Description
Foundations of Nursing 7th Edition Cooper Gosnell Test Bank
ISBN-13: 978-0323100038
ISBN-10: 0323100031
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Chapter 4: Communication
Cooper and Gosnell: Foundations of Nursing, 7th Edition
MULTIPLE CHOICE
- 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.” |
ANS: C
The nonverbal communication should be clarified to prevent miscommunication.
DIF: Cognitive Level: Application REF: Page OBJ: 2| 3
TOP: Communication KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
- The nurse considers the feelings and needs of a patient 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 |
ANS: D
Assertive communication takes a patient’s feelings and needs into account, yet honors the patient’s rights as an individual.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 4
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- If the nurse aggressively says to a patient, “Why couldn’t you have asked me to give you your pain medication when I was in here earlier?” what feeling is the patient most likely to demonstrate?
| a. | Anger |
| b. | Satisfaction that his needs are met |
| c. | Humiliation and worthlessness |
| d. | Confidence that his request will be granted |
ANS: C
Aggressive communication is highly destructive. Although anger may eventually come, the patient most likely feels humiliated first.
DIF: Cognitive Level: Application REF: Page OBJ: 7
TOP: Communication KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity
- 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 |
ANS: A
A positive nurse-patient relationship is facilitated therapeutic communication.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 10
TOP: Communication KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
- 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 |
ANS: C
When demonstrating active listening, the nurse must give his or her full attention and make an effort to understand both the verbal and nonverbal message.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 5
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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 |
ANS: B
Silence is an extremely effective therapeutic communication skill that is frequently underused because the nurse feels uncomfortable applying it.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 5
TOP: Communication KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
- 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 |
ANS: C
Holding the hand of a non–English-speaking patient is effective and comforting.
DIF: Cognitive Level: Application REF: Page OBJ: 9
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- A patient states, “I do cocaine when I feel things are out of my control.” The nurse responds asking, “What else does cocaine do for you?” What communication skill does this exemplify?
| a. | Summarization |
| b. | Restating |
| c. | Showing acceptance |
| d. | Stating observations |
ANS: C
Acceptance is the willingness to listen and respond to what the patient is saying without passing judgment.
DIF: Cognitive Level: Application REF: Page OBJ: 5
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- A patient states, “I’m really strung out about this pregnancy.” The nurse responds asking, “What about this pregnancy worries you?” What communication technique is this?
| a. | Closed inquiry |
| b. | Restating |
| c. | Open-ended question |
| d. | Minimal encouraging |
ANS: C
Open-ended questions convey interest and do not require a specific response.
DIF: Cognitive Level: Application REF: Pages OBJ: 5
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- A grieving young widow cries out, “Why was my husband killed? Why wasn’t it me?” 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.” |
ANS: B
The ability to listen and assist those who are newly grieving through the use of silence and a quiet presence is very effective. Stating “You need to be strong for your children” is a cliché. Asking if there is anyone the widow needs to have notified and stating “You are feeling overwhelmed about your husband’s death” are not therapeutic in this immediate grieving time.
DIF: Cognitive Level: Application REF: Page OBJ: 5
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- A nurse is assessing a patient with a nursing diagnosis of impaired verbal communication. What is the lowest number of defining characteristics for this diagnosis?
| a. | One |
| b. | Two |
| c. | Three |
| d. | Four |
ANS: A
If one or more of the defining characteristics is present, a nursing diagnosis of impaired verbal communication can be determined.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 9
TOP: Communication KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity
- 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 |
ANS: B
A person interacting with an unresponsive patient should assume all sounds and verbal stimuli have the potential of being heard the patient.
DIF: Cognitive Level: Application REF: Page OBJ: 10
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- If in response to the patient statement, “I am upset about all this lab work” the nurse responds, “You’re upset?” What is this is an example of?
| a. | An open-ended question |
| b. | Reflecting |
| c. | Restating |
| d. | Paraphrasing |
ANS: C
Restating is one of the most effective methods of therapeutic communication to encourage the patient to offer more information.
DIF: Cognitive Level: Application REF: Page OBJ: 5
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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. |
ANS: C
Therapeutic communication actively involves the patient in all areas of the nursing process.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 1
TOP: Communication KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
- A nurse is standing at the bedside with the patient lying in bed. What can the nurse be construed as demonstrating?
| a. | Interest |
| b. | Power |
| c. | Caring |
| d. | Support |
ANS: B
Standing at the bedside with the patient in bed may imply that the nurse has power.
DIF: Cognitive Level: Application REF: Page OBJ: 6| 7
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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. |
ANS: C
One-way communication is seldom effective because the sender is in control and gets very little feedback from the receiver.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 7
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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 personal space |
ANS: A
The intimate zone can cause uneasiness for both patient and nurse; therefore, approach the interaction in a professional manner.
DIF: Cognitive Level: Application REF: Page OBJ: 6
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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 |
ANS: B
Writing devices are preferred as they do not limit the patient’s messages compared to a message board or cards. Eye blinks are tiring and time-consuming. Computers require space and the ability to type.
DIF: Cognitive Level: Application REF: Page OBJ: 10
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- A patient roughly asks the nurse to bring him some ice cream. What would be considered an assertive response 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 nursing station and ask them to have the kitchen bring whatever you want.” |
ANS: B
Assertiveness is the most effective style of communication to be responsive to the patient and set limits.
DIF: Cognitive Level: Application REF: Pages OBJ: 4
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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 |
ANS: C
Jargon is terminology unique to people in a special type of work and is not understood everyone. Although jargon does speed communication and is clear to those who know it, it may be misinterpreted and not understood all people.
DIF: Cognitive Level: Comprehension REF: Page 37 OBJ: 7
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- During a complete assessment, which type of questioning is not usually conducive to fostering communication?
| a. | Open-ended |
| b. | Focused |
| c. | Closed |
| d. | Clarifying |
ANS: C
Closed questions are types of questions that the nurse may choose to use that are not usually conducive to fostering communication.
DIF: Cognitive Level: Comprehension REF: Page 42 OBJ: 7
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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. |
ANS: D
The nurse uses minimal encouragement to lead the patient to provide more information.
DIF: Cognitive Level: Application REF: Page 41 OBJ: 5
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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. |
ANS: B
Older adults lose their ability to hear higher frequency sound. Speaking in a lower tone enhances communication. Speaking overly loud and as if to a child may be irritating and demeaning. Rapid speech may be difficult for older adults to understand.
DIF: Cognitive Level: Application REF: Page OBJ: 6
TOP: Physiologic factors affecting communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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 |
ANS: C
Maintaining eye contact for 2 to 6 seconds involves the person in what is being said, is indicative of continued interest, and conveys to the patient an accepting attitude.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 2
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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 |
ANS: C
When the patient is experiencing stress, the nurse should modify communication methods.
DIF: Cognitive Level: Application REF: Page OBJ: 6
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- A nurse communicates with a patient 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 |
ANS: D
Messages transmitted without the use of words (either oral or written) constitute nonverbal communication. Nonverbal cues include tone and rate of voice, volume of speech, eye contact, physical appearance, and use of touch.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 5
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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. |
ANS: C
Frequently looking at one’s watch while interacting with a patient conveys to the patient that the nurse is in a hurry and really has no desire to spend time with him or her.
DIF: Cognitive Level: Application REF: Page OBJ: 8
TOP: Gestures KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- When listening to a patient, what action the nurse demonstrates disinterest and coldness?
| a. | Tightly crossing her arms |
| b. | Uncrossing her arms |
| c. | Uncrossing her legs |
| d. | Facing the patient |
ANS: A
The way that an individual sits, stands, and moves is called posture. Posture has the potential to convey warmth and acceptance, or distance and disinterest. An open posture is demonstrated with a relaxed stance with uncrossed arms and legs while facing the other individual. A slight shift in body position toward an individual, a smile, and direct eye contact are all consistent with open posturing and convey warmth and caring. Closed posture is a more formal, distant stance, generally with the arms, and possibly the legs, tightly crossed. A person will often interpret closed posture as disinterest, coldness, and even nonacceptance.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 1| 7| 8
TOP: Posture KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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 |
ANS: B
The way that an individual sits, stands, and moves is called posture. Posture has the potential to convey warmth and acceptance, or distance and disinterest. An open posture is demonstrated with a relaxed stance with uncrossed arms and legs while facing the other individual. A slight shift in body position toward an individual, a smile, and direct eye contact are all consistent with open posturing and convey warmth and caring. Closed posture is a more formal, distant stance, generally with the arms, and possibly the legs, tightly crossed. A person will often interpret closed posture as disinterest, coldness, and even nonacceptance.
DIF: Cognitive Level: Application REF: Page OBJ: 1| 5| 8
TOP: Posture KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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 |
ANS: B
Standing at the bedside looking down at the patient in the bed places the nurse in a position of authority and control. The patient is likely to experience this as intimidating and condescending. Whenever possible, the nurse should be level with the patient; this is especially important with pediatric patients. Sitting at the bedside in a relaxed and open posture is one example.
DIF: Cognitive Level: Application REF: Page OBJ: 1| 5
TOP: Posture KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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.” |
ANS: D
Aggressive communication is when a person interacts with another in an overpowering and forceful manner to meet his or her own personal needs at the expense of the other. By only medicating a patient every 4 hours for excruciating pain, the nurse meets his or her own needs at the expense of the patient.
DIF: Cognitive Level: Application REF: Page 39 OBJ: 7
TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- A nurse is caring for a newly admitted diabetic patient and is performing the initial assessment. What statement made the nurse demonstrates use of a closed question?
| 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?” |
ANS: A
Much of the information gathered from a patient comes from questioning them directly. A closed question is focused and seeks a particular answer. For example, when interviewing a newly admitted patient with diabetes, the nurse asks, “What time do you take your insulin?” A specific question with a specific answer is a typical closed question, which generally requires only one or two words in response.
DIF: Cognitive Level: Application REF: Page OBJ: 7
TOP: Closed questioning KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- A nurse is caring for a patient experiencing respiratory distress. The physician places an endotracheal tube. What is the most appropriate nursing diagnosis for this patient?
| a. | Ineffective coping |
| b. | Risk for infection |
| c. | Altered nutrition: less than body requirements |
| d. | Impaired verbal communication |
ANS: D
Because of the placement of an endotracheal tube, the patient is unable to speak. The nursing diagnosis of impaired verbal communication is most appropriate.
DIF: Cognitive Level: Application REF: Page OBJ: 9
TOP: Nursing diagnosis KEY: Nursing Process Step: Diagnosis
MSC: NCLEX: Psychosocial Integrity
- 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 |
ANS: D
A nurse evaluates the effectiveness of interventions based on the patient’s ability to meet established goals and outcomes.
DIF: Cognitive Level: Application REF: Page OBJ: 9
TOP: Nursing process KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Evaluation
- 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?” |
ANS: C
Only the question “What are you most looking forward to in Europe?” allows an unlimited answer.
DIF: Cognitive Level: Comprehension REF: Pages OBJ: 5
TOP: Open-ended communication KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
MULTIPLE RESPONSE
- 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. |
ANS: A, B, C, E, F
Eye contact is responsible for much communication and much miscommunication. Generally, making eye contact communicates an intention to interact. However, the nature of the interaction and the results of eye contact are not necessarily always positive. Extended eye contact sometimes implies aggression and arouses anxiety.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 3
TOP: Eye contact KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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 has said. |
ANS: A, B, C, D
Listening is sometimes active and sometimes passive. Active listening requires full attention to what the patient is saying. The message is heard, its meaning is interpreted, and the patient is given feedback, indicating understanding of the message. Verbally interpreting the meaning of what the patient has said is an example of active listening. In passive listening, the nurse indicates that they are listening to what the patient is saying either nonverbally, through eye contact and nodding, or verbally through encouraging phrases such as “Uh-huh” and “I see.” All of the other options are examples of passive listening.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 5
TOP: Listening KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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. |
ANS: A, D, E, F
Touch is a form of nonverbal communication that is inherent in the practice of nursing. Nearly every nursing intervention for the purpose of providing physical care calls for touch. Touch is frequently highly personal or of an intimate nature (e.g., giving a bed bath, assisting a patient on or off a bedpan, inserting a urinary catheter). Because of the intimate nature of touch in the nursing context, it is necessary to use it with great discretion to fit into sociocultural norms and guidelines. Some nurses are uncomfortable with touch because of a fear of it seeming inappropriate or being misinterpreted. When a nurse feels comfortable with physical contact with a patient, touch has great potential for conveying warmth, caring, support, and understanding. For the nurse to convey warmth, it is absolutely necessary for the nature of their touch to be sincere and genuine.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 5
TOP: Touch KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- 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 |
ANS: B, C, D, E
Use of touch, eye contact, reference of address, and meaning of gestures all may have cultural significance and connotation. Slow, loud speech would not assist with speaking to a person of a different culture.
DIF: Cognitive Level: Application REF: Pages OBJ: 7
TOP: Culture KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity
- Which defining characteristics support the nursing diagnosis of impaired verbal communication? (Select all that apply.)
| a. | Aphasia |
| b. | Geriatric patients |
| c. | Profoundly deaf |
| d. | Legally blind |
| e. | Severe COPD |
ANS: A, C, D, E
Difficulty speaking, attending, disorientation, dyspnea, and sensory deficits are all defining characteristics that warrant a diagnosis of impaired verbal communication. Being a geriatric patient does not necessarily support the nursing diagnosis of impaired verbal communication.
DIF: Cognitive Level: Application REF: Page OBJ: 9
TOP: Impaired communication KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity
- 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 and timing. |
| e. | Prolonged periods of misunderstood silence can cause tension. |
| f. | Purposeful use of silence often conveys lack of respect. |
ANS: A, C, D, E
Maintaining silence is an extremely effective therapeutic communication technique, and yet tends to be quite underused. Because silence often feels awkward in American society, people tend to feel the need to “fill” it. This impulse does not always allow the people involved in an interaction time to organize their thoughts sufficiently to communicate what they would like. It is common for a person to need several seconds after hearing a verbal message to interpret what has been stated and to formulate the most appropriate response. Unfortunately, the receiver often does not get this amount of time before a response is necessary. In many cases, the sender becomes uncomfortable with the silence and begins speaking again before the receiver has had an opportunity to formulate a response and is really ready to deliver it. The ability to use silence effectively requires skill and timing. It is easy for prolonged periods of misunderstood silence to cause uneasiness and tension. However, in many cases, purposeful use of silence conveys respect, understanding, caring, and support, and it is often used in conjunction with therapeutic touch.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 5
TOP: Silence KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
COMPLETION
- The nurse explains to a patient that based on the description of “personal space,” the area within 18 inches of the patient is designated as the ____________ zone.
ANS:
intimate
Personal space zones: 0 to 18 inches = intimate, 18 inches to 4 feet = personal zone, 4 to 12 feet = social zone, more than 12 feet = public zone.
DIF: Cognitive Level: Knowledge REF: Page OBJ: 8
TOP: Space and territoriality KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
- A patient with aphasia who cannot understand a spoken or written message is said to have ___________ aphasia.
ANS:
receptive
Aphasic patients who do not understand verbal exchanges are classified as receptive aphasics.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 7
TOP: Aphasia KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
- The term that describes an individual’s perception or understanding of a particular word or phrase is _____________.
ANS:
connotation
Connotation is the meaning an individual applies to a word or phrase.
DIF: Cognitive Level: Knowledge REF: Page OBJ: 2
TOP: Connotation KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
- When a nurse lectures to a large group, the method of communication is usually in the form of ____________ communication.
ANS:
one-way
One-way communication allows the sender to be in control with little expectation of or desire for feedback.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 5
TOP: Communication KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
- As the nurse listens to a supervisor, the nurse has a smile on her face but has crossed her arms in front of her chest and has crossed her legs. This is an example of a __________ posture.
ANS:
closed
A posture with crossed limbs frequently is indicative of nonacceptance.
DIF: Cognitive Level: Comprehension REF: Page OBJ: 6| 7
TOP: Posture KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
- ____________ is the reciprocal process in which messages are sent and received between people.
ANS:
communication
Communication is essential to the delivery of nursing care. It is the reciprocal process in which messages are sent and received between people.
DIF: Cognitive Level: Knowledge REF: Page OBJ: 1
TOP: Communication KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
- The ___________ is the person conveying the message, whereas the ____________ is the individual or individuals to whom the message is conveyed.
ANS:
sender, receiver
For communication to occur, a sender and a receiver of a message are both necessary. The sender is the person conveying the message, whereas the receiver is the individual or individuals to whom the message is conveyed.
DIF: Cognitive Level: Knowledge REF: Page OBJ: 1
TOP: Communication KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
