Deck 21: Communication Therapeutic Relationships

Question 1

A 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?

A) "You're lucky you didn't have a stroke; you really need to take your medication."
B) "Tell me more about your experience with your high blood pressure medication."
C) "Why did you stop taking your high blood pressure medication?"
D) "It's very important to take your blood pressure medication."

Answer 1

"Tell me more about your experience with your high blood pressure medication."

Question 2

The nurse manager of the medical intensive care unit formed a group to help her staff cope with stress more effectively.Which of the comments by group members will lead the manager to evaluate the group as successful?

A) "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."
B) "It really helps me to share feelings about how hard it is to see pain and suffering every day."
C) "I now have a group to help me when I need to work through situations at home causing personal stress."
D) "It's nice to have a chance to get away from the unit and talk on a regular basis."

Answer 2

"It really helps me to share feelings about how hard it is to see pain and suffering every day."

Question 3

The nurse must insert a nasogastric (NG)tube into a patient with a bowel obstruction.Before inserting the tube,the nurse must explain the procedure to the patient.Which explanation by the nurse is best? Assume that all provide correct information.

A) "I'm going to insert an NG tube and connect it to low Gomco to keep your stomach empty."
B) "I'm going to insert a tube through your nose into your stomach to prevent you from vomiting."
C) "I'm going to insert an NG tube through your nares to suction your secretions and prevent emesis."
D) "Hold still, please; I need to elevate the head of the bed and insert this tube."

Answer 3

"I'm going to insert a tube through your nose into your stomach to prevent you from vomiting."

Question 4

A young adult with a severe episode of asthma bronchoconstriction comes to the emergency department with signs of respiratory distress.When the nurse performs the admission assessment,she notes that the patient is not able to say where she is or the time.Which nursing diagnosis is probably most suitable for this patient?

A) Chronic Confusion
B) Acute Confusion
C) Impaired Verbal Communication
D) Readiness for Enhanced Communication

Question 5

A hospital that is interested in purchasing IV infusion pumps organizes a group of nurses to evaluate pumps provided by a variety of vendors.Which type of group has been organized?

A) Short term
B) Ongoing
C) Self-help
D) Work-related social support

Question 6

A patient experiences expressive aphasia after a stroke.Which expected outcome is appropriate for this patient?

A) Uses alternative methods of communication
B) Communicates effectively using a translator
C) Interprets messages accurately
D) Follows commands when asked

Question 7

A patient who speaks only French was admitted to the hospital after a motor vehicle accident.Assuming that the nurse does not speak French,what is the best way to communicate with this patient?

A) Use sign language for communicating.
B) Ask a family member to serve as a translator.
C) Request the services of a hospital translator.
D) Speak in English, but speak very slowly.

Question 8

After a physician discusses cancer treatment options with a patient,the patient asks the nurse which treatment he should choose.Which response by the nurse is best?

A) "If I were you, I'd go with chemotherapy."
B) "What do you think about radiation therapy?"
C) "Why don't you see what your wife thinks?"
D) "I'll give you some information about each option."

Question 9

Which statement or question by the nurse manager demonstrates an assertive approach?

A) "You must assess and document pain status for every patient."
B) "Why haven't you been assessing and documenting pain for every patient?"
C) "Will you please assess and document pain status for every patient?"
D) "Explain why you haven't been assessing and documenting pain for every patient."

Question 10

Which statement or question by the nurse indicates that the nurse-patient relationship is entering the termination phase?

A) "I'll be admitting you to our nursing unit as soon as I obtain your health history."
B) "You seem upset today. Would you like to talk about whatever is bothering you?"
C) "I'm leaving for the day. Is there anything I can do for you before I leave?"
D) "Hello. My name is Leslie and I'm going to be your nurse today."

Question 11

A patient who speaks little English is admitted to the hospital after experiencing severe abdominal pain.Which nursing diagnosis is preferred for this patient?

A) Impaired Communication
B) Readiness for Enhanced Communication
C) Impaired Verbal Communication
D) Sensory Alteration

Question 12

The nurse is preparing a patient for a computed tomography (CT)scan of the abdomen.Which statement by the nurse is best? Assume all are true.

A) "You will need to remain NPO for the 8 hours prior to your CT scan."
B) "You cannot have anything to eat or drink for 8 hours before your test."
C) "You will need to be NPO and drink this contrast medium before your test."
D) "You may need to void before you go down to the department for your CT scan."

Question 13

A physician tells a 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?

A) Assertive
B) Aggressive
C) Passive aggressive
D) Passive

Question 14

The nurse is assigned to the care of the following patients.In planning nursing care,the nurse knows she should use touch cautiously,especially when communicating with which patient?

A) Middle-aged woman just diagnosed with terminal lung cancer
B) Middle-aged man experiencing the acute phase of myocardial infarction
C) Older adult admitted with dehydration with a history of dementia
D) Young adult recovering from surgery for a ruptured appendix who will be discharged tomorrow

Question 15

Which of the following is a nonverbal behavior that enhances communication?

A) Keeping a neutral expression on the face
B) Maintaining a distance of 6 to 12 inches
C) Sitting down to speak with the patient
D) Asking mostly open-ended questions

Question 16

Which intervention by the nurse helps to establish a trusting nurse-patient relationship?

A) Avoiding topics that may provoke emotional responses from the patient
B) Listening to the patient while performing care activities
C) Performing care interventions quietly without explanation
D) Greeting the patient by name whenever entering the patient's room

Question 17

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 he 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 he has time to complete this discussion.Which of the following goals is most appropriate for the nurse to establish when returning to the patient? The patient will:

A) Explain the reason for his incongruent statements
B) Engage in diversional activities to cope with stress
C) Express his concerns to his primary care provider
D) Discuss his concerns and fears with the nurse

Question 18

A patient comes to the emergency department complaining of severe substernal chest pain.He is restless and anxious.Which statement by the nurse appropriately offers reassurance?

A) "I'll give you some medication to help relieve the pain."
B) "If you lie still and relax, you'll be fine in a little while."
C) "Please try not to think about the pain as best as you can.
D) "Don't worry; we're going to take good care of you."

Question 19

A patient had surgery 6 hours ago.When the nurse enters the room to turn him,she notes that he is restless and grimacing.Considering the patient's nonverbal communication,what action should the nurse take first?

A) Administer pain medication to the patient.
B) Turn and reposition the patient.
C) Assess to determine the cause of the grimacing.
D) Leave the patient's room so he can rest quietly.

Question 20

Which form of communication is the nurse using when interviewing the patient during the admission health history and physical assessment?

A) Small group
B) Interpersonal
C) Group
D) Intrapersonal

Question 21

A nurse has sound,scientific evidence to support changing a procedure that would reduce catheter-related infections on the unit.The unit manager states,nevertheless,that she is unwilling to make the change because it would too costly.Which response by the nurse represents assertive communication?

A) "This is a widely used practice. If you read more research, you'd probably wonder why we aren't already doing it."
B) "There is extensive evidence to support the new method, but I understand this change would be too difficult."
C) "Is the budget more important to the hospital than reducing infections and patient suffering?"
D) "I'd like to help gather information regarding cost of new materials versus the savings in treating infections."

Question 22

A patient tells the nurse,"I'm having a lot of pain in my hip." Which response(s)by the nurse most likely would stimulate the patient to provide the most complete data? Select all that apply.

A) "Is your pain severe?"
B) "Tell me about your pain."
C) "When did you first notice this pain?"
D) "How would you describe your pain?"
E) "Is your pain better or worse than it was this morning?"

Question 23

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 her instructor,"I don't know what to do.My patient just can't stop crying." What is the best response from the instructor?

A) "Sometimes just sitting with patient and remaining silent can be the best care."
B) "You will need to wait patiently until your patient stops crying to complete your care."
C) "You will not be effective while he is crying. Tell the patient you will come back later."
D) "Try to distract the patient from crying by trying to change the conversation."

Question 24

In the communication process,which of the following best describes characteristics of an effective oral message? Select all that apply.

A) Age appropriate
B) Developmental level appropriate
C) Short and simple
D) Delivered at an appropriate time
E) Congruent nonverbal cues

Question 25

The nurse caring for a patient with recurrent abdominal pain of unknown origin addresses the patient by name and puts her hand on her shoulder and offers reassuring words: "You'll be okay.Try not to think about things too much,if you can." How would you evaluate the nurse's verbal and nonverbal communication?

A) Words offer hope and consolation
B) Nurse's interaction is comforting
C) Response builds nurse-patient trust
D) Message provides false reassurance

Question 26

The wife of an elderly patient begins crying after she is informed that he is has a terminal illness.Which intervention by the nurse is best?

A) Sit quietly with the patient's wife while she composes her thoughts.
B) Inform his wife that a chaplain is available if she would like to speak to him.
C) Remind his wife that her husband has lived a long and good life.
D) Tell his wife there are always options and suggest she not give up hope.

Question 27

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?

A) Use the bedside intercom to inform her that you will be entering her room.
B) Use brief, light touch on the patient's arm or shoulder when greeting her.
C) Shut the patient's door in the hallway if there is noise or loud talking.
D) Firmly but kindly insist the patient accepts reality as you have presented it.

Question 28

Which statements by the nurse demonstrate that active listening has occurred? Select all that apply.

A) "I listened to my patient while I was changing his IV site."
B) "I made eye contact and listened to my patient to find out his concerns."
C) "I took detailed notes when I listened to my patient describe his symptoms."
D) "I sat with my patient and his wife to talk about their fears before the surgery."
E) "Using my own words, I restated what the patient was saying about his fears."

Question 29

The nurse is conducting an assessment while admitting a female Chinese patient to the medical unit.Which of the following actions will best enhance communication between the nurse and patient during the assessment? Select all that apply.

A) Making direct eye contact
B) Keeping 18 inches to 4 feet between nurse and the patient
C) Assessing for any language barrier
D) Including family members in the assessment process
E) Changing the subject during the assessment

Question 30

What actions by the nurse are best for communicating with an unconscious patient? Select all that apply.

A) Speak loudly and clearly.
B) Explain all procedures.
C) Use touch appropriately.
D) Speak calmly and slowly.
E) Introduce yourself.

Question 31

The primary purpose of communication is to

A) Exchange information
B) Form relationships
C) Establish therapeutic rapport
D) Meet psychosocial needs

Question 32

The nurse is caring for a patient with a fluid and electrolyte imbalance.She asks the certified nursing assistant (CNA)to obtain the intake and output.Which of the following statements below best describes the most appropriate communication to the CNA in delegating this task?

A) "Can you please place a sign on the door for room 3 and start obtaining his I&O?"
B) "Please record all food and fluid the patient takes in and the amount of all urine, stool, and emesis for the next 48 hours."
C) "The patient is starting to have some problems so we'll have to watch his fluids."
D) "What is the intake and output on the patient in room 3?"

Question 33

During patient rounds with the multidisciplinary team,the nurse expresses disagreement with the type of medication prescribed for her patient hospitalized for renal failure.What is the likely result of the nurse's speaking up?

A) Reduces the opportunity for inadvertent error in clinical judgment
B) Increases the risk for medical liability when pointing out possible error
C) Interferes with the good working relationship among the healthcare team
D) Compromises the nurse's reputation as a collaborative team member

Question 34

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.She 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?

A) "I'm calling about the pain medication prescription for Mrs. Garcia. The dose is too high."
B) "Sorry to bother you but I'm not sure about the dose of pain medication you prescribed for Mrs. Garcia."
C) "I'm concerned about the medication dose you prescribed for Mrs. Garcia."
D) "You may disagree with me, but the dose for Mrs. Garcia is too high."

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?

A) Patient will use alternative methods of communication.
B) Patient will learn to communicate needs without becoming frustrated.
C) Patient will learn sign language to communicate effectively.
D) Patient will have family members present for communication.

Question 36

Which of the following statements are reflective of barriers to communication? Select all that apply.

A) "I see you had a heart attack. Why are you still smoking?"
B) "I know you are having pain in your knee. I will check your vital signs before getting your pain medications."
C) "The nursing assistant told me you are having back pain. I'll get your pain medication now."
D) "Tell me a little more about the chest pain you were having at home."
E) "Let's talk about all the possible causes and treatments for chest pain."
F) None of the above

Question 37

When using the SBAR model to communicate with a physician,what information does the nurse offer first?

A) Statement of the problem and its probable cause
B) Nurse's name, patient's name, and reason for the communication
C) History of information related to and leading up to the reason for the communication
D) What the nurse thinks will correct the problem or what is needed from the physician

Question 38

Which statement(s)about communication is/are true? Select all that apply.Communication is:

A) Used to meet physical and psychosocial needs
B) Most basically described as talking and listening
C) The process of sending and receiving information
D) The basis for forming relationships
E) The act of talking or listening to convey a message

Question 39

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?

A) "There have been many advances in breast cancer treatment; hope for the best."
B) "Breast cancer is a serious disease; I can understand why you're worried."
C) "You're strong and have youth on your side to fight the breast cancer."
D) "I'd be worried too; I've seen a lot of patients die of breast cancer."

Question 40

The nurse is caring for a patient after abdominal surgery and notices that his urine is blood tinged.She 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?

A) "Hello my name is Susan and I'm calling about your patient who just had abdominal surgery."
B) "Your patient just had surgery and I've noticed some blood tinged urine in his Foley catheter."
C) "Your patient has blood-tinged urine after surgery. I suggest that we obtain an urinalysis for this patient."
D) "I'm calling to let you know I ordered and sent an urinalysis for this patient."