Question 1

A patient is admitted to the intensive care unit for congestive heart failure. Using the situation-background-assessment-recommendation (SBAR) format, put the following statements in the order in which the nurse should report changes to the health care team.

A) Our patient was admitted 2 days ago with heart failure and has been receiving furosemide (Lasix) for diuresis, but his urine output has been low.
B) I think that our patient needs to be evaluated immediately and may need intubation and mechanical ventilation.
C) This is the nurse on the surgical unit. I am calling about our patient in room 3. After assessing him, I am very concerned about his shortness of breath.
D) Today, our patient has crackles audible throughout the posterior chest and his O2 saturation is 89%. His condition is very unstable.

C, A, D, B
The order of the nurse's statements follows the SBAR format. The nurse explains the situation by identifying herself, then gives the immediate background of the patient. She then assesses the patient and gives her recommendation.

Accepted Answer

C, A, D, B&#10;The order of the nurse's statements follows the SBAR format. The nurse explains the situation by identifying herself, then gives the immediate background of the patient. She then assesses the patient and gives her recommendation.

Question 2

The nurse is seeking clarification of a statement that was made by a patient. What is the best way for the nurse to seek clarification?&#10;A) &#34;What are the common elements here?&#34;&#10;B) &#34;Tell me again about your experiences.&#34;&#10;C) &#34;Am I correct in understanding that&#8230;&#34;&#10;D) &#34;Tell me everything from the beginning.&#34;

Accepted Answer

Clarification ensures that both the nurse and patient share mutual understanding of the communication. The distracters encourage comparison rather than clarification and present implied questions that suggest the nurse was not listening.

Question 3

A nurse is conducting a therapeutic session with a patient in the inpatient psychiatric facility. Which remark by the nurse would be an appropriate way to begin an interview session?&#10;A) &#34;How shall we start today?&#34;&#10;B) &#34;Shall we talk about losing your privileges yesterday?&#34;&#10;C) &#34;Let's get started discussing your marital relationship.&#34;&#10;D) &#34;What happened when your family visited yesterday?&#34;

Accepted Answer

The interview is patient centered; thus, the patient chooses issues. The nurse assists the patient by using communication skills and actively listening to provide opportunities for the patient to reach goals. In the distracters, the nurse selects the topic.

Question 4

The nurse and the patient are conversing face to face. What communication technique is being demonstrated?&#10;A) Linguistic&#10;B) Paralinguistic&#10;C) Explicit&#10;D) Metacommunication

Accepted Answer

Conversing face to face, reading newspapers and books, and even texting are all common forms of linguistic communication. Paralinguistics include less recognizable but important means of transmitting messages such as the use of gestures, eye contact, and facial expressions. Explicit communication is not a therapeutic communication technique. Metacommunication factors that affect how messages are received and interpreted would include internal personal states (such as disturbances in mood), environmental stimuli related to the setting of the communication, and contextual variables (such as the relationship between the people in the communication episode).

Question 5

The nurse is working with a patient diagnosed with posttraumatic stress disorder related to childhood sexual abuse. The patient is crying and states, "I should be over this by now; this happened years ago." Which response(s) by the nurse will facilitate communication? (Select all that apply.)

A) "Why do you think you are so upset?"
B) "I can see that this situation really bothers you."
C) "The abuse you endured is very painful for you."
D) "Crying is a way of expressing the hurt you're experiencing."
E) "Let's talk about something else, since this subject is upsetting you."

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Accepted Answer

Reflecting and giving information are therapeutic techniques. "Why" questions often imply criticism or seem intrusive or judgmental. They are difficult to answer. Changing the subject is a barrier to communication.

Question 6

A patient states, &#34;I had a bad nightmare. When I woke up, I felt emotionally drained, as though I hadn't rested well.&#34; Which response by the nurse would be an example of interpersonal therapeutic communication?&#10;A) &#34;It sounds as though you were uncomfortable with the content of your dream.&#34;&#10;B) &#34;I understand what you're saying. Bad dreams leave me feeling tired, too.&#34;&#10;C) &#34;So, all in all, you feel as though you had a rather poor night's sleep?&#34;&#10;D) &#34;Can you give me an example of what you mean by a 'bad nightmare'?&#34;

Accepted Answer

The technique of clarification is therapeutic and helps the nurse examine meaning. The distracters focus on patient feelings but fail to clarify the meaning of the patient's comment.

Question 7

The nurse is admitting a patient to the medical/surgical unit. Which communication technique would be considered appropriate for this interaction?&#10;A) &#34;I've also had traumatic life experiences. Maybe it would help if I told you about them.&#34;&#10;B) &#34;Why do you think you had so much difficulty adjusting to this change in your life?&#34;&#10;C) &#34;You will feel better after getting accustomed to how this unit operates.&#34;&#10;D) &#34;I'd like to sit with you for a while to help you get comfortable talking to me.&#34;

Accepted Answer

Because the patient is newly admitted to the unit, allowing the patient to become comfortable with the setting a technique that can assist in establishing the nurse-patient relationship. It helps build trust and convey that the nurse cares about the patient. The nurse should not reveal their life experiences as this is not therapeutic. Asking why the patient is having difficulty may provide insight; however, this would be best saved for an established relationship with the patient. Assuring the patient that they will feel better may not be true depending on the reason for the admission.

Deck 45: Communication