Deck 8: Communication Skills: Medium for All Nursing Practice

Question 1

A Filipino-American patient avoided eye contact when interacting with the nurse. The nurse concluded that the patient had low self-esteem. Interventions were used to raise the patient's self-esteem; however, after 3 weeks, the patient's eye contact did not improve. What is the most accurate analysis of this scenario?

A) The patient's eye contact should have been directly addressed by role-playing to increase comfort with eye contact.
B) The nurse should not have independently embarked on treatment planning for this patient.
C) The patient's poor eye contact is indicative of anger and hostility that remain unaddressed.
D) The nurse should have assessed the patient's culture before concluding the patient had low self-esteem.

Answer 1

The nurse should have assessed the patient's culture before concluding the patient had low self-esteem.

Question 2

The relationship between a nurse and patient as it relates to status and power is best described by which term?

A) Symmetric
B) Complementary
C) Incongruent
D) Paralinguistic

Answer 2

Complementary

Question 3

A school-age child tells the school nurse, "Other kids call me mean names and will not sit with me at lunch. Nobody likes me." Select the nurse's most therapeutic response.

A) "Just ignore them and they will leave you alone."
B) "You should make friends with other children."
C) "Call them names if they do that to you."
D) "Tell me more about how you feel."

Answer 3

"Tell me more about how you feel."

Question 4

While talking with a patient diagnosed with major depressive disorder, a nurse notices the patient is unable to maintain eye contact. The patient's chin lowers to the chest while the patient looks at the floor. Which aspect of communication has the nurse assessed?

A) Nonverbal communication
B) A message filter
C) A cultural barrier
D) Social skills

Question 5

An African-American patient says to a Caucasian nurse, "There's no sense talking. You wouldn't understand because you live in a white world." The nurse's best action would be to:

A) explain, "Yes, I do understand. Everyone goes through the same experiences."
B) say, "Please give an example of something you think I wouldn't understand."
C) reassure the patient that nurses interact with people from all cultures.
D) change the subject to one that is less emotionally disturbing.

Question 6

Documentation in a patient's chart shows, "Throughout a 5-minute interaction, patient fidgeted and tapped left foot, periodically covered face with hands, and looked under chair while stating, 'I enjoy spending time with you.'" Which analysis is most accurate?

A) Patient is giving positive feedback about the nurse's communication techniques.
B) Nurse is viewing the patient's behavior through a cultural filter.
C) Patient's verbal and nonverbal messages are incongruent.
D) Patient is demonstrating psychotic behaviors.

Question 7

A nurse interacts with a newly hospitalized patient. Select the nurse's comment that applies the communication technique of "offering self."

A) "I've also had traumatic life experiences. Maybe it would help if I told you about them."
B) "Why do you think you had so much difficulty adjusting to this change in your life?"
C) "I hope you will feel better after getting accustomed to how this unit operates."
D) "I'd like to sit with you for a while to help you get comfortable talking to me."

Question 8

A patient discloses several concerns and associated feelings. If the nurse wants to seek clarification, which comment would be appropriate?

A) "What are the common elements here?"
B) "Tell me again about your experiences."
C) "Am I correct in understanding that…?"
D) "Tell me everything from the beginning."

Question 9

Which principle should guide the nurse in determining the extent of silence to use during patient interview sessions?

A) Nurses are responsible for breaking silences.
B) Patients withdraw if silences are prolonged.
C) Silence can provide meaningful moments for reflection.
D) Silence helps patients know that what they said is understood.

Question 10

Which technique will best communicate to a patient that the nurse is interested in listening?

A) Restate a feeling or thought the patient has expressed.
B) Ask a direct question, such as, "Did you feel angry?"
C) Make a judgment about the patient's problem.
D) Say, "I understand what you're saying."

Question 11

A patient diagnosed with schizophrenia tells the nurse, "The CIA is monitoring us through the fluorescent lights in this room. Be careful what you say." Which response by the nurse would be most therapeutic?

A) "Let's talk about something other than the CIA."
B) "It sounds like you're concerned about your privacy."
C) "The CIA is prohibited from operating in health care facilities."
D) "You have lost touch with reality, which is a symptom of your illness."

Question 12

During the first interview with a parent whose child died in a car accident, the nurse feels empathic and reaches out to take the patient's hand. Select the correct analysis of the nurse's behavior.

A) It shows empathy and compassion. It will encourage the patient to continue to express feelings.
B) The gesture is premature. The patient's cultural and individual interpretation of touch is unknown.
C) The patient will perceive the gesture as intrusive and overstepping boundaries.
D) The action is inappropriate. Patients in a psychiatric setting should not be touched.

Question 13

When a female Mexican-American patient and a female nurse sit together, the patient often holds the nurse's hand. The patient also links arms with the nurse when they walk. The nurse is uncomfortable with this behavior and thinks the patient is homosexual. Which alternative is a more accurate assessment?

A) The patient is accustomed to touch during conversations, as are members of many Hispanic subcultures.
B) The patient understands that touch makes the nurse uncomfortable and controls the relationship based on that factor.
C) The patient is afraid of being alone. When touching the nurse, the patient is reassured and comforted.
D) The nurse is homophobic.

Question 14

A Puerto Rican-American patient uses dramatic body language when describing emotional discomfort. Which analysis most likely explains the patient's behavior? The patient:

A) likely has a histrionic personality disorder.
B) believes dramatic body language is sexually appealing.
C) wishes to impress staff with the degree of emotional pain.
D) belongs to a culture in which dramatic body language is the norm.

Question 15

During an interview, a patient attempts to shift the focus from self to the nurse by asking personal questions. The nurse should respond by saying:

A) "You've turned the tables on me."
B) "Nurses direct the interviews with patients."
C) "Do not ask questions about my personal life."
D) "The time we spend together is to discuss your concerns."

Question 16

A patient tells the nurse, "I don't think I will ever get out of here." Select the nurse's most therapeutic response.

A) "Don't talk that way. Of course you will leave here."
B) "Keep up the good work and you certainly will."
C) "You don't think you're making progress?"
D) "Everyone feels that way sometimes."

Question 17

A patient is having difficulty making a decision. The nurse has mixed feelings about whether to provide advice. Which principle usually applies? Giving advice:

A) is rarely helpful.
B) fosters independence.
C) lifts the burden of personal decision making.
D) helps the patient develop feelings of personal adequacy.

Question 18

A patient says to the nurse, "I dreamed I was stoned. When I woke up, I felt emotionally drained, as though I hadn't rested well." Which comment would be appropriate if the nurse seeks clarification?

A) "It sounds as though you were uncomfortable with the content of your dream."
B) "I understand what you're saying. Bad dreams leave me feeling tired, too."
C) "So, all in all, you feel as though you had a rather poor night's sleep?"
D) "Can you give me an example of what you mean by 'stoned'?"

Question 19

A patient with severe depression states, "God is punishing me for my past sins." What is the nurse's best response?

A) "Why do you think that?"
B) "You sound very upset about this."
C) "You believe God is punishing you for your sins?"
D) "If you feel this way, you should talk to a member of your clergy."

Question 20

The patient says, "My marriage is just great. My spouse and I usually agree on everything." The nurse observes the patient's foot moving continuously as the patient twirls a shirt button. What conclusion can the nurse draw? The patient's communication is:

A) clear.
B) mixed.
C) precise.
D) inadequate.

Question 21

Which benefits are most associated with the use of telehealth? (Select all that apply.)

A) Cost savings for patients
B) Maximization of care management
C) Access to services for patients in rural areas
D) Prompt reimbursement by third-party payers
E) Rapid development of trusting relationships with patients

Question 22

A patient cries as the nurse explores the patient's relationship with a deceased parent. The patient says, "I shouldn't be crying like this. It happened a long time ago." Which responses by the nurse will facilitate communication? (Select all that apply.)

A) "Why do you think you are so upset?"
B) "I can see that you feel sad about this situation."
C) "The loss of your parent is very painful for you."
D) "Crying is a way of expressing the hurt you're experiencing."
E) "Let's talk about something else because this subject is upsetting you."