Chapter 8: Communication
A nurse enters a patient's room and examines the patient's intravenous (IV) fluids and cardiac monitor. When asked, "who are you?", which response by the nurse is most appropriate?
A) "I'm just the IV therapist checking your IV"
B) "I've been transferred to this division and will be caring for you"
C) "I'm sorry, my name is John Smith and I am your nurse"
D) "I am John Smith, your nurse, and I'll be caring for you until 11 pm"
D) "I am John Smith, your nurse, and I'll be caring for you until 11 pm"
A nurse is teaching first aid to counselors of a summer camp for children with asthma. This is an example of what aim of health teaching?
A) Promoting Health
B) Preventing Illness
C) Restoring Health
D) Facilitating Coping
B) Preventing Illness
The nursing assessment of a patient with a diagnosis of anorexia nervosa reveals the patient consumes a vegan diet of 700 calories daily and has lost 30 pounds in 4 months. The nurse's recommendation to meet with a nutritionist is the outcome of which process?
A) Clinical judgment
B) Nursing process
C) Clinical reasoning
D) Critical thinking
A) Clinical judgment
The development of clinical judgement requires intentional focus and a willingness to grow and change both personally and professionally. How can a nursing student best foster the development of clinical judgment?
A) Engaging in learning that only appeals to their preferred learning style
B) Focusing on knowledge acquisition that is straight-forward and clear
C) Developing a model for learning that integrates feedback and reflection
D) Focusing inward to develop emotional intelligence and communication skills
C) Developing a model for learning that integrates feedback and reflection
A nurse manager working in a hospital setting is researching the use of energy healing as an integrative care practice. Which patient would most likely benefit from this type of CHA?
A) One who is anxious about residual pain from cervical spine surgery
B) One who is experiencing abdominal discomfort
C) One who is experiencing chronic pain from diabetes
D) One who has frequent cluster headaches
A) One who is anxious about residual pain from cervical spine surgery
A nurse enters the room of a patient with cancer. The patient is crying and states, "I feel so alone". How will the nurse best communicate a therapeutic response?
A) The nurse stands at the patient's bedside and states, "I understand how you feel. My mother said the same thing when she was ill."
B) The nurse places a hand on the patient's arm and states "You feel so alone."
C) The nurse stands in the patient's room and asks, "Why do you feel so alone? Your wife has been here every day?"
D) The nurse holds the patient's hand and asks, "Tell me what feeling so alone is like for you?"
D) The nurse holds the patient's hand and asks, "Tell me what feeling so alone is like for you?"
A nurse is preparing a teaching plan for a patient with asthma on the use of an inhaler. What teaching method is most appropriate for this patient?
A) Demonstration
B) Lecture
C) Discovery
D) Panel Session
A) Demonstration
An oncology nurse is analyzing a patient's strengths and finds the patient is well educated, learns quickly, and is resilient. In which phase of the nursing process will the nurse use this information?
A) Diagnosing
B) Evaluating
C) Planning
D) Implementing
A) Diagnosing
Nursing students and those studying other health sciences are often engaged in competency-based education. What is the value of competency-based education?
A) It provides comprehensive skills checklists for students to check their progress and move on to other elements
B) It allows for student individualization based on their unique experience and preferences
C) It provides specific guidance on the expected level of performance that integrates knowledge, skills, abilities, and judgment
D) Like most other education models, it is a high-level way of thinking that is not related to clinical judgment
C) It provides specific guidance on the expected level of performance that integrates knowledge, skills, abilities, and judgment
A patient with chronic pain tells the nurse they are very tired and sleeping fitfully. What actions promoting sleep hygiene will the nurse suggest? SELECT ALL THAT APPLY.
A) Sleep with a night light on
B) Play soft, pleasing music
C) Perform a relaxation exercise
D) Establish a regular sleep-wake schedule
E) Minimize noise
B) Play soft, pleasing music
C) Perform a relaxation exercise
D) Establish a regular sleep-wake schedule
E) Minimize noise
A nurse notices a patient is walking to the bathroom with a stooped gait, facial grimacing, and grunting sounds. Based on these nonverbal cues, what action will the nurse take next?
A) Assess for pain and the need for analgesia
B) Ask the patient if they feel anxious
C) Offer to sit with the patient and listen to their feelings
D) Suggest the patient increase their fluid intake to prevent constipation
A) Assess for pain and the need for analgesia
A nurse is caring for a patient who is admitted to the hospital with traumatic injuries sustained in a motor vehicle accident. While hospitalized, the patient's spouse tells the patient that their house flooded, damaging their belongings. When the nurse notes that the patient is visibly upset by this news, the nurse suggests which type of counseling?
A) Long-term developmental
B) Short-term situational
C) Short-term motivational
D) Long-term motivational
B) Short-term situational
A nursing student is committed to providing thoughtful, person-centered care. Which nursing actions demonstrate this type of care? SELECT ALL THAT APPLY.
A) Assisting patients to select meals based on their cultural observances
B) Providing nursing care based on patients' needs and preferences
C) Documenting nursing interventions in the electronic health record
D) Reviewing fingerstick blood glucose levels with the primary nurse
E) Listening to a patient's concern for their ill significant other
A) Assisting patients to select meals based on their cultural observances
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B) Providing nursing care based on patients' needs and preferences
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E) Listening to a patient's concern for their ill significant other
A student nurse walks into a patient room, introduces themselves, and begins to complete a full head-to-toe assessment. The clinical faculty member enters the room, introduces themselves, and asks the student to step out of the room for a moment. The student meets the faculty member in the hallway and is asked to identify 15 cues or observations they noted during their initial contact with the patient and the patient's environment. Although the student is unable to reach 15 observations, the faculty guides the student to recognize the linen on the floor, old dinner tray on the windowsill, empty water pitcher, twisted oxygen tubing, the patient's pallor, and several other things requiring action. What is the value of engaging in this kind of activity with students in the clinical setting?
A) Developing situational awareness is important to risk prevention, timely implementation of interventions, and prioritizing actions
B) Managing cognitive load begins with systematically sorting mental images and immediately addressing pressing concerns
C) Nursing best practice requires that an environmental scan be completed and documented in the electronic health record (EHR)
D) Designing interventions that increase patient satisfaction is an essential focus for nurses when completing their initial assessments
A) Developing situational awareness is important to risk prevention, timely implementation of interventions, and prioritizing actions
A nurse in the pain management clinic is explaining complementary health approaches to a patient with severe back pain who is interested in holistic health. What approaches could the nurse include in the discussion? SELECT ALL THAT APPLY.
A) Acupressure or acupuncture
B) QI gong or tai chi
C) Minimally invasive surgery
D) Gentle yoga
E) Aromatherapy
A) Acupressure or acupuncture
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B) QI gong or tai chi
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D) Gentle yoga
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E) Aromatherapy
A nurse enters a patient's room and finds them vomiting bright red blood. After taking vital signs, the nurse communicates the event to the health care provider using the SBAR format. Which information will the nurse include in the "A" portion of the SBAR communication?
Electronic Health Record (EHR)
Past medical history: Peptic Ulcer. Bleeding disorder.
Vital Signs: T 98.8. HR 111. BP 98/50. SPO2 96%. RR 20
A) Admitted with peptic ulcer and bleeding disorder
B) Found vomiting in the bathroom
C) Anti-ulcer medication recommendation
D) Vital signs, oxygen saturation, bright red emesis
D) Vital signs, oxygen saturation, bright red emesis
A registered nurse acts as nurse coach to provide teaching to patients who are recovering from a stroke. Which statement directs the nurse in performing this role?
A) The nurse uses discovery to identify the patients' personal goals and create a plan that will result in change.
B) The nurse is the expert in providing teaching and education strategies to provide dietary and activity modifications.
C) The nurse becomes a mentor to the patients and encourages them to create their own fitness programs.
D) The nurse assumes an authoritative role to design the structure of the coaching session and support the achievement of patient goals.
A) The nurse uses discovery to identify the patients' personal goals and create a plan that will result in change
The nurse uses blended competencies when caring for patients in a rehabilitation facility. Which interventions reflect the use of cognitive skills? SELECT ALL THAT APPLY.
A) Monitoring for side effects of medications
B) Safely administering an injectable medication
C) Teaching a patient about diabetes and its management
D) Acting as witness by signing a surgical consent form
E) Helping a patient identify their progress in physical therapy
F) Comforting a patient who has received bad news
A) Monitoring for side effects of medications
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C) Teaching a patient about diabetes and its management
A nursing program uses Tanner's Clinical Judgment Model, a research-based model that accounts for differences in the patient, environment, and individual student nurse. What makes Tanner's reflection step unique?
A) The emphasis is on noticing, interpreting, and responding: reflection is less important
B) Reflection occurs both in-action (in the moment) and on-action (after the situation)
C) Reflection occurs first in the model that is focused on rapid decision making and patient outcomes
D) Reflection is the last step in a linear model and is designed to minimize bias in the student nurse
B) Reflection occurs both in-action (in the moment) and on-action (after the situation)
A nurse works in a practice with naturopathic health care providers. What nursing actions would this nurse perform? SELECT ALL THAT APPLY.
A) Treating the symptoms of the disease
B) Providing patient education
C) Focusing on treating individual body systems
D) Suggesting interventions to prevent illness
E) Incorporating the healing power of nature
F) Encouraging patients' responsibility for their own health
B) Providing patient education
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D) Suggesting interventions to prevent illness
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E) Incorporating the healing power of nature
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F) Encouraging patients' responsibility for their own health
A patient states, "I have been experiencing complications of diabetes." What question will the nurse use to elicit additional information?
A) "Do you take two injections of insulin to prevent complications?"
B) "Are you using diet and exercise to help regulate your blood sugar?"
C) "Have you been experiencing the complications of neuropathy?"
D) "Can you tell me about the complications you've experienced?"
D) "Can you tell me about the complications you've experienced?"
A nurse develops a contractual agreement with a morbidly obese patient to achieve optimal weight goals. Which statement best describes the nature of this agreement?
A) This agreement forms a legal bond between the two of us to achieve your weight goals
B) This agreement will motivate the two of us to do what is necessary to meet your weight goals
C) This agreement will help us determine what learning outcomes are necessary to achieve your weight goals
D) This agreement will limit the scope of the teaching session and make stated weight goals more attainable
B) This agreement will motivate the two of us to do what is necessary to meet your weight goals
A nurse uses critical thinking skills to develop the care plan for an older adult with dementia awaiting placement in a long-term care facility. Which statements describe characteristics of the critical thinking used by nurses engaged in clinical reasoning? SELECT ALL THAT APPLY
A) Functions independently of nursing standards, ethics, and state practice acts
B) Based on the principles of the nursing process, problem solving, and the scientific method
C) Driven by patient, family, and community needs as well as nurses' needs to give competent, efficient care
D) Avoids designs to compensate for problems created by human nature, such as medication errors
E) Constantly reevaluating, self-correcting, and striving for improvement
F) Focuses on the big picture rather than identifying the key problems, issues, and risks involved with patient care
B) Based on the principles of the nursing process, problem solving, and the scientific method
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C) Driven by patient, family, and community needs as well as nurses' needs to give competent, efficient care
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E) Constantly reevaluating, self-correcting, and striving for improvement
Nursing programs prepare students for safe clinical practice. As a student nurse, why is a basic understanding of NCSBN's Clinical Judgement Measurement Model (CJMM) important? SELECT ALL THAT APPLY.
A) Successful completion of the NCLEX is required for professional licensure in the United States
B) Nurse educators use the CJMM model and and NCLEX test plans to develop exam questions
C) Students should be intimately familiar with theoretical models of education to answer questions
D) Appreciation of the core principles assists students in understanding the structure and intent of nursing exams
E) There is overlap in the core components of clinical judgment models, measurement models, and the nursing process
A) Successful completion of the NCLEX is required for professional licensure in the United States
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B) Nurse educators use the CJMM model and and NCLEX test plans to develop exam questions
AND
D) Appreciation of the core principles assists students in understanding the structure and intent of nursing exams
AND
E) There is overlap in the core components of clinical judgment models, measurement models, and the nursing process
A nurse cares for patients in a chiropractic office. What patient education would the nurse perform? SELECT ALL THAT APPLY.
A) Proper application of heat or ice
B) Explaining the purpose of electrical stimulation
C) Teaching relaxation techniques
D) Educating about a prescription medication
E) Teaching before an invasive procedure
F) Using safety with dietary supplements
A) Proper application of heat or ice
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B) Explaining the purpose of electrical stimulation
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C) Teaching relaxation techniques
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F) Using safety with dietary supplements