Chapter 21 Communication & Therapeutic Relationships

Chapter 21  Communication & Therapeutic Relationships

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. Which form of communication is the nurse using when interviewing the patient during the admission health history and physical assessment?
a)
Small group
b)
Interpersonal
c)
Group
d)
Intrapersonal

ANS: B
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.

Difficulty: Moderate
Nursing Process: Assessment
Client Need: PSI
Cognitive Level: Comprehension

PTS: 1

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, 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 goals is most appropriate for the nurse to establish when returning to the patient? The patient will:
a)
Explain the reason for his incongruent statements
b)
Engage in diversional activities to cope with stress
c)
Express his concerns to his primary care provider
d)
Discuss his concerns and fears with the nurse

ANS: D
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.

Difficulty: Moderate
Nursing Process: Planning
Client Need: PSI
Cognitive Level: Application

PTS: 1

3. The nurse is preparing a patient for a computed tomography (CT) scan of the abdomen. Which statement by the nurse is best? Assume all are true.
a)
“You will need to remain NPO for the 8 hours prior to your CT scan.”
b)
“You cannot have anything to eat or drink for 8 hours before your test.”
c)
“You will need to be NPO and drink this contrast medium before your test.”
d)
“You may need to void before you go down to the department for your CT scan.”

ANS: B
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.

Difficulty: Moderate
Nursing Process: Interventions
Client Need: PSI
Cognitive Level: Application

PTS: 1

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?
a)
Middle-aged woman just diagnosed with terminal lung cancer
b)
Middle-aged man experiencing the acute phase of myocardial infarction
c)
Older adult admitted with dehydration with a history of dementia
d)
Young adult recovering from surgery for a ruptured appendix who will be discharged tomorrow

ANS: C
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 surgery for a ruptured appendix, and with all age groups. However, the nurse should always be conscious of the situation, environment, and receptivity of the patient.

Difficulty: Moderate
Nursing Process: Interventions
Client Need: PSI
Cognitive Level: Analysis

PTS: 1

5. The nurse manager of the medical intensive care unit formed a group to help her staff cope with stress more effectively. Which of the comments by group members will lead the manager to evaluate the group as successful?
a)
“This was a good idea to form a group; I’ve been wanting to get to know some of the people from the other shifts.”
b)
“It really helps me to share feelings about how hard it is to see pain and suffering every day.”
c)
“I now have a group to help me when I need to work through situations at home causing personal stress.”
d)
“It’s nice to have a chance to get away from the unit and talk on a regular basis.”

ANS: B
Work-related social support groups assist members of a profession to cope with the stress associated with their work. The focus of the group is to share feelings about the stress of the work environment. Although this may also be an opportunity to meet other staff members, get away from the unit, or share personal and family problems, these are not the primary focus of the group.

Difficulty: Moderate
Nursing Process: Evaluation
Client Need: PSI
Cognitive Level: Application

PTS: 1