Chapter 20 Communication & Therapeutic Relationships

Chapter 20  Communication & Therapeutic Relationships

Multiple Choice

Identify the choice that best completes the statement or answers the question.

TB20-1

____ 1. Which form of communication is the nurse using when interviewing the patient during the admission health history and physical assessment?
1)
Small group

2) Interpersonal 3)
Group
4) Intrapersonal

ANS: 2
The nurse uses interpersonal communication when interviewing the patient about his health history during the admission assessment. Small-group communication occurs when a person engages in an exchange of ideas with two or more people at the same time. Group communication is interaction that occurs among several people. Intrapersonal communication is conscious internal dialogue.

PTS: 1 DIF: Moderate REF: p. 464
KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Comprehension

____ 2. During admission to the unit, a patient states, “I’m not worried about the results of my tests. I’m sure I’ll be all right.” As he observes the patient, the nurse notes that the patient is shaky and tearful and does not make eye contact. Unfortunately, the nurse is called away to an emergency before he has time to complete this discussion. Which of the following actions is most appropriate for the nurse to establish when returning to the patient? Patient will

1)
Explain the reason for his incongruent statements 2)
Engage in diversional activities to cope with stress 3)
Express his concerns to his primary care provider 4)
Discuss his concerns and fears with the nurse

ANS: 4

Treas Fundamentals Test Bank Ch. 20

TB20-2

The nurse has observed a mismatch between verbal and nonverbal communication. Unfortunately, an emergency has required the nurse to leave the patient. To resolve this mismatch, the nurse will set a goal to have the patient discuss his concerns and fears at their next interaction. It is inappropriate to ask the patient to explain why his verbal message did not match the nonverbal message because this will inhibit further conversation. It may be appropriate to have the patient discuss his concerns with his primary care provider; however, we do not have enough information to suggest this course of action. For example, if the patient is upset about some other matter, this action would not be appropriate. Similarly, it is not appropriate to suggest diversional activities until the reason for the mismatch between his words and behavior is identified.

PTS: 1 DIF: Moderate REF: p. 476
KEY: Nursing process: Planning | Client need: PSI | Cognitive level: Application

____ 3. The nurse is preparing a patient for a computed tomography (CT) scan of the abdomen. Which statement by the nurse is best (all contain correct information)?
1)
“You will need to remain NPO for the 4 hours prior to your CT scan.”

2)
“You cannot have anything to eat or drink for 4 hours before your test.”
3)
“You will need to be NPO and drink this contrast media before your test.”
4)
“You may need to void before you go down to the department for your CT scan.”

ANS: 2
Telling the patient that he cannot have anything to eat or drink for a specific time before his test is the best statement. It uses terms that the patient can understand. The other options use medical jargon that many patients may not understand.

PTS: 1 DIF: Moderate REF: p. 465
KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Application

____ 4. The nurse is assigned to the care of the following patients. In planning nursing care, the nurse knows she should use touch cautiously, especially when communicating with which patient?
1)

Middle-aged woman just diagnosed with terminal lung cancer
2)
Middle-aged man experiencing the acute phase of myocardial infarction 3)

Older adult with a history of dementia admitted for dehydration 4)
Young adult in the rehabilitative phase after arthroscopic surgery

Treas Fundamentals Test Bank Ch. 20

TB20-3

ANS: 3
The nurse should use touch especially cautiously when communicating with a person who suffers from impaired mental health, such as dementia, because the patient may have difficulty interpreting the meaning of touch. In general, touch can be used with most patients, such as patients with cancer, an acute MI, or general orthopedic surgery, and with all age groups. However, the nurse should always be conscious of the situation, environment, and receptivity of the patient.

PTS: 1 DIF: Moderate REF: p. 467
KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Analysis