Effective Communication Strategies in Nursing, Exams of Nursing

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Nursing Exam Week 6 Fundamentals Practice Questions

1. A family has lost a member who was treated for leukemia at a nursing unit. The nurse provides emotional support to the family and counsels them to cope with their loss. Which quality should the nurse use in this situation? a. pity b. empathy c. sympathy d. indifference: b. empathy 2. A nurse finds that a client has infiltration around the IV line that needs to be removed. What explanation should the nurse give to reduce the client's anxiety? a. "You should relax and take deep breaths; the procedure is very minimal and will be over soon." b. "The infiltration is causing you pain and you will be relieved when I remove the IV line." c. "It will be a painless procedure and there is nothing to worry about; many clients experience this." d. "I know that you are anxious, but removal will be painless and the IV location needs to be changed.": d. "I know that you are anxious, but removal will be painless and the IV location needs to be changed." 3. The nurse has arranged to start an IV line for a client with pancreatitis. The nurse notes that the client appears anxious about the procedure. What is the most appropriate response by the nurse to decrease the client's anxiety? a. "I will start an IV, which should not cause you too much pain." b. "I will start an IV that will add fluids directly to the blood stream." c. "I will start an IV, which should not take much time." d. "I will start an IV with the number 18 catheters.": b. "I will start an IV that will add fluids directly to the blood stream." 4. A female client reports to her primary care physician with aggravated chest pain. The physician orders a stress test. The client tells the nurse that she does not want to take the test and feels she should instead continue with the medication a little longer. Understanding that the client is anxious, what is the most appropriate response by the nurse?

a. "Don't you want to improve your health?" b. "Most people tolerate the procedure quite well." c. "Emergency equipment is always kept ready." d. "Tell me more about how you are feeling.": d. "Tell me more about how you are feeling."

5. A client is scheduled for thoracentesis. The nurse assesses that the client appears anxious about the procedure and needs honest support and reassur- ance. What is the most appropriate response by the nurse to this client? a. "The needle causes pain when it goes in, but I will be by your side through- out and will help you hold your position" b. "You might feel a little bit uncomfortable when the needle goes in, but you should breathe rhythmically; I will be here to coach you." c. "The procedure may take only 2 to 3 minutes, so you might get through it by mentally counting up to 120." d. "I will be by your side throughout the procedure; the procedure will be painless if you don't move.": a. "The needle causes pain when it goes in, but I will be by your side throughout and will help you hold your position" 6. A nurse pays a house visit to a client who is on parenteral nutrition (PN). The client expresses that he misses enjoying food with his family. What is the most appropriate response by the nurse? a. "You can sit with your family at meal times, even though you don't eat." b. "I know that you must be missing your favorite foods." c. "Tell me more about how it feels to eat with your family." d. "In a few weeks you may be allowed to eat a little; you may enjoy then.": c. "Tell me more about how it feels to eat with your family." 7. A nurse visits a female victim of sexual assault for the fourth visit. The client expresses that she is unable to cope with the trauma. Even though the assault occurred quite some time ago, she feels as if it just happened yesterday. What is the most appropriate response by the nurse? a. "We should move on from the strong feelings associated with this incident." b. "In reality, the rape did not occur yesterday; it has been over one month now." c. "Can you do something to alleviate the fear of being assaulted again?" d. "Tell me more about the aspects that make you feel as if it happened

a. "No; we can assure you that you will not have a heart attack." b. "Yes, you had a heart attack, but the damage is very minimal." c. "The physician wants to monitor you and control your pain." d. "Yes, you had a heart attack; this is why you are here with us.": c. "The physician wants to monitor you and control your pain."

9. A nurse is caring for a client with depression. The nurse finds that the client is withdrawn and does not communicate with others. What is the most appropriate response by the nurse? a. "Did you sleep well last night?" b. "Do you feel like talking today?" c. Is that a new shirt you're wearing?" d. "Did you like the dinner yesterday?": c. "Is that a new shirt you're wearing?" 10. A nurse is caring for an older adult client. What strategy should the nurse include in order to facilitate effective communication? a. React only to the facts during conversation. b. Use an authoritarian approach toward the client. c. React enthusiastically during conversation. d. Use active listening during communication: d. Use active listening during communication 11. A nurse is caring for a client with myasthenia gravis. The client is having difficulty forming words and his tone is nasal. Which communication strategy is an effective one for this client? a. Engage the client in a lengthy discussion to strengthen his voice. b. Nod continuously when the client is talking. c. Encourage the client to speak quickly while talking. d. Repeat what the client has said to verify the meaning: d. Repeat what the client has said to verify the meaning 12. A nurse is caring for a terminally ill client whose death is imminent. The nurse has developed a close relationship with the family. Which intervention is most appropriate? a. Remain with the family but maintain silence. b. Encourage family discussions of feelings. c. Tell the family to leave the client alone.

d. Make decisions for the family in difficult situations.: b. Encourage family discussions of feelings

13. A nurse is asking a client health-related questions during a medical as- sessment. The client has developed lesions on the skin and warts around the mouth. Which factor affects oral communication? a. cultural differences b. client's lifestyle c. nursing skills d. attention and concentration: d. attention and concentration 14. A nurse and an older adult client with chronic back pain are in the working phase of the nurse-client relationship. Which activity occurs in the working phase? a. The nurse is courteous and actively listens to the client. b. The client identifies one or more health problems. c. The nurse tries to avoid hampering the client's independence. d. The nurse ensures that the client manages independently.: c. The nurse tries to avoid hampering the client's independence 15. A nurse is examining a 3-year-old child with conjunctivitis. During the examination, the child starts crying and refuses to sit still. Which statement is appropriate for the nurse to tell the child? a. "Would you like to see my flashlight?" b. "I know you are upset; we can do this later." c. "Don't be scared, the light will not hurt you." d. "If you sit still, this will be over in no time.": a. "Would you like to see my flashlight?" 16. A nurse is working with a client who is in postoperative day 2 following a total knee replacement. The client has briefly mobilized using a wheeled walker and with the assistance of the physical therapist. However, the client is reluctant to progress further with mobilization for fear of injuring herself. In response to this, the nurse has liaised with the physical therapist to create a plan of care that creates specific goals for the client's mobility. In doing so, this nurse has exemplified what role? a. nurse as collaborator b. nurse as caregiver

bad.": b. "You're worried about how you will tolerate the pain associated with labor."

20. A nurse needs to complete and assessment and vital signs on a client who has Alzheimer's disease. How should the nurse approach this client to gain cooperation? (Select all that apply.)

• Approach the client from the front
• Focus on the nursing task
• Smile and maintain eye contact
• Speak Loudly and clearly
• Use the client's name: - Approach the client from the front
• Smile and maintain eye contact
• Use the client's name 21. A nurse is completing a health history on a client who has a hearing impairment. Which actions can the nurse take to enhance communication? (Select all that apply.)
• using facial and hand gestures
• contacting a person skilled in American Sign Language
• providing paper and pencil for written communication
• assessing how the client would like to communicate
• speaking loudly and with exaggerated facial movements: - providing paper and pencil for written communication
• assessing how the client would like to communicate 22. A nurse is interviewing an American Indian client who has come to the clinic for a follow-up visit. The nurse notices the client does not make eye contact and speaks while looking down. How should the nurse respond? a. Sit silently until the client looks up and makes eye contact. b. Assume a position at eye level with the client and continue with the inter- view. c. Stop the interview and ask, "How are you feeling?" d. Touch the client's hand and say, "You seem upset, is there something bothering you?": b. Assume the position at eye level with the client and continue with the interview 23. A nurse is caring for an older adult client hospitalized following a hip fracture. Which actions made by the nurse will promote the development of a therapeutic relationship? (Select all that apply.)
• Assisting the client with the completion of all activities of daily living

• encouraging the client to talk about the client's life
• asking the client when the client would like to have the bed linens change
• calling the client by their first name: - encouraging the client to talk about the client's life
• asking the client when the client would like to have the bed linens change 24. A nurse is working on a medical-surgical unit with an experienced licensed practical/vocational nurse (LPN/LVN). Which tasks are appropriate to delegate to the LPN/LVN? (Select all that apply.)
• insert a nasogastric tube in a client with absent bowel sounds
• change an intravenous catheter for a client with an infiltrated IV
• reinforce a post-surgical abdominal dressing
• administer oral aspirin and lisinopril to the client hypertension
• teach a client with diabetes how to administer insulin: - insert a nasogastric tube in a client with absent bowel sounds
• reinforce a post surgical abdominal dressing
• administer oral aspirin to the client with hypertension 25. A nurse working with an experienced licensed practical/vocational nurse (LPN/LVN) delegates the task of administering oral medications to a team of clients. The nurse observes the LPN/LVN document a client's medication administration before entering the client's room. What is the most appropriate action of the nurse? a. Stop the LPN/LVN immediately and discuss the possible consequences of this action. b. Continue to supervise the LPN/LVN as medications are being administered. c. Contact the nurse manager to discuss the actions of the LPN/LVN. d. Check all client's medication records to make sure the appropriate drugs were given.: a. Stop the LPN/LVN immediately and discuss the possible conse- quences of this action 26. A nurse is caring for an older adult client who has just died in a hospice unit. The child of the client arrives and asks, "Can I please stay and sit at the bedside? I really wanted to be here so they did not die alone." Which statement made by the nurse best demonstrates the use of empathy? a."You are too late for that, but you can stay for a while if you would like." b. "I tried to contact you earlier, but you did not answer your phone."

c. "I will close the door so you can spend some quiet time at the bedside."

c. to investigate the quality of care in the agency d. to transmit health records between insurance companies: c. to investigate the quality of care in the agency

31. A nurse at a health care facility has just reported for duty. Which of the fol- lowing should the nurse do to ensure maximum efficiency of change-of- shift reports? a. Pay courtesy calls to staff members before attending the meeting. b. Come prepared with material required to take notes. Avoid asking questions related to the medical record. Wait for the physicians to arrive before exchanging notes.: b. Come prepared with material required to take notes 32. When maintaining medical records for a client, the nurse knows that a medical record also serves as a legal document of evidence. What should the nurse do to ensure legal defensible charting? a. Record all facts and subjective interpretations. b. Leave spaces between entries and signature. c. Ensure that the client's name appears on all pages. d. Use abbreviations wherever possible.: c. Ensure that the client's name appears on all pages 33. When documenting information in a client's medical record, what should the nurse do consistently for each entry? a. sign each entry by name and title b. provide the day of the week on the entry c. obtain a signature from the physician d. report each observation to the physician: a. sign each entry by name and title 34. A nurse is manually documenting information related to a client's condi- tion. When documenting this information, the nurse makes an error on the manual record sheet. What is the best technique for recording the error made in documentation? a. Cross out the wrong statement in a way that is not readable b. Erase the incorrect statement and write the correct one c. Cross out the incorrect statement with a single line and place nure's initial above it d. Use correction fluid to obliterate what has been written: c. Cross out the incorrect statement with a single line and place nurse's initials above it 35. A nurse caring for a client who is being treated by three physicians uses

a. It is a unified, cooperative approach for resolving the client's problems. b. It is compiled to facilitate communication among health care professionals. c. It is organized at one location according to the client's health problems d. Information is documented in separate forms by each health care person- nel: d. Information is documented in separate forms by each health care personnel

36. A nurse is maintaining a problem-oriented medical record for a client. Which component of the record describes the client's responses to what has been done and revisions to the initial plan? a. plan of care b. progress notes c. problem list d. data base: b. progress notes 37. A nurse charting the medical record for a client knows that which form of charting involves writing information about the client and client care in chronological order? a. SOAP charting b. FOCUS charting c. PIE charting d. Narrative charting: d. Narrative charting 38. Nurses at a health care facility maintain client records using a method of documentation known as charting by exception (CBE). What is a benefit of this method of documentation? a. It documents assessments on separate forms. b. It provides and refers to a client's problem by a number c. It records progress under problems, interventions, and evaluations d. It provides quick access to abnormal findings: d. It provides quick access to abnormal findings 39. When recording data regarding the client's health record, the nurse men- tions the analysis of the subjective and objective data, in addition to detailing the plan for care of the client. Which of the following styles of documentation is the nurse implementing? a. FOCUS charting

b. SOAP charting

a. list the specific reasons that the client was upset. b. avoid mentioning cognitive or psychosocial issues. c. specify the subsequent interventions that were performed. d. include clearer descriptions of the client's mood and behavior: d. include clearer descriptions of the client's mood and behavior.

44. A client who is bedridden is scheduled to receive subcutaneous injections of heparin at 8:00 a.m. and 8:00 p.m. each day. The client's medication admin- istration record would present these times as: a. 0800 and 1800 b. 0800 and 2200 c. 0800 and 2200 d. 0800 and 2000: d. 0800 and 2000 45. An elderly female client has been admitted to the hospital with a suspected bowel obstruction. The nurse is reviewing the admitting physician's orders and reads the order "NPO". Based on this order, what action should the nurse take? a. Ensure that the client does not eat or drink anything b. Ensure that the client's record is made available to her insurer c. Apply oxygen by nasal prongs if necessary d. Insert a nasogastric or oropharyngeal tube if necessary: a. Ensure that the client does not eat or drink anything 46. While covering a colleague's lunch break, a nurse on an orthopedic unit has responded to a client's call light. The client has requested assistance in transferring from the bed to the bathroom. The nurse has not previously provided care for this client and is unsure of the client's current activity orders. The client's current level of activity can be most easily verified by consulting what written source? a. flow sheet b. checklist c. nursing kardex d. nursing care plan: d. nursing care plan 47. The nurse is caring for a client who is prescribed an antibiotic by mouth every 4 hours. When will the nurse document that the antibiotic has been given?

a. at the end of the shift