provided about the nurse's response to the request, and even if the nurse is irritated, these feelings should not affect the quality of care. There is no guarantee that the client's spouse will always perform the task correctly, because humans make mistakes. Infection of a wound that is dressed correctly is not the likely result of this request.
B)The client used assertive communication to ensure that the dressing changes would be performed correctly, which will likely result in appropriate healing of the client's wound. No information is provided about the nurse's response to the request, and even if the nurse is irritated, these feelings should not affect the quality of care. There is no guarantee that the client's spouse will always perform the task correctly, because humans make mistakes. Infection of a wound that is dressed correctly is not the likely result of this request.
C)The client used assertive communication to ensure that the dressing changes would be performed correctly, which will likely result in appropriate healing of the client's wound. No information is provided about the nurse's response to the request, and even if the nurse is irritated, these feelings should not affect the quality of care. There is no guarantee that the client's spouse will always perform the task correctly, because humans make mistakes. Infection of a wound that is dressed correctly is not the likely result of this request.
D)The client used assertive communication to ensure that the dressing changes would be performed correctly, which will likely result in appropriate healing of the client's wound. No information is provided about the nurse's response to the request, and even if the nurse is irritated, these feelings should not affect the quality of care. There is no guarantee that the client's spouse will always perform the task correctly, because humans make mistakes. Infection of a wound that is dressed correctly is not the likely result of this request.

Question 15

Which of the following statements on the part of the nurse is an example of the communication barrier known as testing?

Accepted Answer

A)Testing involves asking questions that make the patient admit to something. These responses permit the patient only limited answers and often meet the nurse's need rather than the patient's. Of the options listed here, "Do you think you're the only client on the unit right now?" best meets this definition. Telling the client that most people have little or no pain after a procedure is an example of stereotyping. Asking about why a client started using marijuana may be an example of probing. Questioning how the client is still in pain after medication administration is an example of challenging, or making clients prove their statements or point of view.
B)Testing involves asking questions that make the patient admit to something. These responses permit the patient only limited answers and often meet the nurse's need rather than the patient's. Of the options listed here, "Do you think you're the only client on the unit right now?" best meets this definition. Telling the client that most people have little or no pain after a procedure is an example of stereotyping. Asking about why a client started using marijuana may be an example of probing. Questioning how the client is still in pain after medication administration is an example of challenging, or making clients prove their statements or point of view.
C)Testing involves asking questions that make the patient admit to something. These responses permit the patient only limited answers and often meet the nurse's need rather than the patient's. Of the options listed here, "Do you think you're the only client on the unit right now?" best meets this definition. Telling the client that most people have little or no pain after a procedure is an example of stereotyping. Asking about why a client started using marijuana may be an example of probing. Questioning how the client is still in pain after medication administration is an example of challenging, or making clients prove their statements or point of view.
D)Testing involves asking questions that make the patient admit to something. These responses permit the patient only limited answers and often meet the nurse's need rather than the patient's. Of the options listed here, "Do you think you're the only client on the unit right now?" best meets this definition. Telling the client that most people have little or no pain after a procedure is an example of stereotyping. Asking about why a client started using marijuana may be an example of probing. Questioning how the client is still in pain after medication administration is an example of challenging, or making clients prove their statements or point of view.

Question 16

A nurse is providing care for a client who has vocal cord damage and wants to implement strategies that will promote communication with this client. Which interventions would be appropriate? Select all that apply.

Accepted Answer

A)The client who is nonverbal would respond best to use of a picture board or pen and paper. Because the client cannot communicate verbally, facing the client when talking, using an interpreter, or using the client's dominant language would not address the client's inability to communicate.
B)The client who is nonverbal would respond best to use of a picture board or pen and paper. Because the client cannot communicate verbally, facing the client when talking, using an interpreter, or using the client's dominant language would not address the client's inability to communicate.
C)The client who is nonverbal would respond best to use of a picture board or pen and paper. Because the client cannot communicate verbally, facing the client when talking, using an interpreter, or using the client's dominant language would not address the client's inability to communicate.
D)The client who is nonverbal would respond best to use of a picture board or pen and paper. Because the client cannot communicate verbally, facing the client when talking, using an interpreter, or using the client's dominant language would not address the client's inability to communicate.
E)The client who is nonverbal would respond best to use of a picture board or pen and paper. Because the client cannot communicate verbally, facing the client when talking, using an interpreter, or using the client's dominant language would not address the client's inability to communicate.

Question 17

The nurse is starting preoperative teaching when the client receives a phone call. When the call ends and the nurse resumes teaching, the client is visibly upset and begins to cry. Which therapeutic initial response by the nurse is appropriate?

Accepted Answer

A)When clients are anxious and upset, they have difficulty focusing, especially on new information, and their anxiety becomes a barrier to effective communication. The nurse needs to prioritize the client's presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Because the nurse is unaware of the issue and is not knowledgeable of the client's situation, it is false reassurance to tell the client that the matter can be handled after the teaching is completed. This response also belittles the client's independence and self-efficacy, as does recommending problem solving.
B)When clients are anxious and upset, they have difficulty focusing, especially on new information, and their anxiety becomes a barrier to effective communication. The nurse needs to prioritize the client's presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Because the nurse is unaware of the issue and is not knowledgeable of the client's situation, it is false reassurance to tell the client that the matter can be handled after the teaching is completed. This response also belittles the client's independence and self-efficacy, as does recommending problem solving.
C)When clients are anxious and upset, they have difficulty focusing, especially on new information, and their anxiety becomes a barrier to effective communication. The nurse needs to prioritize the client's presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Because the nurse is unaware of the issue and is not knowledgeable of the client's situation, it is false reassurance to tell the client that the matter can be handled after the teaching is completed. This response also belittles the client's independence and self-efficacy, as does recommending problem solving.
D)When clients are anxious and upset, they have difficulty focusing, especially on new information, and their anxiety becomes a barrier to effective communication. The nurse needs to prioritize the client's presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Because the nurse is unaware of the issue and is not knowledgeable of the client's situation, it is false reassurance to tell the client that the matter can be handled after the teaching is completed. This response also belittles the client's independence and self-efficacy, as does recommending problem solving.

Question 18

The nurse is caring for a client with a new colostomy. The client has been taught how to perform colostomy care and has been successful with return demonstration to the staff. Although the client is able to perform care independently and has asked to do so, the charge nurse has instructed the nursing staff to continue performing colostomy care for this client. When addressing this issue directly with the charge nurse, which statement by a staff nurse is the most appropriate?

Accepted Answer

A)The nurse should make a clear, assertive statement saying that the client learned the procedure and wishes to execute it. Saying "You have no right . . ." is a challenge to the charge nurse and will only result in escalation of the argument. Telling the charge nurse that the nurse manager will be notified is a threat and inflames the situation. Insisting that the client will continue to change the apparatus will likely result in the charge nurse taking further action to prevent the client from performing self-care.
B)The nurse should make a clear, assertive statement saying that the client learned the procedure and wishes to execute it. Saying "You have no right . . ." is a challenge to the charge nurse and will only result in escalation of the argument. Telling the charge nurse that the nurse manager will be notified is a threat and inflames the situation. Insisting that the client will continue to change the apparatus will likely result in the charge nurse taking further action to prevent the client from performing self-care.
C)The nurse should make a clear, assertive statement saying that the client learned the procedure and wishes to execute it. Saying "You have no right . . ." is a challenge to the charge nurse and will only result in escalation of the argument. Telling the charge nurse that the nurse manager will be notified is a threat and inflames the situation. Insisting that the client will continue to change the apparatus will likely result in the charge nurse taking further action to prevent the client from performing self-care.
D)The nurse should make a clear, assertive statement saying that the client learned the procedure and wishes to execute it. Saying "You have no right . . ." is a challenge to the charge nurse and will only result in escalation of the argument. Telling the charge nurse that the nurse manager will be notified is a threat and inflames the situation. Insisting that the client will continue to change the apparatus will likely result in the charge nurse taking further action to prevent the client from performing self-care.

Question 19

A nurse is developing objectives for a charter group of nurses from a national association. Which characteristics should the nurse expect to encounter when working with this semiformal group?

Accepted Answer

A)There are three levels of group formality: formal, semiformal, and informal. Most groups move in and out of all three levels, but traditionally, a charter group of an association is a semiformal group with a formal structure, carefully delineated hierarchy, and selective, voluntary membership with attached prestige and status. Semiformal groups also have structured deliberate activities during meetings, objectives and goals that are not easily changed, negotiable day-to-day operating standards and methods, and a leader who has direct control over the choice of a successor.
B)There are three levels of group formality: formal, semiformal, and informal. Most groups move in and out of all three levels, but traditionally, a charter group of an association is a semiformal group with a formal structure, carefully delineated hierarchy, and selective, voluntary membership with attached prestige and status. Semiformal groups also have structured deliberate activities during meetings, objectives and goals that are not easily changed, negotiable day-to-day operating standards and methods, and a leader who has direct control over the choice of a successor.
C)There are three levels of group formality: formal, semiformal, and informal. Most groups move in and out of all three levels, but traditionally, a charter group of an association is a semiformal group with a formal structure, carefully delineated hierarchy, and selective, voluntary membership with attached prestige and status. Semiformal groups also have structured deliberate activities during meetings, objectives and goals that are not easily changed, negotiable day-to-day operating standards and methods, and a leader who has direct control over the choice of a successor.
D)There are three levels of group formality: formal, semiformal, and informal. Most groups move in and out of all three levels, but traditionally, a charter group of an association is a semiformal group with a formal structure, carefully delineated hierarchy, and selective, voluntary membership with attached prestige and status. Semiformal groups also have structured deliberate activities during meetings, objectives and goals that are not easily changed, negotiable day-to-day operating standards and methods, and a leader who has direct control over the choice of a successor.

Question 20

A nurse educator in a medical-surgical unit is demonstrating the use of new equipment to the rest of the nurses on the unit. After initial efforts at having the class gather closely around the models were met with discomfort and inattention, the nurse educator sets up the models in the front of the classroom. Which level of proxemics would be ideal for this situation?

Accepted Answer

A)Because the nurse is communicating with a group and all members of the group must be able to see the models clearly, a social distance of 4 to 12 feet would be appropriate. Social distance is characterized by a clear, visual perception of the whole individual, and it is expedient for communicating with several people at the same time. In contrast, an intimate distance of 1 1/2 feet or less would likely make the group members extremely uncomfortable and prevent them from seeing all aspects of the demonstration. A personal distance of 1 1/2 to 4 feet might still cause discomfort among participants and make it difficult for them to observe the models in full. Finally, a public distance of 12 to 15 feet would make it hard for participants to observe the models' smaller features and would also make the communication process less personal for all parties involved.
B)Because the nurse is communicating with a group and all members of the group must be able to see the models clearly, a social distance of 4 to 12 feet would be appropriate. Social distance is characterized by a clear, visual perception of the whole individual, and it is expedient for communicating with several people at the same time. In contrast, an intimate distance of 1 1/2 feet or less would likely make the group members extremely uncomfortable and prevent them from seeing all aspects of the demonstration. A personal distance of 1 1/2 to 4 feet might still cause discomfort among participants and make it difficult for them to observe the models in full. Finally, a public distance of 12 to 15 feet would make it hard for participants to observe the models' smaller features and would also make the communication process less personal for all parties involved.
C)Because the nurse is communicating with a group and all members of the group must be able to see the models clearly, a social distance of 4 to 12 feet would be appropriate. Social distance is characterized by a clear, visual perception of the whole individual, and it is expedient for communicating with several people at the same time. In contrast, an intimate distance of 1 1/2 feet or less would likely make the group members extremely uncomfortable and prevent them from seeing all aspects of the demonstration. A personal distance of 1 1/2 to 4 feet might still cause discomfort among participants and make it difficult for them to observe the models in full. Finally, a public distance of 12 to 15 feet would make it hard for participants to observe the models' smaller features and would also make the communication process less personal for all parties involved.
D)Because the nurse is communicating with a group and all members of the group must be able to see the models clearly, a social distance of 4 to 12 feet would be appropriate. Social distance is characterized by a clear, visual perception of the whole individual, and it is expedient for communicating with several people at the same time. In contrast, an intimate distance of 1 1/2 feet or less would likely make the group members extremely uncomfortable and prevent them from seeing all aspects of the demonstration. A personal distance of 1 1/2 to 4 feet might still cause discomfort among participants and make it difficult for them to observe the models in full. Finally, a public distance of 12 to 15 feet would make it hard for participants to observe the models' smaller features and would also make the communication process less personal for all parties involved.

Quiz 38: Communication