Ch 24 Nclex- Comunication

Question 1

1. When working with an older adult who is hearing-impaired, the use of which techniques would improve communication? (Select all that apply.)
2. Check for needed adaptive equipment.
3. Exaggerate lip movements to help the patient lip read.
4. Give the patient time to respond to questions.
5. Keep communication short and to the point.
6. Communicate only through written information.

Answer 1

1,3,4

Question 2

2. Nurses must communicate effectively with the health care team for which of the following reasons? (Select all that apply.)
3. Improve the nurse’s status with the health team members
4. Reduce the risk of errors to the patient
5. Provide optimum level of patient care
6. Improve patient outcomes
7. Prevent issues that need to be reported to outside agencies

Answer 2

2,3,4

Question 3

3. A new nurse complains to her preceptor that she has no time for therapeutic communication with her patients. Which of the following is the best strategy to help the nurse find more time for this communication?
4. Include communication while performing tasks such as changing dressings and checking vital signs.
5. Ask the patient if you can talk during the last few minutes of visiting hours.
6. Ask Pastoral care to come back a little later in the day.
7. Remind the nurse to complete all her tasks and then set up remaining time for communication.

Answer 3

1

Question 4

4. Motivational interviewing (MI) is a technique that applies understanding a patient’s values and goals in helping the patient make behavior changes. What are other benefits of using MI techniques? (Select all that apply.)
5. Gaining an understanding of patient’s motivations
6. Focusing on opportunities to avoid poor health choices
7. Recognizing patient’s strengths and supporting their efforts
8. Providing assessment data that can be shared with families to promote change
9. Identifying differences in patient’s health goals and current behaviors

Answer 4

1,3,5

Question 5

5. A nurse is talking with a young-adult patient about the purpose of a new medication. The nurse says, “I want to be clear. Can you tell me in your words the purpose of this medicine?” This exchange 334is an example of which element of the transactional communication process?
6. Message
7. Obtaining feedback
8. Channel
9. Referent

Answer 5

2

Question 6

6. A patient who is Spanish-speaking does not appear to understand the nurse’s information on wound care. Which action should the nurse take?
7. Arrange for a Spanish-speaking social worker to explain the procedure
8. Ask a fellow Spanish-speaking patient to help explain the procedure
9. Use a professional interpreter to provide wound care education in Spanish
10. Ask the patient to write down questions that he or she has for the nurse

Answer 6

3

Question 7

7. A nurse prepares to contact a patient’s physician about a change in the patient’s condition. Put the following statements in the correct order using SBAR (Situation, Background, Assessment, and Recommendation) communication.
8. “She is a 53-year-old female who was admitted 2 days ago with pneumonia and was started on Levaquin at 5 PM yesterday. She complains of a poor appetite.”
9. “The patient reported feeling very nauseated after her dose of Levaquin an hour ago.”
10. “Would you like to make a change in antibiotics, or could we give her a nutritional supplement before her medication?”
11. “The patient started complaining of nausea yesterday evening and has vomited several times during the night.”

Answer 7

4S, 1B, 2A, 3R

Question 8

8. A nurse is assigned to care for a patient for the first time and states, “I don’t know a lot about your culture and want to learn how to better meet your health care needs.” Which therapeutic communication technique did the nurse use in this situation?
9. Validation
10. Empathy
11. Sarcasm
12. Humility

Answer 8

4

Question 9

9. A new nurse is experiencing lateral violence at work. Which steps could the nurse take to address this problem?
10. Challenge the nurses in a public forum to embarrass them and change their behavior
11. Talk with the department secretary and ask if this has been a problem for other nurses
12. Talk with the preceptor or manager and ask for assistance in handling this issue
13. Say nothing and hope things get better

Answer 9

3

Question 10

10. A nurse has been gathering physical assessment data on a patient and is now listening to the patient’s concerns. The nurse sets a goal of care that incorporates the patient’s desire to make treatment decisions. This is an example of the nurse engaged in which phase of the nurse-patient relationship?
11. Working phase
12. Preinteraction phase
13. Termination phase
14. Orientation phase

Answer 10

1

Question 11

11. A patient is evaluated in the emergency department after causing an automobile accident while being under the influence of alcohol. While assessing the patient, which statement would be the most therapeutic?
12. “Why did you drive after you had been drinking?”
13. “We have multiple patients to see tonight as a result of this accident.”
14. “Tell me what happened before, during, and after the automobile accident tonight.”
15. “It will be okay. No one was seriously hurt in the accident.”

Answer 11

3

Question 12

12. A nursing student is reviewing a process recording with the instructor. The student engaged the patient in a discussion about availability of family members to provide support at home once the patient is discharged. The student reviews with the instructor whether the comments used encouraged openness and allowed the patient to “tell his story.” This is an example of which step of the nursing process?
13. Planning
14. Assessment
15. Intervention
16. Evaluation

Answer 12

4

Question 13

13. 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.)
14. Collaboration between staff members from sending and receiving departments
15. Requiring that the patient visit the facility before a transfer is arranged
16. Using a standardized transfer policy and transfer tool
17. Arranging all patient transfers during the same time each day
18. Relying on family members to share information with the new facility

Answer 13

1,3

Question 14

14. A nurse is explaining to a patient how to follow infection control practices at home. During the discussion the nurse touches the patient on the shoulder. Explain which zone of touch the nurse should be practicing and what problems the action might cause.

Answer 14

See evolve

Question 15

15. The nurse uses silence as a therapeutic communication technique. What is the purpose of the nurse’s silence? (Select all that apply.)
16. Prevent the nurse from saying the wrong thing
17. Prompt the patient to talk when he or she is ready
18. Allow the patient time to think and gain insight
19. Allow time for the patient to drift off to sleep
20. Determine if the patient would prefer to talk with another staff member

Answer 15

2,3