CH 20 COMMUNICATION Flashcards
1. A group of nursing students is working together on a presentation for their clinical instructor. One student in the group participates by arguing and attempting to block each step of the process of this presentation. The student’s behavior is causing frustration for the others and slowing their progress. Which of the following best describes the role this individual student is playing in relationship to the group dynamics? A) Self-serving B) Task-oriented C) Maintenance D) Group-building
Ans:
A
Feedback:
The student’s behavior is best described as self-serving. Self-serving roles advance the needs of individual members at the group’s expense. Task-oriented roles focus on the work to be completed. Group-building or maintenance roles focus on the well-being of the people doing the work.
2.
The nurse is caring for a client who speaks Chinese, and the nurse does not speak Chinese. An appropriate approach for communication with this client includes what?
A)
Using a caring voice and repeating messages frequently
B)
Speaking directly and loudly to the client
C)
Avoiding the use of gesture or play-acting
D)
Writing messages for the client and offering him a dictionary for translation.
Ans:
A
Feedback:
Approaches to use when a client speaks a different language include speaking slowly and distinctly, and avoiding loud voices. Use a caring voice, keeping messages simple, and repeat messages frequently. The use of a language dictionary by the nurse is appropriate, but writing messages and asking the client to translate is not an appropriate approach. Gestures, pictures, and play-acting help the client understand.
3.
The daughter of an older adult female client has asked the nurse why a urine specimen was collected from her mother earlier that morning. How can the nurse best respond to the daughter’s query?
A)
“We want to test your mother’s urine to make sure she doesn’t have a urinary tract infection.”
B)
“Your mother’s doctor ordered a urine C&S to rule out a UTI.”
C)
“We want to do everything we can to get your mother healthy again.”
D)
“Sometimes sick urine can make the whole person sick, and this might be causing her fever.”
Ans:
A
Feedback:
In order to communicate effectively, the nurse needs to avoid the use of jargon or abbreviations (“C&S”) that are unfamiliar to those outside the health care system. At the same time, accuracy is important, and vague and “dumbed-down” answers (“we want to do everything we can,” “sick urine”) are inappropriate.
4.
A nurse has drafted an SBAR communication before contacting the primary care provider of a client whose condition has worsened suddenly. How should the nurse best conclude this communication?
A)
Ask the care provider to come and assess the client.
B)
Provide the client’s most recent vital signs.
C)
Ask the care provider if he or she is familiar with this client.
D)
Provide the most likely diagnosis of the problem.
Ans:
A
Feedback:
The final phase of an SBAR communication involves making a recommendation. In the case of a client whose condition is worsening, this may entail recommending that the primary care provider come to assess the client. Asking the care provider if he or she is familiar with the client should be done early in the communication. Providing assessment data and possible diagnoses are addressed in the background and assessment sections of the tool.
5. The nurse has entered a client’s room and observes that the client is hunched over and appears to be breathing rapidly. What type of question should the nurse first implement in this interaction? A) A yes/no question B) A directing question C) An open-ended question D) A reflective question
Ans:
A
Feedback:
There are times when yes/no questions are appropriate. In this case, the nurse may want to ask, “Do you feel short of breath?” or something similar. Directing questions and reflective questions follow up on earlier communication. An open-ended question may elicit the necessary assessment data, but a yes/no question accomplishes this goal more directly.
6.
The nurse has entered a client’s room after receiving a morning report. The nurse rapidly assessed the client’s airway, breathing, and circulation and greeted the client by saying “Good morning.” The client has made no reciprocal response to the nurse. How should the nurse best respond to the client’s silence?
A)
The nurse should ask appropriate questions to understand the reasons for the client’s silence.
B)
The nurse should apologize for bothering the client, perform necessary assessments efficiently and leave the room.
C)
The nurse should document the client’s withdrawal and diminished mood in the nurse’s notes.
D)
The nurse should ask the client if he feels afraid or angry.
Ans:
A
Feedback:
Silence can have many meanings, and the nurse should attempt to identify the meaning of the client’s silence in a tactful manner. Directly asking if the client is angry or fearful is likely presumptuous and may harm rapport. The nurse should not make assumptions around the client’s mood nor should the nurse cease to engage with the client.
7. A nurse touches a client’s hand to indicate caring and support. What channel of communication is the nurse using? A) Auditory B) Visual C) Olfactory D) Kinesthetic
Ans:
D
Feedback:
The nurse is using a kinesthetic channel of communication. The channel of communication is the medium the sender has selected to send the message. The channel might target any of the receiver’s senses. The channels are auditory (spoken words and cues), visual (sight, observations, and perceptions), and kinesthetic (touch).
8.
A nurse is educating a home care client on how to administer a topical medication. The client is watching television while the nurse is talking. What might be the result of this interaction?
A)
The message will likely be misunderstood.
B)
The stimulus for communication is unclear.
C)
The receiver will accurately interpret the message.
D)
The communication will be reciprocal.
Ans:
A
Feedback:
Noise, which is a factor that distorts the quality of a message, can interfere with communication at any point in the process. If the client is watching television, it is likely that the message from the nurse will be misunderstood.
9. The family of a client in a burn unit asks the nurse for information. The nurse sits with the family and discusses their concerns. What type of communication is this? A) Intrapersonal B) Interpersonal C) Organizational D) Focused
Ans:
B
Feedback:
Interpersonal communication occurs among two or more people with a goal to exchange messages. Nurses spend most of their day communicating with clients, family members, and health care team members.
10.
Which of the following is an example of nonverbal communication?
A)
A nurse says, “I am going to help you walk now.”
B)
A nurse presents information to a group of clients.
C)
A client’s face is contorted with pain.
D)
A client asks the nurse for a pain shot.
Ans:
C
Feedback:
Nonverbal communication is the transmission of information without the use of words. In this situation, the facial contortion is a nonverbal message of pain.
11.
A nursing student caring for an unconscious client knows that communication is important even if the client does not respond. Which nonverbal action by the nursing student would communicate caring?
A)
Making constant eye contact with the client
B)
Waving to the client when entering the room
C)
Sighing frequently while providing care
D)
Holding the client’s hand while talking
Ans:
D
Feedback:
Tactile sense is a form of nonverbal communication and is viewed as one of the most effective nonverbal ways to express feelings of comfort.
Tactile sense is a form of nonverbal communication and is viewed as one of the most effective nonverbal ways to express feelings of comfort.
12.
Which of the following statements is true of factors that influence communication?
A)
Nurses provide the same information to all clients, regardless of age.
B)
Men and women have similar communication styles.
C)
Culture and lifestyle influence the communication process.
D)
Distance from a client has little effect on a nurse’s message.
Ans:
C
Feedback:
Culture and lifestyle do influence the communication process; understanding a client’s culture assists nurses in understanding nonverbal communication and enables the nurse to deliver accurate care.
13.
A nurse is sitting near a client while conducting a health history. The client keeps edging away from the nurse. What might this mean in terms of personal space?
A)
The nurse is outside the client’s personal space.
B)
The nurse is in the client’s personal space.
C)
The client does not like the nurse.
D)
The client has concerns about the questions.
Ans:
B
Feedback:
Each person has a sense of how much personal or private space is needed and what distance between individuals is optimum. It is best to take cues from the client; a client moving backward indicates discomfort with invasion of his or her personal space.
14.
Why is communication important to the “assessing” step of the nursing process?
A)
The major focus of assessing is to gather information.
B)
Assessing is primarily focused on physical findings.
C)
Assessing involves only nonverbal cues.
D)
Written information is rarely used in assessment.
Ans:
A
Feedback:
The major focus of assessment is to gather information using both verbal and nonverbal communication forms. Nurses use the written word, the spoken word, and one-to-one communication with clients. Effective communication techniques, as well as observational skills, are used extensively during assessment.
15. A nurse uses the SBAR method to hand off the communication to the health care team. Which of the following might be listed under the “B” of the acronym? A) Vital signs B) Mental status C) Client request D) Further testing
Ans:
B
Feedback:
SBAR stands for Situation, Background, Assessment, and Recommendations, and provides a consistent method for hand-off communication that is clear, structured, and easy to use. Vital signs would fall under the category of situation; mental status: background; client request: assessment; further testing: recommendations.