Ch 24

Question 1

Communication

Answer 1

Lifelong learning process

Question 2

The following nursing actions are examples that reflect caring:

Answer 2

• Becoming sensitive and supportive to self and others
• Being present and encouraging the expression of positive and
negative feelings
• Developing healing relationships
• Instilling faith and hope
• Promoting interpersonal teaching and learning
• Promoting patient advocacy
• Providing for nursing care needs in a supportive way
• Respecting and allowing for spiritual expression

Question 3

perceptual biases or stereotypes

Answer 3

Interferes with accurately perceiving and interpreting messages from others.

Question 4

circular transactional model

Answer 4

-includes several elements: the refer- ent, sender and receiver, message, channels, context or environment in which the communication process occurs, feedback, and interpersonal variables
- In this model each person in the communication interaction is both a speaker and a listener and can be simultaneously sending and receiving messages.
-Both parties view the perceptions, attitudes, and potential reactions to a sent message. Communication is continuous and interactive. Feedback from the receiver or environment enables the communicators to correct or validate the communication.
-This model also describes the role relationship of the communicators as complementary and symmetrical. Complementary role relationships function with one person holding an elevated position over the other person. Symmetrical relationships are more equal. A complementary role occurs when a nurse provides education to a patient about a new medication or therapy. A group of patients discussing their plans after discharge is an example of a symmetrical role relationship

Question 5

referent

Answer 5

-motivates one person to communicate with another. In a health care setting, sights, sounds, sensations, percep- tions, and ideas are examples of cues that initiate the communication process.

Question 6

Sender and Receiver

Question 7

Message

Answer 7

-the content of the communication. It contains verbal and nonverbal expressions of thoughts and feelings. Effective mes- sages are clear, direct, timely, and in understandable language.
- Individuals with cognitive disorders (e.g., confusion, dementia) or communication barriers may need assistance (e.g., hearing aids, interpreters, or pictures) to clarify information to understand messages sent and received.

Question 8

channels

Answer 8

Individuals use communication channels to send and receive messages through visual, auditory, and tactile senses. Facial expressions send visual messages; spoken words travel through audi- tory channels. Touch uses tactile channels. Individuals usually under- stand a message more clearly when the sender uses more channels to send it.

Question 9

Feedback

Answer 9

the message a sender receives from the receiver. It indicates the extent to which the receiver understood the meaning of the sender’s message. Feedback occurs continuously between a sender and receiver.
-A sender seeks verbal and nonverbal feedback to evaluate the receiver’s response and effectiveness of a communicated message. The type of feedback a sender or receiver gives depends on factors such as background, prior experiences, education, attitudes, cultural beliefs, and self-esteem. A sender and receiver need to be sensitive and open to each other’s messages, to clarify the messages, and to modify behavior accordingly for successful communication.

Question 10

Interpersonal variables

Answer 10

factors within both the sender and receiver that influence communication. Perception provides a uniquely personal view of reality formed by an individual’s culture, expectations, and experiences. Each person senses, interprets, and understands a communicated message differently.

Question 11

environment

Answer 11

The environment is the setting for sender-receiver interaction. An effective communication setting provides participants with physical and emotional comfort and safety. Noise, temperature extremes, distractions, and lack of privacy or space create confusion, tension, and discomfort. Environmental distractions are common in health care settings and interfere with messages sent between people. You control the environment as much as possible to create favorable conditions for effective communication.

Question 12

Metacommunication

Answer 12

a broad term that refers to all factors that influence communication. Awareness of influ- encing factors helps people better understand what is communicated

Question 13

Motivational interviewing (MI)

Answer 13

a technique that encourages patients to share their thoughts, goals, beliefs, fears, and concerns with the aim of changing their behavior. MI provides a way of working with patients who may not seem ready to make behavioral changes that are considered necessary by their health practitioners. You can use it to evoke change talk, which links to improved patient outcomes

Question 14

The acronym SACCIA is one way to assist nurses in communicat- ing effectively with other team members.

Answer 14

The acronym stands for Sufficiency, Accuracy, Clarity, Contextualization, and Interpersonal Adaptation. For example, consider a situation in which a charge nurse is preparing for a change of shift on an inpatient rehabilitation unit. She is preparing to report to a nurse who is a new graduate but has been working on the unit for 4 weeks.

Question 15

SBAR

Answer 15

This technique is a popular communication tool that standardizes communication between health care providers. SBAR is the acronym for Situation, Background, Assessment, and Recom- mendation

Some organizations have added an Identify step (ISBAR) into the SBAR process. The Identify step is used when health care providers do not actively know one another. They start with an introduction, a description of their location, and their role in caring for the patient

Question 16

Lateral violence

Answer 16

work- place bullying between colleagues sometimes occurs and includes behaviors such as withholding information, being hypercritical, raising blame or making put-downs, criticizing without solutions, excluding, and using nonverbal expressions of disapproval such as raising eyebrows or making faces. Lateral violence adversely affects the work environment, leading to job dissatisfaction, a decreased sense of value, poor teamwork, poor retention of qualified nurses, and nurses leaving the profession

Question 17

AIDET®

Answer 17

echnique developed by the Studer Group (2021) to enable health care workers to provide accurate and timely professional communication to patients and families while focusing on excellent patient service. It is a technique commonly used in hospitals today. The acronym stands for Acknowledge, Introduce, Duration, Explain, and Thank you.
-When using AIDET, you first acknowledge the person standing in front of you with a positive attitude and make the person feel comfortable. Introduce yourself and let the person know what your role is in the department and in the person’s care. It is important to always wear a name badge when working in a health care setting. When possible, give a patient or family an idea of how long a proce- dure may take. This keeps the patient informed of any delays that may occur. It is also helpful to let a patient know how long it will take to get results if they are related to testing. When explaining procedures, describe what the patient will experience with the treatment, proce- dure, or test. Inform the patient of any safety precautions. When using AIDET, thank patients for coming to your organization for care and let them know how much you enjoyed working with them

Question 18

When working with an older adult who is hearing-impaired, the use of which techniques would improve communication? (Select all that apply.)
1. Checkforneededadaptiveequipment.
2. Exaggeratelipmovementstohelpthepatientlip-read. 3. Givethepatienttimetorespondtoquestions.
4. Keepcommunicationshortandtothepoint.
5. Communicateonlythroughwritteninformation

Answer 18

1.,3.,4.,

Question 19

A patient has gone through a number of treatment changes during a shift of care. During the hand-off report, the nurse plans to communicate effectively with the nurse who will be caring next for the patient for which of the following reasons? (Select all that apply.)
1. To improve the nurse’s status with the health team members 2. To reduce the risk of errors to the patient
3. To provide an optimum level of patient care
4. To improve patient outcomes
5. To prevent issues that need to be reported to outside agencies

Answer 19

2.,3.,4.,

Question 20

A nurse is using motivational interviewing with a patient. What
outcomes does the nurse expect? (Select all that apply.)
1. Gainanunderstandingofthepatient’shealthgoals.

2. Direct the patient to avoid poor health choices.
3. Recognize the patient’s strengths and support the patient’s efforts.
4. Provide assessment data that can be shared with families to
   promote change.
5. Identify differences in patient’s health outcomes and current
   behaviors.

Answer 20

1.,3.,5.,

Question 21

Which techniques demonstrate a therapeutic response to an adult
patient who is anxious? (Select all that apply.)
1. Matching the rate of speech to be the same as that of the patient
2. Providinggoodeyecontact
3. Demonstratingacalmpresence
4. Spendingtimeattentivelywiththepatient
5. Assuringthepatientthatallwillbewell

Answer 21

2.,3.,4.,

Question 22

A nurse prepares to contact a patient’s health care provider about a change in the patient’s condition. Put the following statements in the correct order using SBAR (Situation, Background, Assessment, and Recommendation) communication.
1. “She is a 53-year-old woman who was admitted 2 days ago with pneumonia and was started on levofloxacin at 5 p.m. yesterday. She states she has a poor appetite; her weight has remained stable over the past 2 days.”
2. “The patient reported feeling very nauseated after her dose of levofloxacin an hour ago.”
3. “Is it possible to make a change in antibiotics, or could we give her a nutritional supplement before her medication?”
4. “The patient started to complain of nausea yesterday evening and vomited several times during the night.”

Answer 22

4.,1.,2.,3.,

Question 23

A patient states, “I don’t have confidence in my doctor. She looks so young.” What is the nurse’s therapeutic response?
1. Tell me more about your concern.
2. You have nothing to worry about. Your doctor is perfectly
competent.
3. You can go online and see how others have rated your doctor.
I do that.
4. Youshouldaskyourdoctortotellyouherbackground.

Answer 23

1

Question 24

The nurse applying effective communication skills throughout the nursing process should: (Place the following interventions in the correct order.)
1. Validate health care needs through verbal discussion with the patient.
2. Compare actual and expected patient care outcomes with the patient.
3. Provide support through therapeutic communication techniques.
4. Complete a nursing history using verbal communication
techniques.

Answer 24

4.,1.,3.,2.,

Question 25

A nurse works with a patient using therapeutic communication during all phases of the therapeutic relationship. Place the nurse’s statements in order according to these phases.
1. The nurse states, “Let’s work on learning injection techniques.”
2. The nurse is mindful of biases and knowledge in working with
the patient with B12 deficiency.
3. The nurse summarizes progress made during the nursing
relationship.
4. After providing introductions, the nurse defines the scope and
purpose of the nurse-patient relationship.

Answer 25

2.,4.,1.,3.,

Question 26

Which strategies should a nurse use to facilitate a safe transition of care during a patient’s transfer from the hospital to a skilled nursing facility? (Select all that apply.)
1. Collaboration between staff members from sending and receiving departments
2. Requiring that the patient visit the facility before a transfer is arranged
3. Using a standardized transfer policy and transfer tool
4. Arranging all patient transfers during the same time each day
5. Relying on family members to share information with the new
facility

Answer 26

1.,3.,

Question 27

What outcome demonstrates the effective use of silence as a therapeutic communication technique?
1. The nurse feels like there was enough time to be therapeutic when communicating with the patient.
2. The patient states a preference to talk with another staff member.
3. The patient perceives having gained insight into the issue after
the conversation.
4. The patient was able to drift off to sleep more easily.

Answer 27

3