Question 1

A nurse educator is teaching a group of students about therapeutic touch.In which situation is it appropriate to use therapeutic touch as a means of communication?
A) When a family member is making inappropriate comments to the nurse.
B) When an upset spouse is alone and the client has just expired.
C) It is never appropriate in the nursing profession.
D) When a young male client asks a young student nurse for a hug.

Accepted Answer

A) The use of therapeutic touch is an appropriate means for communication when providing nursing care. The appropriate use of touch reinforces caring feelings. However, the nurse must be sensitive to the differences in attitudes and practices of clients and self. Touch is not appropriate when a family member is making inappropriate comments to the nurse or when a client asks a student nurse for a hug.
B) The use of therapeutic touch is an appropriate means for communication when providing nursing care. The appropriate use of touch reinforces caring feelings. However, the nurse must be sensitive to the differences in attitudes and practices of clients and self. Touch is not appropriate when a family member is making inappropriate comments to the nurse or when a client asks a student nurse for a hug.
C) The use of therapeutic touch is an appropriate means for communication when providing nursing care. The appropriate use of touch reinforces caring feelings. However, the nurse must be sensitive to the differences in attitudes and practices of clients and self. Touch is not appropriate when a family member is making inappropriate comments to the nurse or when a client asks a student nurse for a hug.
D) The use of therapeutic touch is an appropriate means for communication when providing nursing care. The appropriate use of touch reinforces caring feelings. However, the nurse must be sensitive to the differences in attitudes and practices of clients and self. Touch is not appropriate when a family member is making inappropriate comments to the nurse or when a client asks a student nurse for a hug.

Question 2

The nurse is providing care to a visually impaired client who is scheduled for a colonoscopy.The client requires a bowel prep prior to the diagnostic test.Which approach will the nurse use to facilitate the client's understanding of the material?
A) Use layman's term and ask the client to describe the procedure afterwards.
B) Explanation the procedure to the client using medical terms for clarity.
C) Focus on intonation when teaching the client.
D) Speak slowly to the client.

Accepted Answer

A) Good verbal communication incorporates simplicity, which includes the use of commonly understood words, brevity, and completeness. The term "bowel prep" may be completely meaningless to a client, but telling the client that there is a need to drink a gallon of laxative-like medication gets the point across better. Colonoscopy is a complicated word. Explaining the procedure by using words like "small camera inserted into your rectum" will make much more sense to the client. Pace and intonation indicate interest, anxiety, boredom, or fear, all of which modify the feeling and impact of the message. Clarity implies that the message is direct and simple–saying precisely what is meant and using the fewest words necessary.
B) Good verbal communication incorporates simplicity, which includes the use of commonly understood words, brevity, and completeness. The term "bowel prep" may be completely meaningless to a client, but telling the client that there is a need to drink a gallon of laxative-like medication gets the point across better. Colonoscopy is a complicated word. Explaining the procedure by using words like "small camera inserted into your rectum" will make much more sense to the client. Pace and intonation indicate interest, anxiety, boredom, or fear, all of which modify the feeling and impact of the message. Clarity implies that the message is direct and simple–saying precisely what is meant and using the fewest words necessary.
C) Good verbal communication incorporates simplicity, which includes the use of commonly understood words, brevity, and completeness. The term "bowel prep" may be completely meaningless to a client, but telling the client that there is a need to drink a gallon of laxative-like medication gets the point across better. Colonoscopy is a complicated word. Explaining the procedure by using words like "small camera inserted into your rectum" will make much more sense to the client. Pace and intonation indicate interest, anxiety, boredom, or fear, all of which modify the feeling and impact of the message. Clarity implies that the message is direct and simple–saying precisely what is meant and using the fewest words necessary.

Question 3

A female nurse is caring for a 21-year-old male client with a questionable gastrointestinal blockage.The healthcare provider prescribes an enema.Which reaction by the client does the nurse anticipate when planning care?
A) "May I have a visitor as support in the room?"
B) "I would rather have my doctor perform this procedure."
C) "I have never had an enema before."
D) "I am afraid of having an enema."

Accepted Answer

A) The nurse would anticipate that most young adults will be embarrassed by this procedure when the nurse and young client are of different genders. When the client states that the doctor could perform the enema, the client is probably acting on embarrassment and on the assumption that the doctor is male. The nurse should approach the client beforehand to address the issue. Most clients would only experience annoyance, not fear for this procedure. A client who has never experienced an enema is exhibiting a lack of knowledge, which is not usually the case for a 21-year-old; most people of that age have experienced an enema. The nurse would definitely not expect the client to request the presence of another individual in the room for an intimate procedure.
B) The nurse would anticipate that most young adults will be embarrassed by this procedure when the nurse and young client are of different genders. When the client states that the doctor could perform the enema, the client is probably acting on embarrassment and on the assumption that the doctor is male. The nurse should approach the client beforehand to address the issue. Most clients would only experience annoyance, not fear for this procedure. A client who has never experienced an enema is exhibiting a lack of knowledge, which is not usually the case for a 21-year-old; most people of that age have experienced an enema. The nurse would definitely not expect the client to request the presence of another individual in the room for an intimate procedure.
C) The nurse would anticipate that most young adults will be embarrassed by this procedure when the nurse and young client are of different genders. When the client states that the doctor could perform the enema, the client is probably acting on embarrassment and on the assumption that the doctor is male. The nurse should approach the client beforehand to address the issue. Most clients would only experience annoyance, not fear for this procedure. A client who has never experienced an enema is exhibiting a lack of knowledge, which is not usually the case for a 21-year-old; most people of that age have experienced an enema. The nurse would definitely not expect the client to request the presence of another individual in the room for an intimate procedure.
D) The nurse would anticipate that most young adults will be embarrassed by this procedure when the nurse and young client are of different genders. When the client states that the doctor could perform the enema, the client is probably acting on embarrassment and on the assumption that the doctor is male. The nurse should approach the client beforehand to address the issue. Most clients would only experience annoyance, not fear for this procedure. A client who has never experienced an enema is exhibiting a lack of knowledge, which is not usually the case for a 21-year-old; most people of that age have experienced an enema. The nurse would definitely not expect the client to request the presence of another individual in the room for an intimate procedure.

Question 4

The nurse is starting preoperative teaching when the client receives a phone call.When the nurse resumes teaching,the client is visibly upset and begins to cry.Which therapeutic initial response by the nurse is appropriate?
A) "Whatever is upsetting you can be dealt with once we have finished."
B) "It is very important to focus on this teaching so that you will recover quickly after surgery."
C) "I can see the phone call has upset you. Let's talk about why you are upset before we move on with teaching."
D) "What can you do to solve the problem?"

Accepted Answer

A) When clients are anxious and upset, they have difficulty focusing, especially on new information, and their anxiety becomes a barrier to effective communication. The nurse needs to prioritize the client's presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Because the nurse is unaware of the issue and is not knowledgeable of the client's situation, it is false reassurance to tell the client that the matter can be handled after the teaching is completed. This also belittles the client's independence and self-efficacy, as does recommending problem solving.
B) When clients are anxious and upset, they have difficulty focusing, especially on new information, and their anxiety becomes a barrier to effective communication. The nurse needs to prioritize the client's presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Because the nurse is unaware of the issue and is not knowledgeable of the client's situation, it is false reassurance to tell the client that the matter can be handled after the teaching is completed. This also belittles the client's independence and self-efficacy, as does recommending problem solving.
C) When clients are anxious and upset, they have difficulty focusing, especially on new information, and their anxiety becomes a barrier to effective communication. The nurse needs to prioritize the client's presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Because the nurse is unaware of the issue and is not knowledgeable of the client's situation, it is false reassurance to tell the client that the matter can be handled after the teaching is completed. This also belittles the client's independence and self-efficacy, as does recommending problem solving.
D) When clients are anxious and upset, they have difficulty focusing, especially on new information, and their anxiety becomes a barrier to effective communication. The nurse needs to prioritize the client's presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Because the nurse is unaware of the issue and is not knowledgeable of the client's situation, it is false reassurance to tell the client that the matter can be handled after the teaching is completed. This also belittles the client's independence and self-efficacy, as does recommending problem solving.

Question 5

The nurse is sitting in on an Alcoholic Anonymous (AA)meeting clients on a behavioral health unit.Which decision-making methods used by the group indicates the group is functioning effectively? Select all that apply.
A) The expertise of group members is being used.
B) The group atmosphere is positive.
C) Members feel satisfied with their participation.
D) The group listens to the ideas of certain group members.
E) The discussion focuses on all problems brought by group members.

Accepted Answer

A) The ability to make sound decisions is essential to effective group functioning. Effective decisions are made when the following things occur: the group determines which decision method to adopt; the group listens to all the ideas of members; members feel satisfied with their participation; the expertise of group members is well used; the problem-solving ability of the group is facilitated; the group atmosphere is positive; time is used well-that is, the discussion focuses on the decision to be made; and members feel committed to the decision and responsible for its implementation.
B) The ability to make sound decisions is essential to effective group functioning. Effective decisions are made when the following things occur: the group determines which decision method to adopt; the group listens to all the ideas of members; members feel satisfied with their participation; the expertise of group members is well used; the problem-solving ability of the group is facilitated; the group atmosphere is positive; time is used well-that is, the discussion focuses on the decision to be made; and members feel committed to the decision and responsible for its implementation.
C) The ability to make sound decisions is essential to effective group functioning. Effective decisions are made when the following things occur: the group determines which decision method to adopt; the group listens to all the ideas of members; members feel satisfied with their participation; the expertise of group members is well used; the problem-solving ability of the group is facilitated; the group atmosphere is positive; time is used well-that is, the discussion focuses on the decision to be made; and members feel committed to the decision and responsible for its implementation.
D) The ability to make sound decisions is essential to effective group functioning. Effective decisions are made when the following things occur: the group determines which decision method to adopt; the group listens to all the ideas of members; members feel satisfied with their participation; the expertise of group members is well used; the problem-solving ability of the group is facilitated; the group atmosphere is positive; time is used well-that is, the discussion focuses on the decision to be made; and members feel committed to the decision and responsible for its implementation.
E) The ability to make sound decisions is essential to effective group functioning. Effective decisions are made when the following things occur: the group determines which decision method to adopt; the group listens to all the ideas of members; members feel satisfied with their participation; the expertise of group members is well used; the problem-solving ability of the group is facilitated; the group atmosphere is positive; time is used well-that is, the discussion focuses on the decision to be made; and members feel committed to the decision and responsible for its implementation.

Question 6

The nurse completes a teaching session on wound care for a client who will require dressing changes after discharge.The nurse evaluates the effectiveness of a teaching session for wound care with the family and determines that more education is required.Which statement by the nurse is appropriate in this situation?
A) "Let me clarify again some of the steps that are required during wound care."
B) "You did not pay attention, did you?"
C) "Here, let me do it for you."
D) "I do not think you understood me correctly the first time."

Accepted Answer

A) Responding with some clarifications indicates the client understood some of the teaching and preserves the client's dignity and trust in the nurse. Saying that the client did not understand the information is belittling. Beginning a negative phrase with "you" is assigning blame, which impedes the therapeutic relationship. Telling the client the nurse can do it better defeats the goal of the feedback; the nurse would want to instill self-confidence in the client, and this type of action will hurt that goal.
B) Responding with some clarifications indicates the client understood some of the teaching and preserves the client's dignity and trust in the nurse. Saying that the client did not understand the information is belittling. Beginning a negative phrase with "you" is assigning blame, which impedes the therapeutic relationship. Telling the client the nurse can do it better defeats the goal of the feedback; the nurse would want to instill self-confidence in the client, and this type of action will hurt that goal.
C) Responding with some clarifications indicates the client understood some of the teaching and preserves the client's dignity and trust in the nurse. Saying that the client did not understand the information is belittling. Beginning a negative phrase with "you" is assigning blame, which impedes the therapeutic relationship. Telling the client the nurse can do it better defeats the goal of the feedback; the nurse would want to instill self-confidence in the client, and this type of action will hurt that goal.
D) Responding with some clarifications indicates the client understood some of the teaching and preserves the client's dignity and trust in the nurse. Saying that the client did not understand the information is belittling. Beginning a negative phrase with "you" is assigning blame, which impedes the therapeutic relationship. Telling the client the nurse can do it better defeats the goal of the feedback; the nurse would want to instill self-confidence in the client, and this type of action will hurt that goal.

Question 7

A young adolescent client is in the hospital preparing for major surgery for the removal of a tumor on the kidney.The client's mother tells the nurse that she doesn't want the child to receive narcotics for pain postoperatively.Which is the best response by the nurse?
A) "Okay, I'll tell the healthcare provider not to order any. Are you sure you want to do this?"
B) "The pain will be severe. Why don't we ask your child about this?"
C) "The pain for your child will be severe after surgery. Can you tell me why you feel this way?"
D) "You do not have a choice of medication. Decisions involving pain relief are up to the healthcare providers."

Accepted Answer

A) As a client advocate, the nurse would defend the need for effective pain medication by using assertive communication. The nurse tells the mother the truth about pain and then proceeds to explore the mother's objection to the drugs. Acceding to the request of the mother is submissive communication and would not be in the best interests of the child. Telling the mother she does not have a choice is aggressive and untrue. Putting the child in the middle of the discussion is a divisive maneuver.
B) As a client advocate, the nurse would defend the need for effective pain medication by using assertive communication. The nurse tells the mother the truth about pain and then proceeds to explore the mother's objection to the drugs. Acceding to the request of the mother is submissive communication and would not be in the best interests of the child. Telling the mother she does not have a choice is aggressive and untrue. Putting the child in the middle of the discussion is a divisive maneuver.
C) As a client advocate, the nurse would defend the need for effective pain medication by using assertive communication. The nurse tells the mother the truth about pain and then proceeds to explore the mother's objection to the drugs. Acceding to the request of the mother is submissive communication and would not be in the best interests of the child. Telling the mother she does not have a choice is aggressive and untrue. Putting the child in the middle of the discussion is a divisive maneuver.
D) As a client advocate, the nurse would defend the need for effective pain medication by using assertive communication. The nurse tells the mother the truth about pain and then proceeds to explore the mother's objection to the drugs. Acceding to the request of the mother is submissive communication and would not be in the best interests of the child. Telling the mother she does not have a choice is aggressive and untrue. Putting the child in the middle of the discussion is a divisive maneuver.

Question 8

The nurse is caring for a client with cancer who is struggling with chronic pain.The nurse tells the client,"It is normal to feel frustrated about the discomfort." Which skill associated with the working phase of the nurse-client relationship does the nurse's statement best reflect?
A) Confronting
B) Respect
C) Concreteness
D) Genuineness

Accepted Answer

A) Respect is correct because the nurse is validating the client's feelings. It is not genuineness because the nurse is giving information versus making a personal statement. Rather than being confrontational by pointing out discrepancies between thoughts, feelings, and actions that inhibit the client's self-understanding or exploration of specific areas, the nurse is being supportive by respecting the client's feelings. Concreteness involves assisting the client by giving specific examples rather than speaking in generalities.
B) Respect is correct because the nurse is validating the client's feelings. It is not genuineness because the nurse is giving information versus making a personal statement. Rather than being confrontational by pointing out discrepancies between thoughts, feelings, and actions that inhibit the client's self-understanding or exploration of specific areas, the nurse is being supportive by respecting the client's feelings. Concreteness involves assisting the client by giving specific examples rather than speaking in generalities.
C) Respect is correct because the nurse is validating the client's feelings. It is not genuineness because the nurse is giving information versus making a personal statement. Rather than being confrontational by pointing out discrepancies between thoughts, feelings, and actions that inhibit the client's self-understanding or exploration of specific areas, the nurse is being supportive by respecting the client's feelings. Concreteness involves assisting the client by giving specific examples rather than speaking in generalities.
D) Respect is correct because the nurse is validating the client's feelings. It is not genuineness because the nurse is giving information versus making a personal statement. Rather than being confrontational by pointing out discrepancies between thoughts, feelings, and actions that inhibit the client's self-understanding or exploration of specific areas, the nurse is being supportive by respecting the client's feelings. Concreteness involves assisting the client by giving specific examples rather than speaking in generalities.

Question 9

Whether in the classroom or clinical setting,the way a group functions,communicates,sets goals,and achieves objectives is related to which concept?
A) Cohesiveness
B) Group dynamics
C) Commitment
D) Member behavior
E) Power

Accepted Answer

A) Group dynamics, or group processes, are related to how the group functions, communicates, sets goals, and achieves objectives. Cohesiveness, group dynamics, commitment, member behavior, and power are aspects of group dynamics.
B) Group dynamics, or group processes, are related to how the group functions, communicates, sets goals, and achieves objectives. Cohesiveness, group dynamics, commitment, member behavior, and power are aspects of group dynamics.
C) Group dynamics, or group processes, are related to how the group functions, communicates, sets goals, and achieves objectives. Cohesiveness, group dynamics, commitment, member behavior, and power are aspects of group dynamics.
D) Group dynamics, or group processes, are related to how the group functions, communicates, sets goals, and achieves objectives. Cohesiveness, group dynamics, commitment, member behavior, and power are aspects of group dynamics.
E) Group dynamics, or group processes, are related to how the group functions, communicates, sets goals, and achieves objectives. Cohesiveness, group dynamics, commitment, member behavior, and power are aspects of group dynamics.

Question 10

A novice nurse is working with a client who is admitted to a medical-surgical unit.The nurse is establishing a therapeutic relationship with the client by conveying empathy.Which statement by the nurse best exemplifies empathy?
A) "I wouldn't be afraid, if I were you."
B) "You shouldn't have done it that way."
C) "You seem to be frightened by the procedure. Tell me how you are feeling."
D) "I know just how you feel, as my mother has the same illness."

Accepted Answer

A) The goal of empathy is to let the client be aware that the nurse understands the client's feelings as well as the words. By stating that the client appears to be frightened and asking the client to describe his or her feelings, the nurse is demonstrating understanding and is giving the client the opportunity to further define feelings. Telling the client that the nurse knows how the client feels is going to be met with disbelief, and rightly so; one individual never knows how another individual is feeling unless that individual tells them. Telling the client not to be afraid is demeaning; rather, the nurse should ascertain the source of fear and then teach. Saying the client should not have done something is passing judgment and inappropriate.
B) The goal of empathy is to let the client be aware that the nurse understands the client's feelings as well as the words. By stating that the client appears to be frightened and asking the client to describe his or her feelings, the nurse is demonstrating understanding and is giving the client the opportunity to further define feelings. Telling the client that the nurse knows how the client feels is going to be met with disbelief, and rightly so; one individual never knows how another individual is feeling unless that individual tells them. Telling the client not to be afraid is demeaning; rather, the nurse should ascertain the source of fear and then teach. Saying the client should not have done something is passing judgment and inappropriate.
C) The goal of empathy is to let the client be aware that the nurse understands the client's feelings as well as the words. By stating that the client appears to be frightened and asking the client to describe his or her feelings, the nurse is demonstrating understanding and is giving the client the opportunity to further define feelings. Telling the client that the nurse knows how the client feels is going to be met with disbelief, and rightly so; one individual never knows how another individual is feeling unless that individual tells them. Telling the client not to be afraid is demeaning; rather, the nurse should ascertain the source of fear and then teach. Saying the client should not have done something is passing judgment and inappropriate.
D) The goal of empathy is to let the client be aware that the nurse understands the client's feelings as well as the words. By stating that the client appears to be frightened and asking the client to describe his or her feelings, the nurse is demonstrating understanding and is giving the client the opportunity to further define feelings. Telling the client that the nurse knows how the client feels is going to be met with disbelief, and rightly so; one individual never knows how another individual is feeling unless that individual tells them. Telling the client not to be afraid is demeaning; rather, the nurse should ascertain the source of fear and then teach. Saying the client should not have done something is passing judgment and inappropriate.

Question 11

The nurse is providing teaching for an inpatient lupus support group meeting.Which group behaviors indicate the teaching was effective?
A) The group members appear relaxed and interested in the topic.
B) Group members are tentative in expressing feelings to the group.
C) The group avoids discussion about lupus signs and symptoms.
D) The group appears self-conscious when asked questions about lupus.

Accepted Answer

A) To be effective a group must accomplish its goals, maintain cohesion, and develop/modify its structure to improve effectiveness. The features of an effective group include an informal, comfortable, and relaxed atmosphere; goals, tasks, and objectives that are clear and understood; leadership and member participation; goal oriented; open and two-way communication; appropriate decision-making procedures; cohesion; conflict tolerance; and shared power.
B) To be effective a group must accomplish its goals, maintain cohesion, and develop/modify its structure to improve effectiveness. The features of an effective group include an informal, comfortable, and relaxed atmosphere; goals, tasks, and objectives that are clear and understood; leadership and member participation; goal oriented; open and two-way communication; appropriate decision-making procedures; cohesion; conflict tolerance; and shared power.
C) To be effective a group must accomplish its goals, maintain cohesion, and develop/modify its structure to improve effectiveness. The features of an effective group include an informal, comfortable, and relaxed atmosphere; goals, tasks, and objectives that are clear and understood; leadership and member participation; goal oriented; open and two-way communication; appropriate decision-making procedures; cohesion; conflict tolerance; and shared power.
D) To be effective a group must accomplish its goals, maintain cohesion, and develop/modify its structure to improve effectiveness. The features of an effective group include an informal, comfortable, and relaxed atmosphere; goals, tasks, and objectives that are clear and understood; leadership and member participation; goal oriented; open and two-way communication; appropriate decision-making procedures; cohesion; conflict tolerance; and shared power.

Question 12

The nurse is caring for a client who is having difficulty understanding the wound care dressing changes that need to be completed in the home after discharge.The client asks the nurse to demonstrate the procedure again and allow the client's spouse to perform the procedure while the nurse watches.Which is the most likely outcome of this assertive request by the client?
A) A slightly increased chance that the wound will become infected due to exposure during dressing changes.
B) Less compassionate care for the client due to the spouse's irritation by the request.
C) A greater likelihood that the wound will heal appropriately.
D) A guarantee that the spouse will change the dressings correctly.

Accepted Answer

A) The client used assertive communication to ensure that the dressing changes would be performed correctly, which will likely result in appropriate healing of the client's wound. No information is provided about the spouse's response to the request. There is no guarantee that the spouse will always perform the task correctly as humans make mistakes. Infection of a wound that is dressed correctly is not the likely result of the care.
B) The client used assertive communication to ensure that the dressing changes would be performed correctly, which will likely result in appropriate healing of the client's wound. No information is provided about the spouse's response to the request. There is no guarantee that the spouse will always perform the task correctly as humans make mistakes. Infection of a wound that is dressed correctly is not the likely result of the care.
C) The client used assertive communication to ensure that the dressing changes would be performed correctly, which will likely result in appropriate healing of the client's wound. No information is provided about the spouse's response to the request. There is no guarantee that the spouse will always perform the task correctly as humans make mistakes. Infection of a wound that is dressed correctly is not the likely result of the care.
D) The client used assertive communication to ensure that the dressing changes would be performed correctly, which will likely result in appropriate healing of the client's wound. No information is provided about the spouse's response to the request. There is no guarantee that the spouse will always perform the task correctly as humans make mistakes. Infection of a wound that is dressed correctly is not the likely result of the care.

Question 13

The nurse is developing objectives for a charter group of nurses from a national association.Which characteristics best describe the semiformal level of formality the nurse can expect when working with this type of group?
A) The structure is formal, with voluntary, selective membership and structured activities during meeting times.
B) The structure is formal, with structured activities, leadership selection from above, and easily recognized basic objectives.
C) The structure is informal, with voluntary, selective membership and negotiable day-to-day operating standards.
D) The structure is informal, with superimposed rules and managers who are symbols of authority.

Accepted Answer

A) There are three levels of group formality: formal, semiformal, and informal. Most groups move in and out of all three levels, but traditionally, a charter group of an association is a semiformal group with a formal structure, carefully delineated hierarchy, and selective, voluntary membership with attached prestige and status. Semiformal groups also have structured deliberate activities during meetings, objectives and goals that are not easily changed, negotiable day-to-day operating standards and methods, and a leader with direct control over the choice of a successor.
B) There are three levels of group formality: formal, semiformal, and informal. Most groups move in and out of all three levels, but traditionally, a charter group of an association is a semiformal group with a formal structure, carefully delineated hierarchy, and selective, voluntary membership with attached prestige and status. Semiformal groups also have structured deliberate activities during meetings, objectives and goals that are not easily changed, negotiable day-to-day operating standards and methods, and a leader with direct control over the choice of a successor.
C) There are three levels of group formality: formal, semiformal, and informal. Most groups move in and out of all three levels, but traditionally, a charter group of an association is a semiformal group with a formal structure, carefully delineated hierarchy, and selective, voluntary membership with attached prestige and status. Semiformal groups also have structured deliberate activities during meetings, objectives and goals that are not easily changed, negotiable day-to-day operating standards and methods, and a leader with direct control over the choice of a successor.
D) There are three levels of group formality: formal, semiformal, and informal. Most groups move in and out of all three levels, but traditionally, a charter group of an association is a semiformal group with a formal structure, carefully delineated hierarchy, and selective, voluntary membership with attached prestige and status. Semiformal groups also have structured deliberate activities during meetings, objectives and goals that are not easily changed, negotiable day-to-day operating standards and methods, and a leader with direct control over the choice of a successor.

Question 14

A nurse is providing care for a nonverbal client.The nurse wants to implement strategies that will promote communication with this client.Which interventions would be appropriate for the client in this situation? Select all that apply.
A) Facing the client when speaking
B) Having pen and paper on hand for the client
C) Making sure that the language spoken is the client's dominant language
D) Using a picture board to facilitate communication
E) Employing an interpreter

Accepted Answer

A) The client who is nonverbal would respond best to using a picture board during communication and allowing the communication through pen or paper. The client is nonverbal, so speaking en face, using an interpreter, or using the client's dominant language would not address the client's inability to communicate verbally.
B) The client who is nonverbal would respond best to using a picture board during communication and allowing the communication through pen or paper. The client is nonverbal, so speaking en face, using an interpreter, or using the client's dominant language would not address the client's inability to communicate verbally.
C) The client who is nonverbal would respond best to using a picture board during communication and allowing the communication through pen or paper. The client is nonverbal, so speaking en face, using an interpreter, or using the client's dominant language would not address the client's inability to communicate verbally.
D) The client who is nonverbal would respond best to using a picture board during communication and allowing the communication through pen or paper. The client is nonverbal, so speaking en face, using an interpreter, or using the client's dominant language would not address the client's inability to communicate verbally.
E) The client who is nonverbal would respond best to using a picture board during communication and allowing the communication through pen or paper. The client is nonverbal, so speaking en face, using an interpreter, or using the client's dominant language would not address the client's inability to communicate verbally.

Question 15

The nurse is caring for an older adult client in a long-term care facility.Which behavior by the nurse convey physical attending when communicating with this client?
A) Facilitating and taking action when needed
B) Maintaining a proper social distance when speaking with the client
C) Leaning toward the client during conversation
D) Being concrete about actions that need to be taken during client care

Accepted Answer

A) The nurse best conveys physical attending by leaning toward the client, which conveys involvement. Facilitating and taking action do not denote that the nurse is conveying physical attendance. Maintaining social distance does not convey physical attending. Being concrete is a method of communicating needed information to the client.
B) The nurse best conveys physical attending by leaning toward the client, which conveys involvement. Facilitating and taking action do not denote that the nurse is conveying physical attendance. Maintaining social distance does not convey physical attending. Being concrete is a method of communicating needed information to the client.
C) The nurse best conveys physical attending by leaning toward the client, which conveys involvement. Facilitating and taking action do not denote that the nurse is conveying physical attendance. Maintaining social distance does not convey physical attending. Being concrete is a method of communicating needed information to the client.
D) The nurse best conveys physical attending by leaning toward the client, which conveys involvement. Facilitating and taking action do not denote that the nurse is conveying physical attendance. Maintaining social distance does not convey physical attending. Being concrete is a method of communicating needed information to the client.

Question 16

The nurse is caring for a client with a new colostomy.The client has been taught care and has been successful with return demonstration to the staff.Although the client is able to perform care independently,and has asked to do so,the charge nurse has instructed the nursing staff to continue performing colostomy care for this client.When addressing this issue directly with the charge nurse,which statement by the nurse is the most appropriate?
A) "The client will change the apparatus whether you like it or not."
B) "The client has been trained to change the apparatus and has expressed interest to continue doing so."
C) "You have no right to continue delegating this task to nursing when the client has been trained to change the apparatus."
D) "I will report you to the nurse manager for not allowing the client to change the apparatus independently."

Accepted Answer

A) The nurse would make a clear, assertive statement saying that the client learned the procedure and wishes to execute it. Saying "You have no right..." is a challenge to the charge nurse and will only result in an escalation of the argument. Telling the charge nurse that the nurse manager will be notified is a threat and only inflames the situation. Insisting that the client will continue to change the apparatus will only result in the charge nurse taking further action to prevent the client from being able to care for the colostomy.
B) The nurse would make a clear, assertive statement saying that the client learned the procedure and wishes to execute it. Saying "You have no right..." is a challenge to the charge nurse and will only result in an escalation of the argument. Telling the charge nurse that the nurse manager will be notified is a threat and only inflames the situation. Insisting that the client will continue to change the apparatus will only result in the charge nurse taking further action to prevent the client from being able to care for the colostomy.
C) The nurse would make a clear, assertive statement saying that the client learned the procedure and wishes to execute it. Saying "You have no right..." is a challenge to the charge nurse and will only result in an escalation of the argument. Telling the charge nurse that the nurse manager will be notified is a threat and only inflames the situation. Insisting that the client will continue to change the apparatus will only result in the charge nurse taking further action to prevent the client from being able to care for the colostomy.
D) The nurse would make a clear, assertive statement saying that the client learned the procedure and wishes to execute it. Saying "You have no right..." is a challenge to the charge nurse and will only result in an escalation of the argument. Telling the charge nurse that the nurse manager will be notified is a threat and only inflames the situation. Insisting that the client will continue to change the apparatus will only result in the charge nurse taking further action to prevent the client from being able to care for the colostomy.

Question 17

The nurse is caring for a young adult client after a cervical biopsy.The client has expressed anxiety about the results.The healthcare provider peeks into the client's room and says,"The biopsy is negative." The nurse later finds the client sobbing.Which response by the nurse is appropriate?
A) "What did the healthcare provider tell you about the biopsy?"
B) "You seem upset. Do you want to talk to me about the test results?"
C) "Why are you crying with such good news?"
D) "The term 'negative' in this case is good!"

Accepted Answer

A) The nurse does not know specifically what the client is sobbing about and should ask the client an open-ended question so the client can talk. The physician, in delivering important news to the client, should have taken time to sit with her to discuss the results of the test. In telling the client that the test was negative, the physician did not clarify what "negative" actually meant. Using medical jargon without an explanation can lead to misinterpretation of the message by the client. Asking the client why she is crying over good news does not allow the client to express concern over the results. Asking the client what the physician told her assumes that she is crying because of what the physician said and does not allow her to express her concern in an open-ended manner. Saying that the test results are good in this case assumes that the client has misunderstood the results, which may be true but does not allow the client to express her concerns.
B) The nurse does not know specifically what the client is sobbing about and should ask the client an open-ended question so the client can talk. The physician, in delivering important news to the client, should have taken time to sit with her to discuss the results of the test. In telling the client that the test was negative, the physician did not clarify what "negative" actually meant. Using medical jargon without an explanation can lead to misinterpretation of the message by the client. Asking the client why she is crying over good news does not allow the client to express concern over the results. Asking the client what the physician told her assumes that she is crying because of what the physician said and does not allow her to express her concern in an open-ended manner. Saying that the test results are good in this case assumes that the client has misunderstood the results, which may be true but does not allow the client to express her concerns.
C) The nurse does not know specifically what the client is sobbing about and should ask the client an open-ended question so the client can talk. The physician, in delivering important news to the client, should have taken time to sit with her to discuss the results of the test. In telling the client that the test was negative, the physician did not clarify what "negative" actually meant. Using medical jargon without an explanation can lead to misinterpretation of the message by the client. Asking the client why she is crying over good news does not allow the client to express concern over the results. Asking the client what the physician told her assumes that she is crying because of what the physician said and does not allow her to express her concern in an open-ended manner. Saying that the test results are good in this case assumes that the client has misunderstood the results, which may be true but does not allow the client to express her concerns.
D) The nurse does not know specifically what the client is sobbing about and should ask the client an open-ended question so the client can talk. The physician, in delivering important news to the client, should have taken time to sit with her to discuss the results of the test. In telling the client that the test was negative, the physician did not clarify what "negative" actually meant. Using medical jargon without an explanation can lead to misinterpretation of the message by the client. Asking the client why she is crying over good news does not allow the client to express concern over the results. Asking the client what the physician told her assumes that she is crying because of what the physician said and does not allow her to express her concern in an open-ended manner. Saying that the test results are good in this case assumes that the client has misunderstood the results, which may be true but does not allow the client to express her concerns.

Question 18

The nurse is providing care for a client who is about to be discharged.The nurse is discussing the discharge orders with the client's primary healthcare provider.Which statement by the nurse is an appropriate example of using assertive communication?
A) "Can we talk about this client prior to discharge?"
B) "That new medication you prescribed for the client is ineffective."
C) "I am worried about the client's blood pressure. It remains high even with the new medication."
D) "Excuse me, Doctor, I think you need to do something about the client's blood pressure."

Accepted Answer

A) The nurse who expresses concern because the client's blood pressure remains high on new medication is being assertive, clear, and concise. Telling the physician that the new medication is ineffective is an inflammatory remark to the doctor. Asking if the physician can talk about a client does not give the physician enough information. Stating that the physician must do something about a client's blood pressure may produce defensiveness from the physician.
B) The nurse who expresses concern because the client's blood pressure remains high on new medication is being assertive, clear, and concise. Telling the physician that the new medication is ineffective is an inflammatory remark to the doctor. Asking if the physician can talk about a client does not give the physician enough information. Stating that the physician must do something about a client's blood pressure may produce defensiveness from the physician.
C) The nurse who expresses concern because the client's blood pressure remains high on new medication is being assertive, clear, and concise. Telling the physician that the new medication is ineffective is an inflammatory remark to the doctor. Asking if the physician can talk about a client does not give the physician enough information. Stating that the physician must do something about a client's blood pressure may produce defensiveness from the physician.
D) The nurse who expresses concern because the client's blood pressure remains high on new medication is being assertive, clear, and concise. Telling the physician that the new medication is ineffective is an inflammatory remark to the doctor. Asking if the physician can talk about a client does not give the physician enough information. Stating that the physician must do something about a client's blood pressure may produce defensiveness from the physician.

Question 19

A home health nurse is precepting a new nurse during a routine wound care visit.The new nurse is assessing the client's wound and notes that the wound is showing signs and symptoms of infection.The client's spouse asks the new nurse how the wound looks.The new nurse responds by stating,"It looks fine," but the new nurse's face indicates a different story.When evaluating the new nurse,the preceptor should note that work is needed on which aspect of communication?
A) Credibility
B) Adaptability
C) Timing and relevance
D) Clarity and brevity

Accepted Answer

A) Adaptability is adjusting tone of speech and facial expression to match the spoken message. Clearly, if the nurse's facial expression does not match the words, the client's family will identify a problem with the situation. Credibility means worthiness of belief, trustworthiness, and reliability. Timing and relevance affect how the message is taken or heard. Clarity and brevity are characteristics involving preciseness and use of few words.
B) Adaptability is adjusting tone of speech and facial expression to match the spoken message. Clearly, if the nurse's facial expression does not match the words, the client's family will identify a problem with the situation. Credibility means worthiness of belief, trustworthiness, and reliability. Timing and relevance affect how the message is taken or heard. Clarity and brevity are characteristics involving preciseness and use of few words.
C) Adaptability is adjusting tone of speech and facial expression to match the spoken message. Clearly, if the nurse's facial expression does not match the words, the client's family will identify a problem with the situation. Credibility means worthiness of belief, trustworthiness, and reliability. Timing and relevance affect how the message is taken or heard. Clarity and brevity are characteristics involving preciseness and use of few words.
D) Adaptability is adjusting tone of speech and facial expression to match the spoken message. Clearly, if the nurse's facial expression does not match the words, the client's family will identify a problem with the situation. Credibility means worthiness of belief, trustworthiness, and reliability. Timing and relevance affect how the message is taken or heard. Clarity and brevity are characteristics involving preciseness and use of few words.

Question 20

The nurse case manager spends the morning in a peer meeting and the afternoon in an ad hoc quality management committee meeting that is led by the hospital administrator.Which two types of groups has the nurse case manager participated in?
A) Disaster group and emergency group
B) Work group and administrative group
C) Primary and secondary groups
D) Support group and governance group

Accepted Answer

A) Primary work groups are typically informal work groups that communicate regularly in face-to-face interactions. Secondary groups are larger, more impersonal, and goal-oriented. All of the other options-disaster, emergency, work, administrative, support, governance - are functions of groups.
B) Primary work groups are typically informal work groups that communicate regularly in face-to-face interactions. Secondary groups are larger, more impersonal, and goal-oriented. All of the other options-disaster, emergency, work, administrative, support, governance - are functions of groups.
C) Primary work groups are typically informal work groups that communicate regularly in face-to-face interactions. Secondary groups are larger, more impersonal, and goal-oriented. All of the other options-disaster, emergency, work, administrative, support, governance - are functions of groups.
D) Primary work groups are typically informal work groups that communicate regularly in face-to-face interactions. Secondary groups are larger, more impersonal, and goal-oriented. All of the other options-disaster, emergency, work, administrative, support, governance - are functions of groups.

Quiz 38: Communication

A nurse educator is teaching a group of students about therapeutic touch.In which situation is it appropriate to use therapeutic touch as a means of communication?

The nurse is providing care to a visually impaired client who is scheduled for a colonoscopy.The client requires a bowel prep prior to the diagnostic test.Which approach will the nurse use to facilitate the client's understanding of the material?

A female nurse is caring for a 21-year-old male client with a questionable gastrointestinal blockage.The healthcare provider prescribes an enema.Which reaction by the client does the nurse anticipate when planning care?

The nurse is starting preoperative teaching when the client receives a phone call.When the nurse resumes teaching,the client is visibly upset and begins to cry.Which therapeutic initial response by the nurse is appropriate?

The nurse is sitting in on an Alcoholic Anonymous (AA) meeting clients on a behavioral health unit.Which decision-making methods used by the group indicates the group is functioning effectively? Select all that apply.

A young adolescent client is in the hospital preparing for major surgery for the removal of a tumor on the kidney.The client's mother tells the nurse that she doesn't want the child to receive narcotics for pain postoperatively.Which is the best response by the nurse?

The nurse is caring for a client with cancer who is struggling with chronic pain.The nurse tells the client,"It is normal to feel frustrated about the discomfort." Which skill associated with the working phase of the nurse-client relationship does the nurse's statement best reflect?

Whether in the classroom or clinical setting,the way a group functions,communicates,sets goals,and achieves objectives is related to which concept?

A novice nurse is working with a client who is admitted to a medical-surgical unit.The nurse is establishing a therapeutic relationship with the client by conveying empathy.Which statement by the nurse best exemplifies empathy?

The nurse is providing teaching for an inpatient lupus support group meeting.Which group behaviors indicate the teaching was effective?

The nurse is developing objectives for a charter group of nurses from a national association.Which characteristics best describe the semiformal level of formality the nurse can expect when working with this type of group?

A nurse is providing care for a nonverbal client.The nurse wants to implement strategies that will promote communication with this client.Which interventions would be appropriate for the client in this situation? Select all that apply.

The nurse is caring for an older adult client in a long-term care facility.Which behavior by the nurse convey physical attending when communicating with this client?

The nurse is caring for a young adult client after a cervical biopsy.The client has expressed anxiety about the results.The healthcare provider peeks into the client's room and says,"The biopsy is negative." The nurse later finds the client sobbing.Which response by the nurse is appropriate?

The nurse is providing care for a client who is about to be discharged.The nurse is discussing the discharge orders with the client's primary healthcare provider.Which statement by the nurse is an appropriate example of using assertive communication?

The nurse case manager spends the morning in a peer meeting and the afternoon in an ad hoc quality management committee meeting that is led by the hospital administrator.Which two types of groups has the nurse case manager participated in?