Chapter 3: Communication

Chapter 3: Communication

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The patient is a 54-year-old man who has made a living as a construction worker. He dropped out of high school at age 16 and has been a laborer ever since. He never saw any need for “book learning,” and has lived his life “my way” since he was a teenager. He has smoked a pack of cigarettes a day for 40 years and follows no special diet, eating a lot of “fast food” while on the job. He now is admitted to the coronary care unit for complaints of chest pain and is scheduled for a cardiac catheterization in the morning. Which of the following would be the best way for the nurse to explain why he needs the procedure?

a.	“The doctor believes that you have atherosclerotic plaques occluding the major arteries in your heart, causing ischemia and possible necrosis of heart tissue.”
b.	“There may be a blockage of one of the arteries in your heart, causing the chest discomfort. He needs to know where it is to see how he can treat it.”
c.	“We have pamphlets here that can explain everything. Let me get you one.”
d.	“It’s just like a clogged pipe. All the doctor has to do is ‘Roto-Rooter’ it to get it cleaned out.”

 

 

ANS:  B

To send an accurate message, the sender of verbal communication must be aware of different developmental perspectives as well as cultural differences between sender and receiver, such as the use of dialect or slang.

 

DIF:    Cognitive Level: Application           REF:   Text reference: p. 28

OBJ:   Explain the communication process.                                 TOP:   Verbal Communication

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Psychosocial Integrity

 

2. The nurse is assessing a patient who says that she is feeling fine. The patient, however, is wringing her hands and is teary eyed. The nurse should respond to the patient in which of the following ways?

a.	“You seem anxious today. Is there anything on your mind?”
b.	“I’m glad you’re feeling better. I’ll be back later to help you with your bath.”
c.	“I can see you’re upset. Let me get you some tissue.”
d.	“It looks to me like you’re in pain. I’ll get you some medication.”

 

 

ANS:  A

When assessing a patient’s needs, assess both the verbal and the nonverbal messages and validate them. In this case, if you see a patient wringing her hands and sighing, it is appropriate to ask, “You seem anxious today. Is there anything on your mind?” It is not enough to accept only the verbal message if nonverbal signals conflict, and it is inappropriate to jump to conclusions about what the nonverbal signals mean.

 

DIF:    Cognitive Level: Application           REF:   Text reference: pp. 36-37

OBJ:   Explain the communication process.                                 TOP:   Nonverbal Communication

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Psychosocial Integrity

 

3. Nonverbal communication incorporates messages conveyed by:

a.	touch.
b.	cadence.
c.	tone quality.
d.	use of jargon.

 

 

ANS:  A

Nonverbal communication describes all behaviors that convey messages without the use of words. This type of communication includes body movement, physical appearance, personal space, and touch. Cadence, tone quality, and the use of jargon are all part of verbal communication.

 

DIF:    Cognitive Level: Knowledge            REF:   Text reference: p. 28

OBJ:   Explain the communication process.                                 TOP:   Nonverbal Communication

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Psychosocial Integrity

 

4. The patient is an elderly male who had hip surgery 3 days ago. He states that his hip hurts, but he does not like how the medicine makes him feel. He believes that he can tolerate the pain better than he can tolerate the medication. What would be the best response from the nurse?

a.	Explain the need for the pain medication using a slower rate of speech.
b.	Explain the need for the pain medication using a simpler vocabulary.
c.	Explain the need for the pain medication, but ask the patient if he would like the doctor called and the medication changed.
d.	Explain in a loud manner the need for the pain medication.

 

 

ANS:  C

Suggesting, which is presenting alternative ideas for patient consideration relative to problem solving, can be effective in helping the patient maintain control by increasing the patient’s perceived options or choices. Nurses often use elder-speak, which includes a slower rate of speech, greater repetition, and simpler grammar than normal adult speech, when caring for older adults. However, many older patients perceive this type of communication as patronizing.

 

DIF:    Cognitive Level: Application           REF:   Text reference: p. 31

OBJ:   Identify the purpose of therapeutic communication, communication in various phases of the nurse-patient relationship, and special issues related to communication.

TOP:   Communication with the Elderly      KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Psychosocial Integrity

 

5. When comparing therapeutic communication versus social communication, the professional nurse realizes that therapeutic communication:

a.	allows equal opportunity for personal disclosure.
b.	allows both participants to have personal needs met.
c.	is goal directed and patient centered.
d.	provides an opportunity to compare intimate details.

 

 

ANS:  C

Therapeutic communication empowers patients to make decisions but differs from social communication in that it is patient centered and goal directed with limited disclosure from the professional. Social communication involves equal opportunity for personal disclosure, and both participants seek to have personal needs met. Nurses do not share with patients intimate details of their personal lives.

 

DIF:    Cognitive Level: Application           REF:   Text reference: p. 30

OBJ:   Develop skills for therapeutic communication in various phases of the nurse-patient relationship.   TOP:           Establishing the Nurse-Patient Relationship

KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Psychosocial Integrity