Chapter 23: Communication Nursing School Test Banks

Potter & Perry: Fundamentals of Nursing, 6th Edition

MULTIPLE CHOICE

1. The nurse has provided the client with information regarding the treatment plan for the diagnosis. The client tells the nurse that he understands most of the information, but still has questions concerning the medication. This response is an example of:

a.

Referent

b.

Receiver

c.

Channel

d.

Feedback

ANS: d

d. This response is an example of feedback. Feedback is the message returned by the receiver.

a. The referent motivates one person to communicate with another, such as a time schedule. This is not an example of a referent.

b. The receiver is the person who receives and decodes the message. This question is asking not about the receiver, but rather the response.

c. Channels are means of conveying and receiving messages through visual, auditory, and tactile senses. This response is not an example of a channel.

REF: Text Reference: p. 428

2. The nurse is in the process of conducting an admission interview with the client. At one point in the discussion, the client has provided information that the nurse would like to clarify. The nurse uses the technique of clarification, as indicated by the response:

a.

Im not sure that I understand what you mean by that statement.

b.

The electrocardiogram (ECG) records information about your hearts electrical activity.

c.

Lets look at the problem you have had with your medication at home.

d.

Whats your biggest concern at the moment?

ANS: a

a. Clarifying exists when the nurse checks whether understanding is accurate by restating an unclear message to clarify the senders meaning, or by asking the other person to restate the message, explain further, or give an example of what the person means. This response indicates that the nurse wants to clarify what the client is saying so he or she can have an accurate understanding of what the client means.

b. This is an example of providing information, not clarification.

c. This is an example of focusing, not clarification.

d. This is an example of sharing empathy.

REF: Text Reference: p. 439

3. The faculty member is reviewing a process recording with the student nurse. The student has been working with a client who has had an amputation of the lower left leg and is emotionally fragile. The student receives positive feedback from the faculty member for the following response made to the client:

a.

Why are you so upset today?

b.

Im sure that everything will be all right.

c.

You shouldnt cry. The wound will heal soon.

d.

It must be very difficult to have this happen to you.

ANS: d

d. This response is an example of using the therapeutic communication technique of sharing empathy.

a. This response is an example of a nontherapeutic communication technique of asking for explanations.

b. This response is an example of a nontherapeutic communication technique of giving false reassurance.

c. This is an example of a nontherapeutic communication technique of giving disapproval.

REF: Text Reference: p. 438

4. The client draws back when the nurse reaches over the side rails to take his blood pressure. To promote effective communication, the nurse should first:

a.

Tell the client that the blood pressure can be taken at a later time

b.

Rotate the nurses who are assigned to take the clients blood pressure

c.

Continue to perform the procedure quickly and quietly

d.

Apologize for startling the client and explain the need for contact

ANS: d

d. Nurses often have to enter a clients personal space to provide care. The nurse should convey confidence, gentleness, and respect for privacy. This response demonstrates respect and provides information so the client may understand the need for personal contact.

a. Telling the client that the blood pressure can be taken at a later time does not promote effective communication.

b. Rotating the nurses who are assigned to take the clients blood pressure impedes the nurses ability to form a therapeutic, helping relationship.

c. Continuing to perform the procedure quickly and quietly may send a negative nonverbal message. It also does not promote effective communication.

REF: Text Reference: p. 431

5. Active listening and body language work together. The nurse actively listens to the client and:

a.

Sits facing the client

b.

Keeps the arms and legs crossed

c.

Leans back in the chair away from the client

d.

Avoids eye contact as much as possible

ANS: a

a. Active listening means to be attentive to what the client is saying both verbally and nonverbally. A nonverbal skill to facilitate attentive listening is to sit facing the client. This posture gives the message that the nurse is there to listen and is interested in what the client is saying.

b. For active listening, the arms and legs should be uncrossed. This posture suggests that the nurse is open to what the client says.

c. For active listening, the nurse should lean toward the client. This posture conveys that the nurse is involved and interested in the interaction.

d. For active listening, the nurse should establish and maintain intermittent eye contact. This conveys the nurses involvement in and willingness to listen to what the client is saying.

REF: Text Reference: p. 437

6. During the assessment phase of the nursing process, the nurse may uncover data that help to identify communication problems. An example of this information is:

a.

Extreme dyspnea or shortness of breath

b.

Urinary frequency and pain

c.

Chronic stomach pain

d.

Lack of appetite

ANS: a

a. An extremely breathless person must use oxygen to breathe rather than to speak.

b. Urinary frequency may interrupt conversation, but is not a communication problem.

c. Chronic stomach pain would not be a communication problem. The patient with chronic pain is, to some degree, used to the pain.

d. A lack of appetite is not a communication problem.

REF: Text Reference: p. 434

7. A nurse tells an advanced nurse practitioner that the client is slipping a little in reference to hemodynamic pressures. The nurse is using:

a.

Brevity

b.

Relevance

c.

Pacing and control

d.

Connotative meaning

ANS: d

d. The connotative meaning is the shade or interpretation of a words meaning influenced by the thoughts, feelings, or ideas people have about the word. Slipping a little in reference to hemodynamic pressures is an example of using connotative meaning.

a. Brevity means that communication is simple, brief, and direct. This is not an example of using brevity.

b. Relevance means the message is relevant or important to the situation at hand. This is not an example of using relevance.

c. Pacing and control means speaking slowly enough to enunciate clearly and not changing subjects rapidly. This is not an example of using pacing and control.

REF: Text Reference: p. 429

8. A client is admitted for a computed tomography (CAT scan; diagnostic test) of the cranium. As the nurse explains this diagnostic test, the client moves away from the nurse. This is an example of what influencing factor in communication?

a.

Gender

b.

Environment

c.

Space and territoriality

d.

Sociocultural background

ANS: c

c. Territoriality is the need to gain, maintain, and defend ones right to space. The client who moves away from the nurse during a conversation is demonstrating the influence of space and territoriality on communication.

a. This not an example of gender influencing communication.

b. This is not an example of environment influencing communication. Noise, temperature extremes, distractions, and lack of privacy are examples of environmental factors that may influence communication.

d. Although people do maintain varying distances between each other depending on their culture, this is not an example of sociocultural background influencing communication, as cultural orientation is not mentioned in this situation.

REF: Text Reference: p. 430

9. The nurse will often display empathy in communication with clients. Of the following responses by the nurse, which one best conveys empathy?

a.

Good morning. How did you sleep last night?

b.

I can understand your concern about learning to inject yourself.

c.

Do you mean you would like to talk to the new family nurse practitioner?

d.

Can you describe what the pain in your abdomen feels like?

ANS: b

b. Empathy is the ability to understand and accept another persons reality, to perceive feelings accurately, and to communicate this understanding to others.

a. This response is asking a question. It does not convey empathy.

c. This response is asking a question to clarify the clients meaning. It does not convey empathy.

d. This response is asking a relevant question that may focus on a particular topic. It is not an example of empathy.

REF: Text Reference: p. 438

10. In working with a client who is newly diagnosed with diabetes mellitus, the nurse provides feedback to the client on her progress in learning the treatment regimen. Of the following, the nurse demonstrates the use of therapeutic communication by stating:

a.

I believe that you have come a long way in learning how to manage your care.

b.

It didnt look as if you were ever going to be able to get the injection technique.

c.

You really need to be checking your blood sugar more often unless you want to come back here to the hospital.

d.

You dont appear to have any interest in your dietary intake.

ANS: a

a. The nurse is demonstrating the use of therapeutic communication by sharing hope. The nurse is pointing out that personal growth can come from illness experiences.

b. This is a negative statement. The nurse should not state observations that might embarrass or anger the client.

c. This response does not demonstrate the use of therapeutic communication. It implies disapproval and is an aggressive, threatening type of response.

d. This is not a therapeutic statement. It is negative and aggressive in nature. If it is a true observation, it is one the nurse should not state, as it could anger the client.

REF: Text Reference: p. 438

11. A parent tells the pediatric nurse practitioner, Ive never told anyone this information about my son. This is an example of:

a.

Identifying problems and goals

b.

Building trust

c.

Clarifying roles

d.

Revealing

ANS: b

b. This response is an example of trust. Trusting another person involves risk and vulnerability, but it also fosters open, therapeutic communication and enhances the expression of feelings, thoughts, and needs.

a. This statement is not an example of identifying problems and goals.

c. This statement is not clarifying roles of the nurse and client.

d. This statement is not an example of revealing. Although the parent may have provided information that was never before revealed, in this statement the parent is indicating that there is trust between himself or herself and the nurse practitioner.

REF: Text Reference: p. 433

12. Discussing the clients follow-up dietary needs immediately after the surgery when the client is experiencing discomfort is an error in:

a.

Pacing

b.

Intonation

c.

Timing and relevance

d.

Denotative meaning

ANS: c

c. Discussing follow-up dietary needs immediately after surgery when the client is experiencing discomfort is an error in timing and relevance. The client is less likely to be able to pay attention and comprehend instruction when feeling pain, and immediately after surgery, discussing follow-up dietary needs would seem irrelevant.

a. Pacing has to do with the speed of conversation. This is not an example of an error in pacing.

b. Intonation is the tone of voice used. This is not an example of an error in intonation.

d. Denotative meaning is when a single word can have several meanings. This is not an example of an error in denotative meaning.

REF: Text Reference: p. 429

13. The nurse is aware of the clients zones of personal space when planning interactions. The zone of personal space and touch that extends the greatest amount from an individual is the:

a.

Personal zone

b.

Social zone

c.

Consent zone

d.

Vulnerable zone

ANS: b

b. The social zone extends the greatest amount from an individual in personal space and touch. It is a distance of 4 to 12 feet. Permission is not needed for touch in the social zone.

a. The personal zone is 18 inches to 4 feet.

c. The consent zone of touch requires permission.

d. The vulnerable zone is in the consent zone of touch. Because the vulnerable zone implies that special care is needed, permission is required.

REF: Text Reference: p. 430

14. Communication is used throughout the nursing process. In the evaluation phase, the nurse specifically uses communication to:

a.

Delegate activities to other staff members.

b.

Validate the clients health needs.

c.

Acquire verbal and nonverbal feedback.

d.

Document expected outcomes and planned interventions.

ANS: c

c. The nurse and client determine whether the plan of care has been successful by evaluating the client communication outcomes established during planning. This process involves acquiring verbal and nonverbal feedback.

a. Delegation is not the purpose of communication in the evaluation phase of the nursing process. Delegation is more likely to be used in the implementation phase of the nursing process.

b. Validation of the clients needs is not why the nurse specifically uses communication in the evaluation phase of the nursing process. Validation of the clients needs is often determined when data are gathered during the assessment phase of the nursing process.

d. Documenting expected outcomes and planned interventions is part of the planning phase of the nursing process, not the evaluation phase.

REF: Text Reference: p. 444

15. A number of variables may influence the clients communication with the health care team. Which of the following is an example of an interpersonal variable?

a.

Postoperative discomfort

b.

An extremely warm room

c.

A talkative roommate

d.

A loud television

ANS: a

a. Interpersonal variables are factors within both the sender and receiver that influence communication. An example of an interpersonal variable is postoperative discomfort.

b. An extremely warm room is an example of an environmental variable that may affect communication.

c. A talkative roommate is an example of an environmental variable that may affect communication because of the lack of privacy and distraction.

d. Noise, such as a loud television, is an example of an environmental variable that may affect communication.

REF: Text Reference: p. 428

16. The nurse is establishing a helping relationship with the client. In addressing the client, the nurse should:

a.

Use the clients first name.

b.

Touch the client right away to establish contact.

c.

Sit far enough away from the client.

d.

Knock before entering the clients room.

ANS: d

d. Common courtesy is part of professional communication. To practice courtesy, the nurse says hello and goodbye, knocks on doors before entering, and uses self-introduction. Knocking on doors is important in addressing the client.

a. Because using last names is respectful in most cultures, nurses usually use the clients last name in the initial interaction, and then use the first name if the client requests it.

b. Touching the client right away would not be an appropriate action in establishing a helping relationship. It would more likely be interpreted as invading the clients personal space.

c. Sitting far enough away from the client is important, in that the nurse should not enter the clients personal space when establishing a helping relationship. However, leaning toward the client conveys that the nurse is involved and interested in the client. Knocking on the door before entering the clients room would be the first step in addressing the client properly.

REF: Text Reference: p. 433

17. In using communication skills with clients, the nurse evaluates which response as being the most therapeutic?

a.

Why dont you stick to the special diet?

b.

I noticed that you didnt eat lunch. Is something wrong?

c.

I think you need to find another physician thats better than this one.

d.

We cant continue talking about your financial problems right now. Its time for your bath.

ANS: b

b. The nurse who is sharing an observation is using the most therapeutic response. Sharing observations often helps the client communicate without the need for extensive questioning, focusing, or clarification.

a. This is an example of a nontherapeutic response. It is asking for an explanation. Why questions can cause resentment, insecurity, and mistrust.

c. This is not a therapeutic response. It is giving a personal opinion.

d. Changing the subject is not therapeutic.

REF: Text Reference: p. 437, Text Reference: p. 438

18. Communication skills are adapted by the nurse for pediatric clients. What communication technique may be used most effectively with toddlers or preschoolers?

a.

Using analogies to explain health-related ideas

b.

Allowing manipulation of equipment to be used

c.

Moving quickly and minimizing contact to avoid distress

d.

Focusing on what other children have done

ANS: b

b. Allowing toddlers and preschoolers to touch and examine objects that will come in contact with them is an effective communication technique.

a. Toddlers and preschoolers are unable to understand analogies.

c. Sudden movements can be frightening. Children often prefer to make the first move in interpersonal contacts.

d. Focusing on what other children have done is not an effective communication technique for toddlers or preschoolers. Communication should be focused on the child.

REF: Text Reference: p. 443

19. Communication skills are adapted for clients with special needs. For a client with aphasia, the nurse may enhance communication by:

a.

Using visual cues

b.

Speaking loudly

c.

Using open-ended questions

d.

Using a speech therapist to communicate with the client

ANS: a

a. The nurse may enhance communication for a client with aphasia by using visual cues (e.g., words, pictures, and objects) when possible.

b. The nurse should not shout or speak too loudly to enhance communication with a person who has aphasia.

c. The nurse should ask simple questions that require yes or no answers to enhance communication with the client who has aphasia.

d. Using a speech therapist is not the primary way to enhance communication with a client who has aphasia. The nurse can use communication techniques to facilitate communication and to develop a helping relationship with the client. The speech therapist may help the client to learn new ways or to relearn how to communicate.

REF: Text Reference: p. 443

Copyright 2005 by Mosby, Inc. All rights reserved.

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