Chapter 4

Question 1

. Although the patient denies pain, the nurse observes the patient breathing rapidly with clenched fists and facial grimacing. What is the nurse’s best response to these observations?
a. “I am glad you are feeling better and have no discomfort.”
b. “Where do you hurt?”
c. “What you are saying and what I am observing don’t seem to match.”
d. “It makes me uncomfortable when you are not honest with me.”

Answer 1

c. “What you are saying and what I am observing don’t seem to match.”

Question 2

The nurse considers the feelings and needs of a patient by stating, “I know you are concerned about your surgery tomorrow. How can I help you?” What type of communication is this?
a. Intrusive
b. Aggressive
c. Closed
d. Assertive

Answer 2

d. Assertive

Question 3

What does therapeutic communication accomplish?
a. Facilitates the formation of a positive nurse-patient relationship.
b. Manipulates the patient.
c. Assigns the patient a passive role.
d. Requires the patient to accept what the nurse says.

Answer 3

a. Facilitates the formation of a positive nurse-patient

Question 4

The nurse is sitting in a chair near the patient’s bed, leaning forward to hear what the patient is saying, and does not interrupt. What is the nurse demonstrating?
a. Support
b. Caring
c. Active listening
d. Interest

Answer 4

c. Active listening

Question 5

What therapeutic communication technique requires a great deal of skill and is not used as frequently as other communication techniques?
a. Touch
b. Silence
c. Listening
d. Summarizing

Answer 5

b. Silence

Question 6

A patient does not speak English; therefore, the nurse cannot use words to provide comfort during a painful procedure. What is another intervention that may provide comfort to this patient?
a. Silence
b. Listening
c. Touch
d. Restating

Answer 6

c. Touch

Question 7

A patient states, “I do cocaine when I feel things are out of my control.” The nurse responds by asking, “What else does cocaine do for you?” What communication skill does this exemplify?
a. Summarization
b. Restating
c. Showing acceptance
d. Stating observations

Answer 7

c. Showing acceptance

Question 8

A patient states, “I’m really strung out about this pregnancy.” The nurse responds byasking, “What about this pregnancy worries you?” What communication technique is this?
a. Closed inquiry
b. Restating
c. Open-ended question
d. Minimal encouraging

Answer 8

c. Open-ended question

Question 9

A grieving young widow cries out, “Why was my husband killed? Why wasn’t itme?” What is the nurse’s best response?
a. Stating “You need to be strong for your children.”
b. Silently placing her hand on the widow’s arm.
c. Asking if there is anyone the widow needs to have notified.
d. Stating “You are feeling overwhelmed about your husband’s death.”

Answer 9

b. Silently placing her hand on the widow’s arm.

Question 10

A nurse is assessing a patient with a patient problem of impaired verbal communication. What is the lowest number of defining characteristics for this diagnosis?
a. One
b. Two
c. Three
d. Four

Answer 10

a. One

Question 11

What communication technique should the nurse use when communicating with an unresponsive patient?
a. Avoid speaking directly to the patient.
b. Assume verbal stimuli are heard.
c. Speak in a loud voice.
d. Use simple words.

Answer 11

b. Assume verbal stimuli are heard.

Question 12

The patient states, “I am upset about all this lab work.” The nurse responds “You’re upset?” This response is an example of:
a. An open-ended question
b. Reflecting
c. Restating
d. Paraphrasing

Answer 12

c. Restating

Question 13

What is one of the main characteristics of therapeutic communication?
a. It allows the patient a passive role.
b. It uses only verbal communication.
c. It involves the patient as a person.
d. It is directive.

Answer 13

c. It involves the patient as a person.

Question 14

A nurse actively avoids the use of one-way communication. What is the major problem with one-way communication?
a. The receiver is in control.
b. Feedback is provided to the sender.
c. Participation is not equal.
d. The communication is unstructured.

Answer 14

c. Participation is not equal.

Question 15

A nurse must violate the personal space of a patient to perform an invasive procedure. How can the nurse reduce the discomfort of the patient?
a. By approaching the interaction in a professional manner
b. By distracting the patient with jokes and humor
c. By asking another nurse to be present at the bedside
d. By assuring the patient that all people dislike invasion of personalspace

Answer 15

a. By approaching the interaction in a professional manner

Question 16

What would be the best method for a literate, English-speaking patient on a ventilator to communicate his or her needs?
a. Eye blinking for “yes” and “no”
b. Magic slate or paper and pencil
c. Computer
d. Message board or cards

Answer 16

b. Magic slate or paper and pencil

Question 17

A patient roughly asks the nurse to bring him some ice cream. What would be considered an assertive response by the nurse?
a. “You are hungry and want a snack.”
b. “I can do that in 10 minutes when I finish my rounds.”
c. “Maybe I can get one of the aides to bring you something in a while.”
d. “Call the nurses’ station and ask them to have the kitchen bring whatever you want.”

Answer 17

b. “I can do that in 10 minutes when I finish my rounds.”

Question 18

A nurse tells a patient, “This PM you are going for an abdominal A&P, an H&H, as well as an IV pyelogram. Please sign these consent forms.” What may this use of medical jargon cause?
a. Understanding
b. Speed in communication
c. Misinterpretation
d. Clarity in the message

Answer 18

c. Misinterpretation

Question 19

During a complete assessment, which type of questioning is not usually conducive to fostering communication?
a. Open-ended
b. Focused
c. Closed
d. Clarifying

Answer 19

c. Closed

Question 20

A patient states, “My husband has told me how he feels about my having a mastectomy.” The nurse nods and says, “Go on.” This is an example of:
a. clarifying.
b. restating.
c. focusing.
d. minimal encouraging.

Answer 20

d. minimal encouraging.

Question 21

A nurse is communicating with an older adult. How might the nurse enhance communication?
a. Speak in a rapid manner to accommodate the patient’s short attention span.
b. Speak in a lower voice tone to accommodate hearing loss.
c. Speak in a simple manner as if speaking to a child.
d. Speak in a loud voice directly at ear level.

Answer 21

b. Speak in a lower voice tone to accommodate hearing loss.

Question 22

What does maintaining eye contact for 2 to 6 seconds during communication with a patient do?
a. Keeps the nurse’s attention on the conversation
b. Counteracts shyness in the patient
c. Indicates continuous focused attention
d. Assesses if the patient is involved in the conversation

Answer 22

c. Indicates continuous focused attention

Question 23

The nurse recognizes that a patient experiencing stress feels vulnerable. What would be the most appropriate way for the nurse to intervene?
a. Use technical language.
b. Direct the conversation.
c. Modify communication methods.
d. Offer all the information.

Answer 23

c. Modify communication methods.

Question 24

A nurse communicates with a patient by maintaining eye contact and through the use of touch. What type of communication technique is the nurse demonstrating?
a. Verbal
b. Persuasive
c. Directive
d. Nonverbal

Answer 24

d. Nonverbal

Question 25

A nurse frequently looks at her watch when giving a patient a bed bath. What message is most likely conveyed to the patient from the nurse?
a. She desires to spend more time with the patient.
b. She is anxious to listen to the patient’s concerns.
c. She is feeling hurried.
d. She likes her watch.

Answer 25

c. She is feeling hurried.

Question 26

When listening to a patient, what action by the nurse demonstrates disinterest and coldness?
a. Tightly crossing her arms
b. Uncrossing her arms
c. Uncrossing her legs
d. Facing the patient

Answer 26

a. Tightly crossing her arms

Question 27

27. How can the nurse demonstrate warmth and acceptance when listening to a patient? a. Tightly crossing her arms
    b. Uncrossing her arms
    c. Tightly crossing her legs
    d. Facing away from the patient

Answer 27

b. Uncrossing her arms

Question 28

How may a nurse caring for a pediatric patient best be perceived as nonthreatening? a. Tightly crossing her arms
b. Maintaining an open posture
c. Maintaining a tense posture
d. Standing at the bedside

Answer 28

b. Maintaining an open posture

Question 29

A nurse is caring for a patient who is experiencing excruciating pain and requires frequent administration of analgesics. What statement would be an example of the nurse demonstrating aggressive communication?
a. “Please let me know when you start to have pain.”
b. “Let’s practice some guided imagery.”
c. “Let’s try repositioning you.”
d. “I will only medicate you every 4 hours.”

Answer 29

d. “I will only medicate you every 4 hours.”

Question 30

A nurse is caring for a newly admitted diabetic patient and is performing the initial assessment. What statement made by the nurse demonstrates the use of a closedquestion?
a. “What time do you take your insulin?”
b. “How do you feel about taking insulin?”
c. “Tell me about your support system.”
d. “How do you feel about having diabetes?”

Answer 30

a. “What time do you take your insulin?”

Question 31

A nurse is caring for a patient experiencing respiratory distress. The health care provider places an endotracheal tube. What is the most appropriate patient problem for this patient?
a. Ineffective coping
b. Risk for infection
c. Altered nutrition: less than body requirements
d. Impaired verbal communication

Answer 31

d. Impaired verbal communication

Question 32

A nurse examines whether patient interventions have been appropriate and expected outcomes have been met. The nurse is demonstrating which step in the nursing process? a. Assessment
b. Planning
c. Implementation
d. Evaluation

Answer 32

d. Evaluation

Question 33

Which question below is open-ended?
a. “Are you going to Europe this fall?”
b. “Are you sailing to Europe?”
c. “What are you most looking forward to in Europe?”
d. “Have you been to Europe before?”
e. “Where in Europe are you going?”

Answer 33

c. “What are you most looking forward to in Europe?”

Question 34

Which are true regarding communicating while using eye contact? (Select all that apply.)
a. Eye contact is responsible for much communication.
b. Eye contact is responsible for much miscommunication.
c. Making eye contact generally indicates an intention to interact.
d. Eye contact always results in a positive outcome.
e. Extended eye contact can imply aggression.
f. Extended eye contact can lead to heightened anxiety.

Answer 34

a. Eye contact is responsible for much communication.
b. Eye contact is responsible for much miscommunication.
c. Making eye contact generally indicates an intention to interact.
e. Extended eye contact can imply aggression.
f. Extended eye contact can lead to heightened anxiety.

Question 35

Which are examples of passive listening? (Select all that apply.)
a. The nurse nods frequently while the patient speaks.
b. The nurse maintains eye contact while listening to the patient.
c. The nurse occasionally interjects, “I see,” when listening to the patient.
d. The nurse gives verbal feedback to the patient.
e. The nurse verbally interprets the meaning of what the patient hassaid.

Answer 35

A,B,C,D

Question 36

What is true about the use of touch in therapeutic communication? (Select all that apply.) a. Touch is a form of nonverbal communication.
b. Touch is a form of verbal communication.
c. Touch should be used with indiscretion.
d. Touch can convey warmth and caring.
e. Touch can convey support and understanding.
f. Touch should be used sincerely and genuinely.

Answer 36

A,D,E,F

Question 37

When speaking to a person of a different culture, how should the nurse consider modifying his or her communication style? (Select all that apply.)
a. Speak slowly and with increased volume
b. Use of touch
c. Use of eye contact
d. Reference of address
e. Meaning of gestures

Answer 37

B,C,D,E

Question 38

Which defining characteristics support the patient problem of impaired verbal communication? (Select all that apply.)
a. Aphasia
b. Geriatric patients
c. Profoundly deaf
d. Legally blind
e. Severe COPD

Answer 38

ANS: A, C, D, E

Question 39

What is true about the use of silence in therapeutic communication? (Select all that apply.) a. Maintaining silence is an effective therapeutic communication technique. b. Maintaining silence is generally overused in therapeutic communication.
c. The sender often becomes uncomfortable when using silence.
d. The ability to use silence effectively requires skill andtiming.
e. Prolonged periods of misunderstood silence can cause tension.
f. Purposeful use of silence often conveys lack of respect.

Answer 39

ANS: A, C, D, E