Deck 20: Communicating Therapeutic Relationships

Question 1

A patient comes to the emergency department complaining of severe substernal chest pain.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."

Answer 1

"I'll give you some medication to help relieve the pain."

Question 2

Which intervention by the nurse first 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 and respectfully
D) Greeting the patient by name whenever entering the patient's room

Answer 2

Greeting the patient by name whenever entering the patient's room

Question 3

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.

Answer 3

Assess to determine the cause of the grimacing.

Question 4

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,assuming 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) "Lie still,please; I need to elevate the head of the bed and insert this tube."

Question 5

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 6

The nurse is assigned to the care of the following patients.In planning nursing care,the nurse knows to use touch cautiously 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 (MI)
C) Older adult with a history of dementia admitted for dehydration
D) Young adult in the rehabilitative phase after arthroscopic surgery

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 an interpreter.
C) Request the services of a hospital interpreter.
D) Speak in English,but speak very slowly.

Question 8

Which statement or question by the nurse manager demonstrates an assertive approach when communicating with the staff nurse about a patient care issue?

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 9

The nurse is preparing a patient for a computed tomography (CT)scan of the abdomen.Which statement by the nurse is best (all contain correct information)?

A) "You will need to remain NPO for the 4 hours prior to your CT scan."
B) "You cannot have anything to eat or drink for 4 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 10

After being informed of a cancer diagnosis,the patient responds,"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 11

The nurse manager of the medical intensive care unit formed a group to help the staff cope with stress more effectively.Which of the comments by a group member causes 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 working 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 in my own life causing me stress."
D) "It feels good to have a chance to get away from the unit and talk on a regular basis."

Question 12

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 13

A newly admitted patient states not being concerned about diagnostic tests but is shaky and tearful and does not maintain eye contact.When conducting a conversation with the client,what should the nurse encourage the client to do?

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

Question 14

A health center 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 15

Which 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

A patient being admitted in hypertensive crisis reports stopping 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."

Question 17

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 18

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,the patient is not oriented to place or time.Which nursing diagnosis is most suitable for this patient?

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

Question 19

After a physician discusses cancer treatment options,the patient asks which treatment to 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 spouse thinks?"
D) "I'll give you some information about each option."

Question 20

The wife of an elderly patient begins crying after she is informed that he 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 happy life.
D) Tell his wife there are always options and suggest she not give up hope.

Question 21

The nurse notes that a healthcare provider speaks with the same tone to every client about every situation.What characteristics of verbal communication should the nurse keep in mind when talking with a client? Select all that apply.

A) Pitch
B) Timing
C) Brevity
D) Volume
E) Cadence

Question 22

Which statement by the nurse demonstrates 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 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) "I find the best time to talk with my patient is during the morning bath."

Question 23

A patient tells the nurse,"I'm having a lot of pain in my hip." Which response by the nurse is open-ended and 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) "What makes the pain worse?"

Question 24

A nurse has sound,scientific evidence to support changing a procedure that would reduce catheter-related infections on the unit.The nurse manager is unwilling to make the change because it would be 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 don't want to create an issue."
C) "Is the budget more important to the hospital than reducing infections and patient suffering?"
D) "I'd like to help gather information regarding the cost of new materials versus the savings in treating infections."

Question 25

Which statement about communication is true? Select all that apply.

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) Method to ensure a message is understood

Question 26

The nurse prepares to meet with assigned clients after receiving hand-off communication.Which statement or question demonstrates that the nurse is in the working phase with a client?

A) "I see that you live near the hospital.Have you been living here awhile?"
B) "After breakfast we can review the instructions for insulin self-injection again."
C) "I'm going to miss talking with you ever day but you are better and ready to go home now."
D) "As soon as I get your admission papers I'll be in to talk with you about your health problem."

Question 27

A patient newly diagnosed with breast cancer tells the nurse,"I'm worried I won't live 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 28

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 situation
D) A solution to the problem or what is needed from the physician

Question 29

After observing a conversation,the nurse manager determines that a new nurse's communication technique was effective.Which aspects of communication did the manager observe? Select all that apply.

A) Correct channel
B) Effective message
C) Minimized concerns
D) Encouraged
E) Appropriate encoding