Chapter 14 Communicating With Patients and Co-Workers

Chapter 14  Communicating With Patients and Co-Workers

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The instructor asks the nursing student to define therapeutic communication. The student’s most appropriate response is that therapeutic communication refers to:
a.
psychotherapy.
b.
social communication.
c.
developing a trusting relationship.
d.
emotional commitment to another.

ANS: C
The purpose of therapeutic communication is to establish a trusting relationship. The RN should try to understand with sensitivity. Therapeutic communication and the establishment of the therapeutic relationship require empathy, genuineness, positive regard, and self-awareness. Psychotherapy, social communication, and emotional commitment to another are not definitions of therapeutic communication.

DIF: Cognitive Level: Knowledge REF: Page 211
OBJ: Define therapeutic communication. TOP: The RN as Communicator
MSC: NCLEX: Psychosocial Integrity

2. An example of a communication blocker is:
a.
silence.
b.
eye contact.
c.
advising.
d.
clarifying.

ANS: C
Communication blockers tend to stop conversation and build mistrust. Giving advice fosters dependency and conveys to the patient that the nurse knows best. Silence, eye contact, and clarifying are techniques that enhance (facilitate) communication.

DIF: Cognitive Level: Knowledge REF: Pages 212-213
OBJ: State four techniques that can hinder communication. TOP: The RN as Communicator
MSC: NCLEX: Psychosocial Integrity

3. The nurse is caring for a patient 2 hours after a left above-the-knee amputation. The patient states, “My left leg is really hurting, and that medicine you gave me earlier didn’t help.” Which response is the most therapeutic, if made by the nurse?
a.
“That’s impossible!”
b.
“You’ll have to talk to your doctor.”
c.
“Keep your chin up.”
d.
“I will call your physician.”

ANS: D
“I will call your physician” is validating the patient’s perception of pain. “That’s impossible!” minimizes the patient’s feelings. “You’ll have to talk to your doctor” may cause the patient to feel rejected by the nurse. Making a stereotypical comment such as “Keep your chin up” is never therapeutic.

DIF: Cognitive Level: Application REF: Page 212
OBJ: Apply therapeutic communication skills to the clinical setting.
TOP: The RN as Communicator MSC: NCLEX: Psychosocial Integrity

4. The RN is documenting the patient’s complaint of pain rated 6 on a scale of 0 to 10. Which chart entry would be the most appropriate, if made by the nurse?
a.
Pt. complaining of pain. MD notified.
b.
Pt complaining of pain rated at 6 on a scale of 0-10, states “My left leg is really hurting.” Pt. grimacing, voice elevated. MD notified.
c.
Pt. complaining of pain rated at 6 on a scale of 0-10. Appears to be in pain. MD notified.
d.
Pt. complaining of pain rated 6. Wants more pain medication; appears to be drug-seeking. MD notified.

ANS: B
With “Pt complaining of pain rated at 6 on a scale of 0-10, states ‘My left leg is really hurting.’ Pt. grimacing, voice elevated. MD notified,” the entry contains the problem, the assessment, subjective comments, observations, and the plan. The entry “Pt. complaining of pain. MD notified,” does not define the patient’s pain. The entries “Pt. complaining of pain rated at 6 on a scale of 0-10. Appears to be in pain. MD notified” and “Pt. complaining of pain rated 6. Wants more pain medication; appears to be drug-seeking. MD notified” reflect opinions of the nurse.

DIF: Cognitive Level: Application REF: Page 231
OBJ: Apply the principles of written documentation as a form of communication.
TOP: The RN as Communicator
MSC: NCLEX: Safe, Effective Care Environment: Management of Care

5. The RN has assigned the nursing assistant (NA) a task. The NA becomes angry and begins yelling at the RN. What is the best approach for the RN to take?
a.
Tell the NA that you will let her leave early if she will do this for you.
b.
Ignore her and reassign the task.
c.
Meet with the NA to explore his or her feelings and the reason for resistance.
d.
Call the nursing supervisor and report the NA for insubordination.

ANS: C
Meeting with the NA to explore the reason for resisting the request is the best approach in order to address the underlying issue. Telling the NA that you will let her leave early if she will do this for you and ignoring her and reassigning the task are negative reinforcements and will likely perpetuate the behavior. Calling the nursing supervisor and reporting the NA for insubordination should occur if the RN has been unsuccessful in resolving the problem.

DIF: Cognitive Level: Application REF: Page 228
OBJ: Apply the principles of effective communication to the clinical setting.
TOP: The RN as Communicator
MSC: NCLEX: Safe, Effective Care Environment: Management of Care