Deck 21: Communication Therapeutic Relationships

Question 1

Which statement or question by the nurse manager demonstrates an assertive approach?
1)"Pain status must be assessed and documented for every patient."
2)"Why haven't you been assessing and documenting pain for every patient?"
3)"Will you please assess and document pain status for every patient?"
4)"Explain why you haven't been assessing and documenting pain for every patient."

Answer 1

1

Question 2

A hospital that is interested in purchasing intravascular infusion pumps organizes a group of nurses to evaluate pumps provided by a variety of vendors. Which type of group has been organized?
1)Short-term
2)Ongoing
3)Self-help
4)Work-related social support

Answer 2

1

Question 3

A patient who speaks little English is admitted to the hospital after experiencing severe abdominal pain. Which nursing diagnosis is preferred for this patient?
1)Impaired Communication
2)Readiness for Enhanced Communication
3)Impaired Verbal Communication
4)Sensory Alteration

Answer 3

1

Question 4

A patient experiences expressive aphasia after a stroke. Which expected outcome is appropriate for this patient?
1)Uses alternative methods of communication
2)Communicates effectively using an interpreter
3)Interprets messages accurately
4)Follows commands when asked

Question 5

A patient with severe substernal chest pain comes to the emergency department. The patient is restless and anxious. Which statement by the nurse appropriately offers reassurance?
1)"I'll give you some medication to help relieve the pain."
2)"If you lie still and relax, you'll be fine in a little while."
3)"Please try not to think about the pain as best as you can."
4)"Don't worry; we're going to take good care of you."

Question 6

After a physician discusses cancer treatment options with a patient, the patient asks the nurse which treatment should be used. Which response by the nurse is best?
1)"If I were you, I'd go with chemotherapy."
2)"What do you think about radiation therapy?"
3)"Why don't you see what your spouse thinks?"
4)"I'll give you some information about each option."

Question 7

Which form of communication is the nurse using when interviewing the patient during the admission health history and physical assessment?
1)Small group
2)Interpersonal
3)Group
4)Intrapersonal

Question 8

A patient who speaks only French was admitted to the hospital after a motor vehicle accident. Since the nurse does not speak French, what is the best way to communicate with this patient?
1)Use sign language for communicating.
2)Ask a family member to serve as an interpreter.
3)Request the services of a hospital translator.
4)Speak in English, but speak very slowly.

Question 9

Which statement or question by the nurse indicates that the nurse-patient relationship is entering the termination phase?
1)"I'll be admitting you to our nursing unit as soon as I obtain your health history."
2)"You seem upset today. Would you like to talk about whatever is bothering you?"
3)"I'm leaving for the day. Is there anything I can do for you before I leave?"
4)"Hello. My name is Leslie, and I'm going to be your nurse today."

Question 10

A male patient had surgery 6 hours ago. When the nurse enters the room to turn him, the nurse notes that he is restless and grimacing. Considering the patient's nonverbal communication, what action should the nurse take first?
1)Administer pain medication to the patient.
2)Turn and reposition the patient.
3)Share observations about the behaviors.
4)Leave the room so that the patient can rest quietly.

Question 11

The nurse manager of the medical intensive care unit formed a group to help the staff cope with stress more effectively. Which comment by a group member will lead the manager to evaluate the group as successful?
1)"This was a good idea to form a group; I've been wanting to get to know some of the people from the other shifts."
2)"It really helps me to share feelings about how hard it is to see pain and suffering every day."
3)"I now have a group to help me when I need to work through situations at home causing personal stress."
4)"It's nice to have a chance to get away from the unit and talk on a regular basis."

Question 12

During admission to the unit, a patient states, "I'm not worried about the results of my tests. I'm sure I'll be all right." As the nurse observes the patient, the nurse notes that the patient is shaky, tearful, and does not make eye contact. Unfortunately, the nurse is called away to an emergency before completing this discussion. Which goal is most appropriate for the nurse to establish when returning to the patient? The patient will:
1)Explain the reason for the incongruent statements
2)Engage in diversional activities to cope with stress
3)Express concerns to the primary care provider
4)Discuss concerns and fears with the nurse

Question 13

Which action by the nurse is a nonverbal behavior that enhances communication?
1)Keeping a neutral expression on the face
2)Maintaining a distance of 6 to 12 inches
3)Sitting down to speak with the patient
4)Asking mostly open-ended questions

Question 14

Which intervention by the nurse helps to establish a trusting nurse-patient relationship?
1)Avoiding topics that may provoke emotional responses from the patient
2)Listening to the patient while performing care activities
3)Performing care interventions quietly without explanation
4)Greeting the patient by name whenever entering the patient's room

Question 15

A male patient being admitted in hypertensive crisis informs the nurse that he stopped taking his blood pressure medication 3 weeks ago. Which response by the nurse is best?
1)"You're lucky you didn't have a stroke; you really need to take your medication."
2)"Tell me more about your experience with your high blood pressure medication."
3)"Why did you stop taking your high blood pressure medication?"
4)"It's very important to take your blood pressure medication."

Question 16

The nurse must insert a nasogastric (NG) tube into a patient with a bowel obstruction. After inserting the NG tube, the nurse thinks about the interaction to improve communication skills. Which attribute is the nurse exhibiting?
1)Respect
2)Genuineness
3)Empathy
4)Confrontation

Question 17

The nurse is preparing a patient for a computed tomography (CT) scan of the abdomen. Patients must be NPO (nothing by mouth) for 8 hours and void several minutes before the test. Which statement by the nurse is best to help prepare the patient?
1)"You are to remain NPO for the 8 hours prior to your CT scan."
2)"You cannot have anything to eat or drink for 8 hours before your test."
3)"You will need to be NPO and drink this contrast medium before your test."
4)"You may need to void before you go to the department for your CT scan."

Question 18

A physician tells a female patient that she has cancer and that she should have surgery as soon as possible. The patient is not certain she wants to pursue this treatment approach, but responds by saying, "I'll do whatever you think I should do." Which communication style is this patient using?
1)Assertive
2)Aggressive
3)Passive aggressive
4)Passive

Question 19

A young adult with a severe episode of asthma-related bronchoconstriction comes to the emergency department with signs of respiratory distress. When the nurse performs the orientation assessment, the nurse notes that the patient cannot identify the place/location or the time. Which nursing diagnosis is most suitable for this patient?
1)Chronic Confusion
2)Acute Confusion
3)Impaired Verbal Communication
4)Readiness for Enhanced Communication

Question 20

The nurse is assigned to care for the following patients. In planning nursing care, the nurse knows touch should be used cautiously when communicating with which patient?
1)A middle-aged woman just diagnosed with terminal lung cancer
2)A middle-aged man experiencing the acute phase of myocardial infarction
3)An older adult admitted with dehydration with a history of dementia
4)A young adult recovering from surgery for a ruptured appendix who will be discharged tomorrow

Question 21

Which statements by the nurse demonstrate that active listening has occurred? Select all that apply.
1)"I listened to my patient while I was changing the intravenous (IV) site."
2)"I made eye contact and listened to my patient to find out concerns."
3)"I took detailed notes when I listened to my patient describe symptoms."
4)"I sat with my patient, and the patient's spouse to talk about their fears before surgery."
5)"I did not interrupt while the patient was expressing anxiety about the diagnostic tests."

Question 22

The nurse is caring for an elderly woman with dementia who is frightened in the hospital room. Which is the best action by the nurse to communicate empathy and compassion?
1)Use the bedside intercom to inform her that the nurse will be entering the room.
2)Lightly touch the patient's arm or shoulder before greeting her.
3)Shut the patient's door in the hallway if there is noise or loud talking.
4)Firmly but kindly insist the patient accepts reality as the nurse has presented it.

Question 23

The nurse is caring for a patient with a fluid and electrolyte imbalance. The nurse asks the certified nursing assistant (CNA) to obtain the intake and output. Which statement below best describes the most appropriate communication to the CNA in delegating this task?
1)"Can you please place a sign on the door for room 3 and start obtaining I&O?"
2)"Please record all food and fluid the patient takes in and the amount of all urine, stool, and emesis for the next 48 hours."
3)"The patient is starting to have some problems so we'll have to watch the patient's fluids for the entire shift."
4)"What is the intake and output on the patient in room 3?"

Question 24

What is the primary purpose of communication?
1)Exchange information
2)Form relationships
3)Establish therapeutic rapport
4)Meet primarily psychosocial needs

Question 25

A patient newly diagnosed with breast cancer tells the nurse, "I'm worried I won't survive to see my children grow up." Which response by the nurse best conveys concern and active listening?
1)"There have been many advances in breast cancer treatment; hope for the best."
2)"Breast cancer is a serious disease; I can understand why you're worried."
3)"You're strong and have youth on your side to fight the breast cancer."
4)"I'd be worried too; I've seen a lot of patients die of breast cancer."

Question 26

When using the SBAR model to communicate with a physician, what information does the nurse offer first?
1)Statement of the problem and its probable cause
2)Nurse's name, patient's name, and reason for the communication
3)History of information related to and leading up to the reason for the communication
4)What the nurse thinks will correct the problem or what is needed from the physician

Question 27

The nurse is caring for a patient with severe arthritis and notices a written pain medication order that appears to have an extremely high dose. The nurse places a call to the physician to question the prescription dose. Which statement below best describes an assertive communication style by the nurse in interacting with the physician regarding the pain medication order?
1)"I'm calling about the pain medication prescription for Mrs. Garcia. The dose is too high."
2)"Sorry to bother you but I'm not sure about the dose of pain medication you prescribed for Mrs. Garcia."
3)"I'm concerned about the medication dose that was prescribed for Mrs. Garcia."
4)"You may disagree with me, but the dose for Mrs. Garcia is too high."

Question 28

The nurse is caring for a patient after abdominal surgery and notices that the urine is blood tinged. The nurse places a call to the physician regarding the color of the urine. When communicating to the physician using the SBAR format, which statement by the nurse below best describes the "R" in SBAR?
1)"Hello, my name is Susan, and I'm calling about your patient who just had abdominal surgery."
2)"Your patient just had surgery, and I've noticed some blood-tinged urine in the Foley catheter."
3)"Your patient has blood-tinged urine after surgery. I suggest that we obtain a urinalysis for this patient."
4)"I'm calling to let you know I ordered and sent a urinalysis for this patient."

Question 29

In the communication process, which characteristics best describe an effective verbal message? Select all that apply.
1)Clear and long
2)Developmental level appropriate
3)Situation appropriate
4)Delivered at an appropriate time
5)Organized information

Question 30

The wife of an elderly patient begins crying after she is informed that the patient has a terminal illness. Which intervention by the nurse is best?
1)Sit quietly with the patient's wife while she composes her thoughts.
2)Inform the wife that a chaplain is available if she would like to speak to him.
3)Remind the wife that her husband has lived a long and good life.
4)Tell the wife there are always options and suggest she not give up hope.

Question 31

A nurse has sound, scientific evidence to support changing a procedure that would reduce catheter-related infections on the unit. The unit manager, nevertheless, is unwilling to make the change because it would be too costly. Which response by the nurse represents assertive communication?
1)"This is a widely used practice. If you read more research, you'd probably wonder why we aren't already doing it."
2)"There is extensive evidence to support the new method, but I understand this change would be too difficult."
3)"Is the budget more important to the hospital than reducing infections and patient suffering?"
4)"I'd like to help gather information regarding cost of new materials versus the savings in treating infections."

Question 32

During patient rounds with the multidisciplinary team, the nurse expresses disagreement with the type of medication prescribed for the patient hospitalized for renal failure. What is the likely result of the nurse's speaking up?
1)Reduces the opportunity for inadvertent error in clinical judgment
2)Increases the risk for medical liability when pointing out possible error
3)Interferes with the good working relationship among the healthcare team
4)Compromises the nurse's reputation as a collaborative team member

Question 33

The nurse caring for a patient with recurrent abdominal pain of unknown origin addresses the patient by name and puts a hand on the patient's shoulder and offers reassuring words: "You'll be okay. Try not to think about things too much, if you can." How would another nurse most likely evaluate this nurse's verbal and nonverbal communication?
1)Words offer hope and consolation
2)Nurse's interaction is comforting
3)Response builds nurse-patient trust
4)Message provides false reassurance

Question 34

The nurse is conducting an assessment while admitting a female Chinese patient to the medical unit. Which actions will best enhance communication between the nurse and patient during the assessment? Select all that apply.
1)Interacting in a causal manner
2)Keeping 18 inches to 4 feet between nurse and the patient
3)Assessing for any language barrier
4)Including family members in the assessment process
5)Changing the subject during the assessment

Question 35

The nurse is caring for a patient who suffered a stroke and now has expressive aphasia. The nurse is having a difficult time communicating and the patient is becoming angry and frustrated. In developing the plan of care, what is the most appropriate outcome for this patient?
1)Patient will use alternative methods of communication.
2)Patient will understand the reason for the frustration.
3)Patient will learn sign language to communicate effectively.
4)Patient will have family members present for communication.

Question 36

A patient tells the nurse, "I'm having a lot of pain in my hip." Which responses by the nurse most likely would stimulate the patient to provide the most complete data? Select all that apply.
1)"Is your pain severe?"
2)"Tell me about your pain."
3)"Do you need pain medicine?"
4)"How would you describe your pain?"
5)"Is your pain better or worse than it was this morning?"

Question 37

Which statements are reflective of barriers to communication? Select all that apply.
1)"I see you had a heart attack. Why are you still smoking?"
2)"I know you are having pain in your knee. I will check your vital signs before getting your pain medications."
3)"The nursing assistant told me you are having back pain. I'll get your pain medication now."
4)"Tell me a little more about the chest pain you were having at home."
5)"Let's talk about all the possible causes and treatments for chest pain."

Question 38

Which elements of the communication process are accurately matched? Select all that apply.
1)Receiver-decodes the message
2)Message-process of selecting the words and gestures
3)Channel-method in which message is conveyed
4)Encoding-verbal and/or nonverbal information sent
5)Sender-provides feedback

Question 39

The nursing student is assigned to care for a patient who has just been diagnosed with advanced-stage cancer. The patient is very upset and crying. The nursing student states to the instructor, "I don't know what to do. My patient just can't stop crying." What is the best response from the instructor?
1)"Sometimes just sitting with patient and remaining silent can be the best care."
2)"You will need to wait patiently until your patient stops crying to complete your care."
3)"You will not be effective while the patient is crying. Tell the patient you will come back later."
4)"Try to distract the patient from crying by trying to change the conversation."