Chapter 8: Communication Skills: Medium for All Nursing Practice

Chapter 8: Communication Skills: Medium for All Nursing Practice

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient says to the nurse, “I dreamed I was stoned. When I woke up, I felt emotionally drained, as though I hadn’t rested well.” Which comment would be appropriate if the nurse seeks clarification?

a.	“It sounds as though you were uncomfortable with the content of your dream.”
b.	“I understand what you’re saying. Bad dreams leave me feeling tired, too.”
c.	“So, all in all, you feel as though you had a rather poor night’s sleep?”
d.	“Can you give me an example of what you mean by ‘stoned’?”

 

 

ANS:  D

The technique of clarification is therapeutic and helps the nurse examine the meaning of the patient’s statement. Asking for a definition of “stoned” directly asks for clarification. Restating that the patient is uncomfortable with the dream’s content is parroting, a nontherapeutic technique. The other responses fail to clarify the meaning of the patient’s comment.

 

DIF:    Cognitive Level: Application           REF:   Pages: 121-126

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

2. A patient with paranoid schizophrenia tells the nurse, “The CIA is monitoring us through the fluorescent lights in this room. Be careful what you say.” Which response by the nurse would be most therapeutic?

a.	“Let’s talk about something other than the CIA.”
b.	“It sounds like you’re concerned about your privacy.”
c.	“The CIA is prohibited from operating in health care facilities.”
d.	“You have lost touch with reality, which is a symptom of your illness.”

 

 

ANS:  B

It is important not to challenge the patient’s beliefs, even if they are unrealistic. Challenging undermines the patient’s trust in the nurse. The nurse should try to understand the underlying feelings or thoughts the patient’s message conveys. The correct response uses the therapeutic technique of reflection. The other comments are nontherapeutic. Asking to talk about something other than the concern at hand is changing the subject. Saying that the CIA is prohibited from operating in health care facilities gives false reassurance. Stating that the patient has lost touch with reality is truthful but uncompassionate.

 

DIF:    Cognitive Level: Application           REF:   Pages: 121-126

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

3. The patient says, “My marriage is just great. My spouse and I usually agree on everything.” The nurse observes the patient’s foot moving continuously as the patient twirls a shirt button. What conclusion can the nurse draw? The patient’s communication is:

a.	clear.
b.	mixed.
c.	precise.
d.	inadequate.

 

 

ANS:  B

Mixed messages involve the transmission of conflicting or incongruent messages by the speaker. The patient’s verbal message that all is well in the relationship is modified by the nonverbal behaviors denoting anxiety. Data are not present to support the choice of the verbal message being clear, explicit, or inadequate.

 

DIF:    Cognitive Level: Comprehension     REF:   Page: 121

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Psychosocial Integrity

 

4. A nurse interacts with a newly hospitalized patient. Select the nurse’s comment that applies the communication technique of “offering self.”

a.	“I’ve also had traumatic life experiences. Maybe it would help if I told you about them.”
b.	“Why do you think you had so much difficulty adjusting to this change in your life?”
c.	“I hope you will feel better after getting accustomed to how this unit operates.”
d.	“I’d like to sit with you for a while to help you get comfortable talking to me.”

 

 

ANS:  D

“Offering self” is a technique that should be used in the orientation phase of the nurse-patient relationship. Sitting with the patient, an example of “offering self,” helps build trust and conveys that the nurse cares about the patient. Two incorrect responses are ineffective and nontherapeutic. The other incorrect response is therapeutic but an example of “offering hope.”

 

DIF:    Cognitive Level: Application           REF:   Pages: 123-126

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity