Module 38 Communication

Module 38   Communication

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

The Concept of Communication

1) A nurse explains to a client that there is a need for the client to have a bowel prep before undergoing a colonoscopy. The client is visually impaired. How would the nurse best approach this educational session so the client has the best chance of understanding?

1. A) Use words that are commonly understood in the neighborhood and culture.
2. B) Provide clarity.
3. C) Focus on intonation.
4. D) Speak slowly to the client.

Answer:  A

Explanation:

1. A) Good verbal communication incorporates simplicity, which includes the use of commonly understood words, brevity, and completeness. The term “bowel prep” may be completely meaningless to a client, but telling the client that there is a need to drink a gallon of laxative-like medication gets the point across better. Colonoscopy is a complicated word. Explaining the procedure by using words like “small camera inserted into your rectum” will make much more sense to the client. Pace and intonation indicate interest, anxiety, boredom, or fear, all of which modify the feeling and impact of the message. Clarity implies that the message is direct and simple–saying precisely what is meant and using the fewest words necessary.
2. B) Good verbal communication incorporates simplicity, which includes the use of commonly understood words, brevity, and completeness. The term “bowel prep” may be completely meaningless to a client, but telling the client that there is a need to drink a gallon of laxative-like medication gets the point across better. Colonoscopy is a complicated word. Explaining the procedure by using words like “small camera inserted into your rectum” will make much more sense to the client. Pace and intonation indicate interest, anxiety, boredom, or fear, all of which modify the feeling and impact of the message. Clarity implies that the message is direct and simple–saying precisely what is meant and using the fewest words necessary.
3. C) Good verbal communication incorporates simplicity, which includes the use of commonly understood words, brevity, and completeness. The term “bowel prep” may be completely meaningless to a client, but telling the client that there is a need to drink a gallon of laxative-like medication gets the point across better. Colonoscopy is a complicated word. Explaining the procedure by using words like “small camera inserted into your rectum” will make much more sense to the client. Pace and intonation indicate interest, anxiety, boredom, or fear, all of which modify the feeling and impact of the message. Clarity implies that the message is direct and simple–saying precisely what is meant and using the fewest words necessary.

 

1. D) Good verbal communication incorporates simplicity, which includes the use of commonly understood words, brevity, and completeness. The term “bowel prep” may be completely meaningless to a client, but telling the client that there is a need to drink a gallon of laxative-like medication gets the point across better. Colonoscopy is a complicated word. Explaining the procedure by using words like “small camera inserted into your rectum” will make much more sense to the client. Pace and intonation indicate interest, anxiety, boredom, or fear, all of which modify the feeling and impact of the message. Clarity implies that the message is direct and simple–saying precisely what is meant and using the fewest words necessary.

Page Ref: 2400

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Implementation

Learning Outcome:  5. Recommend strategies the nurse may implement to improve communication with a client who has communication deficits.

 

 

2) A nurse is teaching a client about a dressing change that should be done three times a day, and the client is from a culture that is “present oriented.” The nurse should instruct the client to perform the dressing change at which of the following times?

1. A) At times that the client selects, as long as they are 8 hours apart
2. B) At 9 a.m., 3 p.m., and 9 p.m.
3. C) Whenever the client chooses, as long as it gets done three times daily
4. D) After breakfast, lunch, and dinner

Answer:  D

Explanation:

1. A) For clients who are “present oriented,” it is important to avoid fixed schedules. The nurse can offer a time range for activities and treatments, such as in the morning or after breakfast, and in the evening or before going to bed. It is not necessary for the dressing changes to be 8 hours apart. Relating the dressing changes to regular daily activities would fit better with the client who is not focused on times of the day, such as 9 a.m., 3 p.m., and 9 p.m. Leaving it up to the client to do at any time so long as it is three times a day does not allow for any regularity in the dressing changes.
2. B) For clients who are “present oriented,” it is important to avoid fixed schedules. The nurse can offer a time range for activities and treatments, such as in the morning or after breakfast, and in the evening or before going to bed. It is not necessary for the dressing changes to be 8 hours apart. Relating the dressing changes to regular daily activities would fit better with the client who is not focused on times of the day, such as 9 a.m., 3 p.m., and 9 p.m. Leaving it up to the client to do at any time so long as it is three times a day does not allow for any regularity in the dressing changes.
3. C) For clients who are “present oriented,” it is important to avoid fixed schedules. The nurse can offer a time range for activities and treatments, such as in the morning or after breakfast, and in the evening or before going to bed. It is not necessary for the dressing changes to be 8 hours apart. Relating the dressing changes to regular daily activities would fit better with the client who is not focused on times of the day, such as 9 a.m., 3 p.m., and 9 p.m. Leaving it up to the client to do at any time so long as it is three times a day does not allow for any regularity in the dressing changes.
4. D) For clients who are “present oriented,” it is important to avoid fixed schedules. The nurse can offer a time range for activities and treatments, such as in the morning or after breakfast, and in the evening or before going to bed. It is not necessary for the dressing changes to be 8 hours apart. Relating the dressing changes to regular daily activities would fit better with the client who is not focused on times of the day, such as 9 a.m., 3 p.m., and 9 p.m. Leaving it up to the client to do at any time so long as it is three times a day does not allow for any regularity in the dressing changes.

Page Ref: 2397

Cognitive Level:  Analyzing

Client Need:  Health Promotion and Maintenance

Nursing Process:  Implementation

Learning Outcome:  1. Describe the various modes of communication and justify when a specific mode of communication may be most useful.

 

3) A nurse educator for a medical-surgical unit is giving a demonstration of new equipment to the rest of the nursing unit and sets up her models in the front of the classroom after her initial efforts at having the class gather closely around the models was met with discomfort and inattention. Which level of proxemics would be appropriate for this situation?

1. A) 4 to 12 feet
2. B) 1-1/2 to 4 feet
3. C) 12 to 15 feet
4. D) Up to 1-1/2 feet

Answer:  A

Explanation:

1. A) Social distance is characterized by a clear, visual perception of the whole individual and generally 4 to 12 feet in distance. Social distance is important in accomplishing the business of the day. It is expedient in communicating with several people at the same time or within a short time, which would be the case in this situation. Intimate distance is touching or up to 1-1/2 feet. This would be appropriate when cuddling a baby, touching a sightless client, repositioning a client, observing an incision, and restraining a toddler for an injection. Personal distance is 1-1/2 to 4 feet and is less overwhelming than intimate distance. Much communication between nurses and clients occurs at this distance, such as sitting with a client, giving medications, or establishing an IV. Public distance is 12 to 15 feet and requires loud, clear vocalizations. It is used most often with a group of people or in the community.
2. B) Social distance is characterized by a clear, visual perception of the whole individual and generally 4 to 12 feet in distance. Social distance is important in accomplishing the business of the day. It is expedient in communicating with several people at the same time or within a short time, which would be the case in this situation. Intimate distance is touching or up to 1-1/2 feet. This would be appropriate when cuddling a baby, touching a sightless client, repositioning a client, observing an incision, and restraining a toddler for an injection. Personal distance is 1-1/2 to 4 feet and is less overwhelming than intimate distance. Much communication between nurses and clients occurs at this distance, such as sitting with a client, giving medications, or establishing an IV. Public distance is 12 to 15 feet and requires loud, clear vocalizations. It is used most often with a group of people or in the community.
3. C) Social distance is characterized by a clear, visual perception of the whole individual and generally 4 to 12 feet in distance. Social distance is important in accomplishing the business of the day. It is expedient in communicating with several people at the same time or within a short time, which would be the case in this situation. Intimate distance is touching or up to 1-1/2 feet. This would be appropriate when cuddling a baby, touching a sightless client, repositioning a client, observing an incision, and restraining a toddler for an injection. Personal distance is 1-1/2 to 4 feet and is less overwhelming than intimate distance. Much communication between nurses and clients occurs at this distance, such as sitting with a client, giving medications, or establishing an IV. Public distance is 12 to 15 feet and requires loud, clear vocalizations. It is used most often with a group of people or in the community.

 

1. D) Social distance is characterized by a clear, visual perception of the whole individual and generally 4 to 12 feet in distance. Social distance is important in accomplishing the business of the day. It is expedient in communicating with several people at the same time or within a short time, which would be the case in this situation. Intimate distance is touching or up to 1-1/2 feet. This would be appropriate when cuddling a baby, touching a sightless client, repositioning a client, observing an incision, and restraining a toddler for an injection. Personal distance is 1-1/2 to 4 feet and is less overwhelming than intimate distance. Much communication between nurses and clients occurs at this distance, such as sitting with a client, giving medications, or establishing an IV. Public distance is 12 to 15 feet and requires loud, clear vocalizations. It is used most often with a group of people or in the community.

Page Ref: 2407

Cognitive Level:  Applying

Client Need:  Psychosocial Integrity

Nursing Process:  Implementation

Learning Outcome:  7. Contrast various styles of communicating, including positive and negative results of each style.

 

4) The nurse is admitting a client to an inpatient psychiatric unit. The client is speaking wildly in another language and is obviously very agitated. The nurse plans to calm the client by

1. A) placing the client in a room away from others.
2. B) speaking in a soft and calm tone.
3. C) administering a prn medication to sedate the client.
4. D) using short sentences.

Answer:  B

Explanation:

1. A) Speaking in a soft, calm manner to an excited client is the first step to try defusing the situation. The nurse’s tone may calm the excited client, regardless of language. Using short sentences is a useful tool, but in the case of an excited client, the nurse would attempt to calm the client first. Isolating the client may be necessary if the client’s behavior escalates to violence, but that is not evident here and is not the first choice of action. Giving a sedative is the last resort and is used only if the client is threatening to hurt self or others.
2. B) Speaking in a soft, calm manner to an excited client is the first step to try defusing the situation. The nurse’s tone may calm the excited client, regardless of language. Using short sentences is a useful tool, but in the case of an excited client, the nurse would attempt to calm the client first. Isolating the client may be necessary if the client’s behavior escalates to violence, but that is not evident here and is not the first choice of action. Giving a sedative is the last resort and is used only if the client is threatening to hurt self or others.
3. C) Speaking in a soft, calm manner to an excited client is the first step to try defusing the situation. The nurse’s tone may calm the excited client, regardless of language. Using short sentences is a useful tool, but in the case of an excited client, the nurse would attempt to calm the client first. Isolating the client may be necessary if the client’s behavior escalates to violence, but that is not evident here and is not the first choice of action. Giving a sedative is the last resort and is used only if the client is threatening to hurt self or others.
4. D) Speaking in a soft, calm manner to an excited client is the first step to try defusing the situation. The nurse’s tone may calm the excited client, regardless of language. Using short sentences is a useful tool, but in the case of an excited client, the nurse would attempt to calm the client first. Isolating the client may be necessary if the client’s behavior escalates to violence, but that is not evident here and is not the first choice of action. Giving a sedative is the last resort and is used only if the client is threatening to hurt self or others.

Page Ref: 2400

Cognitive Level:  Applying

Client Need:  Safe and Effective Care Environment

Nursing Process:  Implementation

Learning Outcome:  6. Recommend strategies that the nurse may implement to improve communication with a client of limited English proficiency.

 

5) The nurse is starting preoperative teaching when the client receives a phone call. When the nurse resumes teaching, the client is visibly upset and begins to cry. Which is the most therapeutic initial response by the nurse?

1. A) “Whatever is upsetting you can be dealt with once we have finished.”
2. B) “It is very important to focus on this teaching so that you will recover quickly after surgery.”
3. C) “I can see the phone call has upset you. Let’s talk about why you are upset before we move on with teaching.”
4. D) “What can you do to solve the problem?”

Answer:  C

Explanation:

1. A) When clients are anxious and upset, they have difficulty focusing, especially on new information, and their anxiety becomes a barrier to effective communication. The nurse needs to prioritize the client’s presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Because the nurse is unaware of the issue and is not knowledgeable of the client’s situation, it is false reassurance to tell the client that the matter can be handled after the teaching is completed. This also belittles the client’s independence and self-efficacy, as does recommending problem solving.
2. B) When clients are anxious and upset, they have difficulty focusing, especially on new information, and their anxiety becomes a barrier to effective communication. The nurse needs to prioritize the client’s presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Because the nurse is unaware of the issue and is not knowledgeable of the client’s situation, it is false reassurance to tell the client that the matter can be handled after the teaching is completed. This also belittles the client’s independence and self-efficacy, as does recommending problem solving.
3. C) When clients are anxious and upset, they have difficulty focusing, especially on new information, and their anxiety becomes a barrier to effective communication. The nurse needs to prioritize the client’s presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Because the nurse is unaware of the issue and is not knowledgeable of the client’s situation, it is false reassurance to tell the client that the matter can be handled after the teaching is completed. This also belittles the client’s independence and self-efficacy, as does recommending problem solving.

 

1. D) When clients are anxious and upset, they have difficulty focusing, especially on new information, and their anxiety becomes a barrier to effective communication. The nurse needs to prioritize the client’s presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Because the nurse is unaware of the issue and is not knowledgeable of the client’s situation, it is false reassurance to tell the client that the matter can be handled after the teaching is completed. This also belittles the client’s independence and self-efficacy, as does recommending problem solving.

Page Ref: 2401

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Implementation

Learning Outcome:  2. Describe barriers to successful communication and suggest strategies to reduce the risk of each barrier.