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A comprehensive guide to effective communication in nursing practice. It covers various aspects of communication, including understanding patient comprehension, recognizing verbal and non-verbal cues, using appropriate language, and fostering therapeutic nurse-patient relationships. The document also addresses the importance of patient education, delegation of tasks, and communication within the healthcare team. By studying this document, nursing students and professionals can enhance their communication skills, improve patient outcomes, and promote effective teamwork in the healthcare setting.
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The nurse can best ensure that communication is understood by: - correct answer โ โ obtaining feedback from the patient that indicates accurate comprehension The nurse recognizes a verbal response when the patient:
- correct answer โ โ writes the answer to a question asked by the nurse The nurse recognizes the patient who demonstrates communication congruency when the patient: - correct answer โ โ is tearful and slow in speech when talking about her husband's death. A Hispanic patient approaches the Asian nurse and, standing very close, touches the nurse's shoulder during their conversation. The nurse begins to step back to 18 to 24 inches, while smiling and nodding to the patient. This situation is most likely an example of: - correct answer โ โ a difference in culturally learned personal space of the nurse and the patient. A nurse says to a patient, "I am going to take your TPR, and then I'll check to see whether you can have a PRN analgesic." In considering factors that affect
communication, the nurse has: - correct answer โ โ used medical jargon, which might not be understood by the patient. A nurse using active listening techniques would: - correct answer โ โ use nonverbal cues such as leaning forward, focusing on the speaker's face, and slightly nodding to indicate that the message has been heard. When the patient says, "I don't want to go home," the nurse's best therapeutic verbal response would be: - correct answer โ โ . "You don't want to go home?" To begin talking with a newly admitted patient about pain management, the nurse would most appropriately state: - correct answer โ โ "Tell me about the pain you've been having." When a patient begins crying during a conversation with the nurse about the patient's upcoming surgery for possible malignancy, the nurse's most therapeutic response would be: - correct answer โ โ "Here is a tissue. I'd like to sit here for a while if you want to talk."
. To enhance the establishment of rapport with a patient, the nurse should: - correct answer โ โ act in a trustworthy and reliable manner; respect the individuality of the patient. The nurse explains that the therapeutic nurse-patient relationship differs from the social relationship because: - correct answer โ โ the nurse-patient relationship ends when the patient is discharged The nurse has selected an outcome for the patient to eat all of the food on the breakfast tray each day. Assessing that the patient has eaten all of the breakfast, the nurse would give positive feedback by saying: - correct answer โ โ . "Hurray! You finished your whole meal! What would you like for tomorrow?" A 67-year-old woman had major abdominal surgery yesterday. She has IV lines, a urinary catheter, and an abdominal wound dressing, and she is receiving PRN pain medication. The end of shift report that best conveys the patient status is: - correct answer โ โ "Abdominal dressing dry, IVsโ800 mL left in #6; NS running at 125 mL/hr; urine output 800 mL this shift; had morphine 15
mg for pain at 8:00 AM and at 1:30 PM. She's comfortable now. Vital signs are stable, no fever."
. An aspect of computer use in patient care in which the LPN may need to be proficient includes: - correct answer โ โ input of data such as requests for radiographs or laboratory services . A patient with a nursing diagnosis of Sensory perception, disturbed auditory, would most appropriately require the nurse to: - correct answer โ โ speak slowly and distinctly, but not shout. When an office nurse asks the patient to repeat information that he has just given to the patient over the telephone, the nurse is: - correct answer โ โ verifying that the patient understands the information A 36-year-old woman who is in traction for a fractured femur that she received in an auto accident is found crying quietly. The nurse can best address this situation by saying: - correct answer โ โ "You are upset. Can you tell me what's wrong?"
When the nurse is giving direction to a nursing assistant who is being delegated part of the patient care, the nurse's most effective direction would be: - correct answer โ โ "Give the patient in 204A a shower after breakfast, and call me to check her feet before you get her dressed." When the patient says, "I get so anxious just lying here in this hospital bed. I have a million things I should be doing at home," the most empathetic response would be: - correct answer โ โ "It sounds like you're having a tough time dealing with this situation." A patient asks the nurse, "What would you do if you had cancer and had to choose between surgery and chemotherapy?" The reply that can best help the patient is: - correct answer โ โ "What solutions have you considered?" The nurse chooses to use touch in the nurse-patient relationship because touch: - correct answer โ โ can convey caring and support when words are difficult.
When the nurse makes the statement, "We can come back to that laterโright now I need to know about when your symptoms started," the nurse is: - correct answer โ โ refocusing the patient to the issue at hand when the conversation has wandered. A patient who has had a stroke is unable to speak clearly and has right sided hemiplegia. The nurse will design the approach to the assessment interview by: - correct answer โ โ speaking slowly and giving the patient time to respond. When a nurse is conducting an assessment interview, the most efficient technique would be: - correct answer โ โ asking closed questions to obtain essential information. While interviewing a Native American man for the admission history, the nurse should expect to: - correct answer โ โ wait patiently through long pauses in the conversation The nurse is aware that the purpose of therapeutic communication is to: - correct answer โ โ focus on the patient and the patient needs to facilitate interaction
The practical nursing student who is engaged in a therapeutic communication with a patient will have the most difficulty with the technique of: - correct answer โ โ silence. To convey the intervention of active listening, the nurse would: - correct answer โ โ make a conscious effort to block out other sounds in the immediate environment. When the nurse enters the room, the patient is laughing out loud at something on TV. The patient stops and apologizes for the laughter, saying, "I guess I ought not be laughing at all since I am stuck here with two broken legs." The nurse can use evidence-based information when she responds: - correct answer โ โ "Laughter truly is the best medicine as it has a positive effect on the immune system." When interacting with an older adult patient, the nurse would enhance communication by: - correct answer โ โ speaking slowly in order to allow the patient to process the message.
When the nurse observes a resident in a long-term facility pounding his fists on his legs and grinding his teeth, the nurse will validate her perception of the patient's nonverbal expression of anger by: - correct answer โ โ sitting down near the patient and saying, "You seem upset...can I help?" When a patient states, "I don't feel like walking today," the nurse's most therapeutic verbal response would be: - correct answer โ โ "You don't want to walk today?" When a patient states, "My son hasn't been to see me in months," the nurse's best verbal response is: - correct answer โ โ "Your son hasn't been around much lately?" An example of a nurse communicating with a patient using open-ended questions would be: - correct answer โ โ "What was your daughter's reaction to your desire for hospice?" The nurse tells a patient, "For the last 2 days we have talked about whether to notify your daughter of your upcoming surgery in 2 days. You have indicated you do not want to be a burden to her, but you also would like to
have her here. You may have to decide rather quickly because of the time constraint." The nurse is using the technique of: - correct answer โ โ summarizing.
. The nurse is caring for a patient who states, "I tossed and turned last night." The nurse responds to the patient, "You feel like you were awake all night?" This is an example of: - correct answer โ โ restatement . The nurse is caring for a patient who has just had a mastectomy (breast removal). The patient expresses concern that her husband will no longer find her attractive because of her mastectomy. The nurse appropriately responds: - correct answer โ โ . "You're concerned your husband will find you unattractive because of your mastectomy?" A patient states, "I'm so worried that I might have cancer." The nurse responds, "It is time for you to eat breakfast." The nurse's response is an example of: - correct answer โ โ changing the subject. The nurse is aware that the use of false reassurance is harmful to the nurse-patient relationship, because this
communication block: - correct answer โ โ discounts the patient's stated concerns. A home health patient with a bleeding ulcer informs the nurse that she ate a bowl of chili with jalapenos. An inappropriate communication block with a judgmental tone by the nurse would be: - correct answer โ โ "I don't think that was a smart thing for you to do considering your ulcer." A patient tells the nurse that she dislikes the food that is served in the hospital. The nurse responds, "Our cooks work very hard; the food that is served is very good." The nurse's response is an example of the communication block of: - correct answer โ โ defensive response. A nurse caring for a patient who fell off the roof while he was intoxicated asks the patient, "Why in the world were you on the roof when you had been drinking?" The nurse's statement is an example of which type of communication? - correct answer โ โ Asking probing questions
The nurse caring for a patient who is concerned about her 10-pound weight loss relative to her chemotherapy tells the patient, "Lucky you! Every cloud has a silver lining." The nurse's statement is an example of which type of communication block? - correct answer โ โ Using clichรฉs The nurse is caring for a patient with a diagnosis of lung cancer. The nurse states, "If I were you, I would have radiation therapy." The nurse's statement is an example of which type of communication block? - correct answer โ โ Giving advice The nurse is caring for a patient who is concerned about living alone. The best response by the nurse is: - correct answer โ โ "Where have you considered living?" The characteristic that is representative of the nurse- patient relationship is that this relationship: - correct answer โ โ focuses on the assessed patient health problems. When communicating with an aphasic patient, the nurse appropriately: - correct answer โ โ assumes the patient can understand what is heard.
When communicating with a hearing impaired patient, the nurse appropriately: - correct answer โ โ uses short, simple sentences. When communicating with a preschooler, the nurse should: - correct answer โ โ consider the developmental level, using familiar words. When communicating with an adolescent, the nurse should be very sensitive to avoid: - correct answer โ โ interrupting frequently. The primary care provider informs the student nurse that he would like to give a telephone order. The best response by the student is: - correct answer โ โ ask the registered nurse to take the telephone order. A nurse is delegating to a nursing assistant. The most appropriate form of this type of communication would be:
- correct answer โ โ . "If Mr. Jones' heart rate is greater than 100, let me know."
In order to safeguard patient information when using a computer, the nurse should: - correct answer โ โ change the computer password frequently.
. The nurse is alert to avoid using blocks to effective communication that include: (Select all that apply.) - correct answer โ โ a. changing the subject. c. giving advice. d. asking probing questions f. using clichรฉs . During the initial interview of a patient, the nurse should: (Select all that apply.) - correct answer โ โ a. assess the language capabilities of the patient. c. limit the interview to approximately 30 minutes. d. assess comprehension abilities of the patient. e. make the patient as comfortable as possible. When using the telephone to communicate with a primary care provider about a patient, the student nurse should have ready: (Select all that apply.) - correct answer โ โ a. current information relative to patient's condition change. b. assessment of vital signs.
c. information on urinary output. e. medications received. The nurse will appropriately and deliberately use the closed question technique when the patient is: (Select all that apply.) - correct answer โ โ a. being asked for specific information. b. extremely anxious and unfocused. d. confused. Behaviors that indicate to the patient that the nurse is inattentive to the patient's concerns are such activities as: (Select all that apply.) - correct answer โ โ a. turning back to straighten the bedside table while the patient is talking. b. tapping feet or fingers. c. sitting down in a chair near the bed with arms crossed. d. leaving a hand on the door to go out
To elicit more information from a patient, the nurse should ask questions that require more than a one-word answer. This type of question is called _______. - correct answer โ โ open ended The communication technique of __________ gives the caregiver the opportunity to ask and respond to questions. - correct answer โ โ ISBAR R
. Before beginning to teach a patient to give himself insulin, the nurse asks, "Have you ever known anyone who gave himself insulin injections?" This question is primarily designed to: - correct answer โ โ assess the patient's learning needs The nurse uses a syringe and vial of insulin to show how to draw up the correct dose while she explains the procedure to the patient. To best promote learning, her next step should be to: - correct answer โ โ have the patient practice the procedure with the nurse helping . Patient education for an 82-year-old patient to perform a dressing change to be done at home after discharge, the
nurse would adjust the teaching session to: - correct answer โ โ slow the pace and frequently ask questions to assess comprehension An 80-year-old patient is to be taught the process of colostomy irrigation and reattachment of the colostomy bag. The nurse's initial assessment prior to instruction should address the patient's: - correct answer โ โ motivation to learn. The nurse can assess her patient's ability to read and comprehend written instructions by doing which of the following? - correct answer โ โ Giving the patient a printed instruction sheet and saying, "Some people have difficulty with written instructions. Others find them helpful. Would these be helpful to you?" A patient being assessed for preoperative learning needs says his mother had the same surgery by the same surgeon 3 years ago. The nurse should design the patient education plan to: - correct answer โ โ explore with the patient what he knows about the proposed surgery and add or correct where necessary.
The nurse is aware that the knowledge deficit of a postpartum patient with her first child that can be safely addressed by the community nurse after discharge is: - correct answer โ โ weaning the child from breastfeeding The nurse evaluates the effectiveness of patient education relative to how to use an eye shield after eye surgery is to: - correct answer โ โ have the patient demonstrate that he can secure the eye shield The nurse will choose the best time to continue postoperative education regarding wound care and dressings, which would be: - correct answer โ โ when the patient is comfortable and receptive to the patient education. A nurse plans to teach a 4-year-old about what to expect after his broken arm has been casted by: - correct answer โ โ breaking up the patient education sessions into two separate 5-minute sessions. The best way for a nurse to reinforce learning during a return demonstration by the patient is for the nurse to: - correct answer โ โ . give recognition and praise for the
parts the patient does well and to assist or teach when the patient becomes confused or forgetful A patient states, "I don't think I'll ever be able to give myself an injection." The best reply by the nurse is: - correct answer โ โ "What bothers you most about the idea of giving yourself an injection?" The nurse takes into consideration that when using printed patient education material for a 65-year-old Middle Eastern patient who speaks perfect English, the nurse should: - correct answer โ โ . determine if the patient can read English. Because a person may learn best in a particular manner, to improve patient education, the nurse should: - correct answer โ โ use a combination of the three modes of learning to enhance learning. Once a patient education plan is formulated and placed in the nursing care plan for a hospitalized patient: - correct answer โ โ behavioral objectives are used to identify expected outcomes
In a skilled nursing home, a newly admitted resident becomes terminally ill following a cerebrovascular accident (CVA). To diminish the family's anxiety, the nurse teaches the family members about activities that are being performed to provide care and comfort to their loved one. This patient education is provided in order to: - correct answer โ โ increase the family's comfort in their affective domain The nurse designing a patient education plan for a patient admitted to the hospital for treatment of a heart problem after years of treating the ailment at home with herbal remedies and practices common in his cultural group should: - correct answer โ โ help the patient to identify optimum outcomes that can be achieved through education and compromise The nurse recognizes the American Indian's need for the intervention of a shaman in dealing with illness because the shaman helps the patient in seeking - correct answer โ โ a spiritual route to healing. The nurse appropriately begins discharge planning when:
- correct answer โ โ the patient is admitted to the health care facility.
. A nurse is showing a diabetic patient how to draw insulin out of a syringe. The mode of learning that the nurse is using is: - correct answer โ โ visual learning. The nurse will plan to offer the patient education session in a quiet area in order to: - correct answer โ โ reduce distractions When a nurse is "talking through" a procedure or assisting the patient to learn, the nurse encourages the patient to: - correct answer โ โ A nurse who is communicating with a school age child about receiving anesthesia for surgery later this afternoon would best describe the process by saying: When educating an older adult patient about changing his dressing, the nurse would most appropriately: - correct answer โ โ be certain the patient is wearing his glasses and/or hearing aid The nurse would identify an opportunity for a "teachable moment" in the situation of a patient who: - correct
answer โ โ says, "How will I remember all the things about my new diet?" Continuous learning needs for the patient upon discharge should be communicated to the: (Select all that apply.) - correct answer โ โ a. visiting nurse. b. family. c. primary care provider The nurse reminds the patient that health instruction supports the goals of Healthy People 2020, which include: (Select all that apply.) - correct answer โ โ a. promoting healthy behavior d. ensuring access to adequate health care. e. strengthening community relationships.
. The nurse is aware that the major modes of learning are: (Select all that apply.) - correct answer โ โ c. auditory. d. kinesthetic f. visual.
The LPN/LVN is qualified to provide patient education on information relative to: (Select all that apply.) - correct answer โ โ a. disease process. b. postoperative care. d. rehabilitation e. disaster preparedness Leadership is best defined as a process that - correct answer โ โ . guides staff to use resources to meet patient needs The best description of an autocratic leader is a leader who: - correct answer โ โ . tightly controls team members A laissez faire leader would be most likely to: - correct answer โ โ . allow team members to function independently A team leader with effective communication skills would - correct answer โ โ give specific information in a tactful, friendly manner
The most effective communication from a nurse leader to a team member that is most likely to have a positive outcome would be: - correct answer โ โ "Jane, please give me a list of those vital signs before breakfast." Prior to addressing a situation, the nurse is aware that an effective leader must - correct answer โ โ . define the problem The nurse is aware that the best way to evaluate an unlicensed assistive personnel's (UAP's) ability to perform a skill or task is to: - correct answer โ โ observe the nursing assistant performing the skill or task The nurse's most appropriate selection of a task to be delegated to an unlicensed assistive personnel (UAP) would be: - correct answer โ โ toileting a patient on a bladder training regimen. The nurse is aware that when a task is delegated to an unlicensed assistive personnel (UAP), the nurse is: - correct answer โ โ responsible for overall patient care
The nurse recognizes that one of the responsibilities of a charge nurse as opposed to the team leader is that the charge nurse is responsible for: - correct answer โ โ making rounds and assessing all patients on the unit A nurse has received a new medication order for a patient on the CPOE. Which of the following is the most appropriate response by the nurse? - correct answer โ โ Acknowledge the order that has been entered by the primary care provider and has been verified by the pharmacist. The nurse in a long-term care facility is aware that the accuracy and comprehensiveness of the Minimum Data Set (MDS) facilitate the: - correct answer โ โ reimbursement to the facility from Medicare and Medicaid payments A nurse can best minimize the liability of a lawsuit against the facility by: - correct answer โ โ demonstrating concern and attending to patient complaints. Nursing documentation that would best assist with reimbursement to a facility would be: - correct answer
โ โ patient was assisted to a recliner chair to use the oxygen concentrator The behavior least likely seen in an autocratic leader would be a person who: - correct answer โ โ often consults staff when making decisions
. The nurse recognizes that the use of the democratic approach in leadership will: - correct answer โ โ take more time to accomplish goals. An inappropriate delegation to an unlicensed assistive personnel (UAP) would be - correct answer โ โ . assessing a patient's pain. The nurse is aware that assignment of an unlicensed assistive personnel (UAP) differs from delegation in that in delegation: - correct answer โ โ the nurse has transferred the authority to perform the task. The nurse is initially guided in the process of delegation to an unlicensed assistive personnel (UAP) by the: - correct answer โ โ . state's nurse practice act.