ch.26 Pre-Test

Chapter 26 Pre TestGOMEZ,ANGELICASubmitted

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Grade: 21.4% Attempt Number:

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1.The nurse is involved in a self-help group on women’s health. What is one of the main functions of the nurse’s role?a. To buffer the stress within the group.b. To give information to the group in order to teach about women’s health.c. Tp participate as a member of the self-help group when appropriate.d. To lend the group an air of professionalism.

Grade:0User Responses:d.To lend the group an air of professionalism.Feedback:a.Rationale: A self-help group is a small, voluntary organization. Giving information is a role of the nurse in a teaching group. Buffering stress is a nurse’s role in work-related social groups. The “adding professionalism” choice is a random statement.

Cognitive Level: ComprehensionNursing Process: ImplementationClient Need: Psychosocial Integrity2. A nurse tells a client who is struggling with cancer pain, “It is normal to feel

frustrated about the discomfort.” Which of the following is most representative of the skills associated with the working phase of the helping relationship?a. Confrontationb. Concretenessc. Genuinenessd. Respect

Grade: 0User Responses: b.ConcretenessFeedback: a.Rationale: Respect is correct because the nurse is validating

the client’s feeling. It is not genuineness because the nurse is giving information versus making a personal statement. Concreteness is the nurse assisting the client by giving specific examples rather than speaking in generalities. Rather than being confrontational by pointing out discrepancies between thoughts, feelings, and actions that inhibit the client’s self-understanding or exploration of specific areas, the nurse is being supportive by respecting the client’s feelings.

Cognitive Level: ApplicationNursing Process: ImplementationClient Need: Psychosocial Integrity

3. This "Ranking" question type is not supported in printed tests

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4. A client expresses anxiety about a surgical procedure. What would be the most appropriate therapeutic communication technique to use in this situation?(Select all that apply.)

Note: Credit will be given only if all correct choices and no incorrect choices are selected.a. Restating or paraphrasing the comment made by the clientb. Probing and rejecting the comment made by the clientc. Using open-ended questionsd. Offering unwarranted reassurance

Grade: 0User Responses: c.Using open-ended questionsFeedback: a.Rationale: Therapeutic communication techniques facilitate

communication and focus on the client's concerns. The other choices are considered barriers to communication.


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5. In which of the following situations would the therapeutic communication of “touch” be appropriate?a. When an upset spouse is alone and the client has just expired.b. When a family member is making inappropriate comments to the nurse.c. Touch is never appropriate in the nursing profession.d. When a young male client asks a young student nurse for a hug.

Grade: 0User Responses: c.Touch is never appropriate in the nursing profession.Feedback: a.Rationale: There are situations when appropriate use of touch

reinforces caring feelings. However, the nurse must be sensitive to the differences in attitudes and practices of clients and self. The other answers are not acceptable uses of touch.Cognitive Level: ApplicationNursing Process: ImplementationClient Need: Psychosocial Integrity

6. While assessing a postoperative client for pain, the nurse notices the client is holding the surgical site and making facial grimaces. However, the client claims not to be hurting. What part of the communication process needs to be further clarified?a. Senderb. Receiverc. Feedbackd. Message

Grade: 0User Responses: a.SenderFeedback: a.Rationale: The sender is a person or group who wishes to

convey a message to another. The receiver is the listener. The next component is the message itself. Feedback is the message that the receiver returns to the sender. When the spoken message and the nonverbal message are incongruent, the nurse needs more information in order to choose an intervention.

Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Physiological Integrity

7. The nurse has met a new client who has had a stroke and is preparing to go home. What phase of the relationship are they in if the client claims not to need assistance with any aspect of personal care?a. Preinteraction phaseb. Working phasec. Introductory phased. Exploring phase

Grade: 0User Responses: a.Preinteraction phaseFeedback: a.Rationale: During the initial parts of the introductory phase,

the client may display some resistant behaviors that inhibit

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involvement, cooperation, or change. It may be because of difficulty in asking for assistance. The preinteraction phase is similar to the planning stage before an interview. Exploring is a stage in the working phase in which the nurse helps the client to explore thoughts, feelings, and actions. During the working phase, the nurse and client appreciate their uniqueness and care about each other. Caring is sharing deep and genuine concern about the welfare of another person.

Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Psychosocial Integrity

8. A client has difficulty understanding the dressing changes for his mother while she is at home. The client asks the nurse to work with him and demonstrate the procedure. He then wants the nurse to watch him perform the procedure to make sure he did it correctly. This is an example of the client being:a. Assertive.b. Aggressive.c. Active.d. Passive.

Grade: 0User Responses: b.Aggressive.Feedback: a.Rationale: People who use assertive communication are

honest, direct, and appropriate while being open to ideas and respecting the rights of others.

Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Safe and Effective Care Environment

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9. A client is discharged to a nursing home with a colostomy. The client has been taught how to manage the colostomy care and has returned demonstration. The doctor has given her permission to change her own apparatus to give her autonomy. The charge nurse does not agree with this order, and requires the staff to care for the colostomy care. The client says nothing because she feels that she is in a nursing home, so the staff knows what is best. This is an example of:a. Passiveness.b. Aggressiveness.c. Passive-submissive behavior.d. Submissiveness.

Grade: 0User Responses: b.Aggressiveness.Feedback: a.Rationale: When people use a submissive communication

style, they meet the demands and requests of others without regard to their own feelings and needs, as they believe their own feelings are unimportant.

Cognitive Level: KnowledgeNursing Process: AssessmentClient Need: Psychosocial Integrity

10. One feature of an effective group is:a. It is open and not considered confidential.b. It exists to help people achieve goals.c. It has a hierarchy of power.d. Members are relieved when it is terminated.

Grade: 0User Responses: d.Members are relieved when it is terminated.Feedback: a.Rationale: Groups exist to assist others to achieve goals that

would be unattainable by individual effort alone.

Cognitive Level: KnowledgeNursing Process: AssessmentClient Need: Health Promotion and Maintenance

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11. Messages can be conveyed via several different mediums. Talking face-to-face is always the preferred and most effective channel.a.True b.False

Grade: 1User Responses: b.FalseFeedback: a.Rationale: It is important for the channel to be appropriate for

the message and it should help make the intent of the message clearer. Talking face-to-face with a person may be more effective in some instances than telephoning or writing a message. Recording messages on tape or communicating by radio or television may be more appropriate for larger audiences. Written communication is often appropriate for long explanations or for a communication that needs to be preserved. The nonverbal channel of touch is often highly effective.

Cognitive Level: KnowledgeNursing Process: ImplementationClient Need: Psychosocial Integrity

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12. The nurse is using active listening skills, building rapport, and demonstrating a nonjudgmental attitude and nonreactive behaviors. Based on this information, with which populations is the nurse communicating?(Select all that apply.)

Note: Credit will be given only if all correct choices and no incorrect choices are selected.a. Adolescentsb. Infantsc. School-age childrend. Toddlers

Grade: 0User Responses: d.ToddlersFeedback: a.Rationale: The ability to communicate is related to the

development of thought processes, the presence of intact sensory and motor systems, and the extent and nature of an individual's opportunities to practice communication skills. The nurse needs to develop a rapport with each group in order to effectively communicate. The nurse would communicate with infants nonverbally and with a gentle voice that is soothing.

Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Health Promotion and Maintenance

13. When a client is discharged from the hospital with a new diagnosis of diabetes mellitus I, the diabetic nurse educator usually works with the client and family. When the client gets home, the client should continue with:a. A growth group.b. A therapy group.c. A self-help group.d. A teaching group.

Grade: 0User Responses: c.A self-help group.Feedback: a.Rationale: The major purpose of a teaching group is to impart

information to the participants.

Cognitive Level: KnowledgeNursing Process: PlanningClient Need: Health Promotion and Maintenance

14. Groups that work toward self-understanding, more satisfactory ways of handling stress, and changing patterns of behavior toward health are called:a. Therapy groups.b. Self-help groups.c. Growth groups.d. Teaching groups.

Grade: 0

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User Responses: b.Self-help groups.Feedback: a.Rationale: Therapy groups work toward self-understanding,

more satisfactory ways of handling stress, and changing patterns of behavior toward health.


15. An example of a work-related social support group is:a. Weight Watchers.b. The American Nurses Association.c. A political organization.d. Alcoholics Anonymous.

Grade: 1User Responses: b.The American Nurses Association.Feedback: a.Rationale: The American Nurses Association is a type of group

that nurses would participate in that is related to their professional career.


16. A feature of a healthy group is that it:a. Helps people achieve goals.b. Is open and not considered confidential.c. Has a hierarchy. d. Can be a relief when terminated.

Grade: 1User Responses: a.Helps people achieve goals.Feedback: a.Rationale: Groups exist to assist others to achieve goals that

would be unattainable by individual effort alone.


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17. Which of the following is a characteristic of an effective group?a. Disagreements are ignored.b. Reasons for disagreements are examined.c. Mistakes are feared rather than accepted.d. The leader claims full credit for the achievement of goals.

Grade: 1User Responses: b.Reasons for disagreements are examined.Feedback: a.Rationale: In an effective group, members contribute toward

the achievement of goals and maintain cohesion. In ineffective groups, leadership claims credit for accomplishments, members are afraid of making mistakes, and disagreements are ignored.

Cognitive Level: ApplicationNursing Process: AssessmentClient Need: Psychosocial Integrity

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18. An effective group is characterized by:a. Communication, decision making, and power.b. A careful examination of the reasons for disagreements, a fear of conflict, and

voluntary commitment. c. An authoritarian style, comments focused on personal characteristics, and criticism

that may be destructive.d. A lack of priority for feelings, being closed, and being misunderstood.

Grade: 1User Responses: a.Communication, decision making, and power.Feedback: a.Rationale: Effective groups have many attributes. Three

examples are communication, decision making, and power.

Cognitive Level: KnowledgeNursing Process: EvaluationClient Need: Health Promotion and Maintenance

19. Throughout the day, the nurse uses many styles of communication. Which of the following are assertive in nature?(Select all that apply.)

Note: Credit will be given only if all correct choices and no incorrect choices are selected.a. "I really wish that you told me about the changes you had noted with the client while

walking the client to the bathroom. It is important for me to know as soon as you notice a change so that I can further assess the client at that point."

b. “You didn’t order a diet for the client after the client's diagnostic test.”c. “I am concerned about the fluctuation in the client's blood pressure since the client

started taking the new medication.”d. “You didn’t record the client's blood pressure for the past 24 hours? Why not? What

do you think could happen?”

Grade: 0User Responses: a."I really wish that you told me about the changes you had noted

with the client while walking the client to the bathroom. It is important for me to know as soon as you notice a change so that I can further assess the client at that point."

Feedback: a.Rationale: The "I" statements encourage discussion. Concern is expressed about the client's blood pressure and is correlated with an event. Concern is also expressed about a missed opportunity to assess the client when a change was noted by the caregiver. Pointing out that the primary health provider did not order food for the client may be taken as an aggressive statement, especially if the tone is accusative. Many emotions may be expressed by the nurse (surprise, anger, frustration, disbelief, etc.) as the nurse aggressively questions the caregiver about the omitted blood pressure readings.

Cognitive Level: AnalysisNursing Process: ImplementationClient Need: Psychosocial Integrity

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20. The older client asks the primary care provider if it is necessary to move into an assisted living facility instead of living alone. The primary care provider tells the client, "If you were my parent, I would tell you to go into the assisted living facility because your meals would be cooked for you and you would not have to clean anything." The primary care provider is demonstrating what type of barrier to communication?a. Challengingb. Stereotypingc. Being defensived. Giving common advice

Grade: 0User Responses: b.StereotypingFeedback: a.Rationale: Giving common advice is telling the client what to

do. Such responses deny the client’s right to be an equal partner. Stereotyping negates the uniqueness of an individual. Being defensive prevents the client from expressing true concerns. Challenging responses indicate that the physician is not considering the client’s feelings.


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21. The nurse is communicating with a primary care provider about medical interventions prescribed for a client. Which of the following statements is most representative of a collaborative nurse-physician relationship?a. “Excuse me. I think we need to talk about the client's blood pressure.”b. “That new medication you prescribed for the client is ineffective.”c. “I am worried about the client's blood pressure. It is not decreasing even with the new

antihypertensive medication.”d. “Can we talk about the client?”

Grade: 0User Responses: b.“That new medication you prescribed for the client is

ineffective.”Feedback: a.Rationale: “I am worried about the client's blood pressure. It is

not decreasing even with the new antihypertensive medication” uses an “I” statement, which is assertive communication and is clear and direct. The message includes only the necessary information. “That new medication you prescribed for the client is ineffective” contains inflammatory language (“ineffective” and “you prescribed”). “Can we talk about the client?” and “Excuse me. I think we need to talk about the client's blood pressure” do not provide the health care provider with specific information and could stimulate defensive behaviors.

Cognitive Level: AnalysisNursing Process: AssessmentClient Need: Safe and Effective Care Environment

22. A 19-year-old student has had a breast biopsy and is nervous about the results. The resident physician peeks into her room and says, “The biopsy is negative.” The nurse finds the student in her room sobbing. What is the nurse’s best response to this situation?a. “What did the physician tell you?”b. “You seem upset. Do you want to talk to me about the test results?”c. “Why are you crying with such good news?”d. “The term ‘negative’ in this case is good!”

Grade: 1User Responses: b.“You seem upset. Do you want to talk to me about the test

results?”Feedback: a.Rationale: The physician, in delivering important news to the

client, should have taken time to sit with her to discuss the results of the test. In telling the client that the test was “negative,” the physician did not clarify what “negative” actually meant. Using medical jargon without an explanation can lead to misinterpretation of the message by the client. The nurse does not know specifically what the client is sobbing about and asks the client an open-ended question so the client can talk.

Cognitive Level: ComprehensionNursing Process: PlanningClient Need: Psychosocial Integrity

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23. The nurse is administering an enema to a client with a questionable gastrointestinal blockage. The nurse is in what type of the client's personal space?a. Intimateb. Personalc. Publicd. Social

Grade: 0User Responses: d.SocialFeedback: a.Rationale: Intimate-distance communication is characterized

by body contact and heightened sensations of body heat and smell. Personal space is less overwhelming than intimate space. Social-distance and public-distance communication take place within personal space greater than 4 feet.

Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Physiological Integrity

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24. The nurse is starting preoperative teaching when the client receives a phone call from work. When the nurse resumes teaching, the client is visibly upset. The most therapeutic initial approach is to:a. Encourage the client to verbalize concerns and feelings, and then do health teaching

when the client is able to listen.b. Tell the client that it is important to focus on the preoperative teaching so that

recovery will be faster.c. Reassure the client that whatever is happening at work can be dealt with in the

workplace.d. Encourage the client to do problem solving.

Grade: 0User Responses: b.Tell the client that it is important to focus on the preoperative

teaching so that recovery will be faster.Feedback: a.Rationale: When clients are anxious and upset, they have

difficulty focusing, especially on new information. The nurse needs to prioritize the client’s presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Since the nurse is unaware of the issue and is not knowledgeable of the client’s work situation, it is false reassurance to tell the client that the matter can be handled at work. This also belittles the client’s independence and self-efficacy, as does recommending problem solving.


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Activity Name: Chapter 26 Pre Test

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1. c. Tp participate as a member of the self-help group when appropriate.Learning Objective:26-3. Describe four phases of the helping relationship.Feedback:Correct: Rationale: A self-help group is a small, voluntary organization. Giving information is a role of the nurse in a teaching group. Buffering stress is a nurse’s role in work-related social groups. The “adding professionalism” choice is a random statement.

Cognitive Level: ComprehensionNursing Process: ImplementationClient Need: Psychosocial IntegrityIncorrect: Rationale: A self-help group is a small, voluntary organization. Giving information is a role of the nurse in a teaching group. Buffering stress is a nurse’s role in work-related social groups. The “adding professionalism” choice is a random statement.



Cognitive Level: ComprehensionNursing Process: ImplementationClient Need: Psychosocial IntegrityHints:

2. d. RespectLearning Objective:26-3. Describe four phases of the helping relationship.Feedback:Correct: Rationale: Respect is correct because the nurse is validating the client’s feeling. It is not genuineness because the nurse is giving information versus making a personal statement. Concreteness is the nurse assisting the client by giving specific examples rather than speaking in generalities. Rather than being confrontational by pointing out discrepancies between thoughts, feelings, and actions that inhibit the client’s self-understanding or exploration of specific areas, the nurse is being supportive by respecting the client’s feelings.

Cognitive Level: ApplicationNursing Process: ImplementationClient Need: Psychosocial IntegrityIncorrect: Rationale: Respect is correct because the nurse is validating the client’s feeling. It is not genuineness because the nurse is giving information versus making a personal statement. Concreteness is the nurse assisting the client by giving specific examples rather than speaking in

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generalities. Rather than being confrontational by pointing out discrepancies between thoughts, feelings, and actions that inhibit the client’s self-understanding or exploration of specific areas, the nurse is being supportive by respecting the client’s feelings.

Cognitive Level: ApplicationNursing Process: ImplementationClient Need: Psychosocial IntegrityIncorrect: Rationale: Respect is correct because the nurse is validating the client’s feeling. It is not genuineness because the nurse is giving information versus making a personal statement. Concreteness is the nurse assisting the client by giving specific examples rather than speaking in generalities. Rather than being confrontational by pointing out discrepancies between thoughts, feelings, and actions that inhibit the client’s self-understanding or exploration of specific areas, the nurse is being supportive by respecting the client’s feelings.

Cognitive Level: ApplicationNursing Process: ImplementationClient Need: Psychosocial IntegrityIncorrect: Rationale: Respect is correct because the nurse is validating the client’s feeling. It is not genuineness because the nurse is giving information versus making a personal statement. Concreteness is the nurse assisting the client by giving specific examples rather than speaking in generalities. Rather than being confrontational by pointing out discrepancies between thoughts, feelings, and actions that inhibit the client’s self-understanding or exploration of specific areas, the nurse is being supportive by respecting the client’s feelings.

Cognitive Level: ApplicationNursing Process: ImplementationClient Need: Psychosocial IntegrityHints:

3. This "Ranking" question type is not supported in printed tests Learning Objective:

Feedback:

Hints:

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4. c. Using open-ended questions and a.Restating or paraphrasing the comment made by the clientLearning Objective:26-6. Discuss how nurses use communication skills in each phase of the nursing process.

Feedback:Correct: Rationale: Therapeutic communication techniques facilitate communication and focus on the client's concerns. The other choices are considered barriers to communication.


5. a. When an upset spouse is alone and the client has just expired.Learning Objective:26-6. Discuss how nurses use communication skills in each phase of the nursing process.

Feedback:Incorrect: Rationale: There are situations when appropriate use of touch reinforces caring feelings. However, the nurse must be sensitive to the differences in attitudes and practices of clients and self. The other answers are not acceptable uses of touch.

Cognitive Level: ApplicationNursing Process: ImplementationClient Need: Psychosocial IntegrityIncorrect: Rationale: There are situations when appropriate use of touch reinforces caring feelings. However, the nurse must be sensitive to the differences in attitudes and practices of clients and self. The other answers are not acceptable uses of touch.Cognitive Level: ApplicationNursing Process: ImplementationClient Need: Psychosocial IntegrityCorrect: Rationale: There are situations when appropriate use of touch reinforces caring feelings. However, the nurse must be sensitive to the differences in attitudes and practices of clients and self. The other answers are not acceptable uses of touch.

Cognitive Level: ApplicationNursing Process: ImplementationClient Need: Psychosocial IntegrityIncorrect: Rationale: There are situations when appropriate use of touch reinforces caring feelings. However, the nurse must be sensitive to the differences in attitudes and practices of clients and self. The other answers are not acceptable uses of touch.


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6. d. MessageLearning Objective:26-6. Discuss how nurses use communication skills in each phase of the nursing process.

Feedback:Incorrect: Rationale: The sender is a person or group who wishes to convey a message to another. The receiver is the listener. The next component is the message itself. Feedback is the message that the receiver returns to the sender. When the spoken message and the nonverbal message are incongruent, the nurse needs more information in order to choose an intervention.

Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Physiological IntegrityIncorrect: Rationale: The sender is a person or group who wishes to convey a message to another. The receiver is the listener. The next component is the message itself. Feedback is the message that the receiver returns to the sender. When the spoken message and the nonverbal message are incongruent, the nurse needs more information in order to choose an intervention.

Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Physiological IntegrityCorrect: Rationale: The sender is a person or group who wishes to convey a message to another. The receiver is the listener. The next component is the message itself. Feedback is the message that the receiver returns to the sender. When the spoken message and the nonverbal message are incongruent, the nurse needs more information in order to choose an intervention.

Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Physiological IntegrityIncorrect: Rationale: The sender is a person or group who wishes to convey a message to another. The receiver is the listener. The next component is the message itself. Feedback is the message that the receiver returns to the sender. When the spoken message and the nonverbal message are incongruent, the nurse needs more information in order to choose an intervention.

Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Physiological IntegrityHints:

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7. c. Introductory phaseLearning Objective:26-8. Differentiate major characteristics between assertive and nonassertive communication.Feedback:Correct: Rationale: During the initial parts of the introductory phase, the client may display some resistant behaviors that inhibit involvement, cooperation, or change. It may be because of difficulty in asking for assistance. The preinteraction phase is similar to the planning stage before an interview. Exploring is a stage in the working phase in which the nurse helps the client to explore thoughts, feelings, and actions. During the working phase, the nurse and client appreciate their uniqueness and care about each other. Caring is sharing deep and genuine concern about the welfare of another person.

Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Psychosocial IntegrityIncorrect: Rationale: During the initial parts of the introductory phase, the client may display some resistant behaviors that inhibit involvement, cooperation, or change. It may be because of difficulty in asking for assistance. The preinteraction phase is similar to the planning stage before an interview. Exploring is a stage in the working phase in which the nurse helps the client to explore thoughts, feelings, and actions. During the working phase, the nurse and client appreciate their uniqueness and care about each other. Caring is sharing deep and genuine concern about the welfare of another person.



Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Psychosocial IntegrityHints:

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8. a. Assertive.Learning Objective:26-8. Differentiate major characteristics between assertive and nonassertive communication.Feedback:Correct: Rationale: People who use assertive communication are honest, direct, and appropriate while being open to ideas and respecting the rights of others.

Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Safe and Effective Care EnvironmentIncorrect: Rationale: People who use assertive communication are honest, direct, and appropriate while being open to ideas and respecting the rights of others.



Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Safe and Effective Care EnvironmentHints:

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9. d. Submissiveness.Learning Objective:26-8. Differentiate major characteristics between assertive and nonassertive communication.Feedback:Correct: Rationale: When people use a submissive communication style, they meet the demands and requests of others without regard to their own feelings and needs, as they believe their own feelings are unimportant.

Cognitive Level: KnowledgeNursing Process: AssessmentClient Need: Psychosocial IntegrityIncorrect: Rationale: When people use a submissive communication style, they meet the demands and requests of others without regard to their own feelings and needs, as they believe their own feelings are unimportant.



Cognitive Level: KnowledgeNursing Process: AssessmentClient Need: Psychosocial IntegrityHints:

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10. b. It exists to help people achieve goals.Learning Objective:26-2. Discuss nurse–client communication as a dynamic process.Feedback:Correct: Rationale: Groups exist to assist others to achieve goals that would be unattainable by individual effort alone. Cognitive Level: KnowledgeNursing Process: AssessmentClient Need: Health Promotion and MaintenanceIncorrect: Rationale: Groups exist to assist others to achieve goals that would be unattainable by individual effort alone.

Cognitive Level: KnowledgeNursing Process: AssessmentClient Need: Health Promotion and MaintenanceIncorrect: Rationale: Groups exist to assist others to achieve goals that would be unattainable by individual effort alone.


Cognitive Level: KnowledgeNursing Process: AssessmentClient Need: Health Promotion and MaintenanceHints:

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11. b. FalseLearning Objective:26-2. Discuss nurse–client communication as a dynamic process.Feedback:Incorrect: Rationale: It is important for the channel to be appropriate for the message and it should help make the intent of the message clearer. Talking face-to-face with a person may be more effective in some instances than telephoning or writing a message. Recording messages on tape or communicating by radio or television may be more appropriate for larger audiences. Written communication is often appropriate for long explanations or for a communication that needs to be preserved. The nonverbal channel of touch is often highly effective.

Cognitive Level: KnowledgeNursing Process: ImplementationClient Need: Psychosocial IntegrityCorrect: Rationale: It is important for the channel to be appropriate for the message and it should help make the intent of the message clearer. Talking face-to-face with a person may be more effective in some instances than telephoning or writing a message. Recording messages on tape or communicating by radio or television may be more appropriate for larger audiences. Written communication is often appropriate for long explanations or for a communication that needs to be preserved. The nonverbal channel of touch is often highly effective.

Cognitive Level: KnowledgeNursing Process: ImplementationClient Need: Psychosocial IntegrityHints:

12. c. School-age children and a.Adolescents and d.ToddlersLearning Objective:26-2. Discuss nurse–client communication as a dynamic process.Feedback:Correct: Rationale: The ability to communicate is related to the development of thought processes, the presence of intact sensory and motor systems, and the extent and nature of an individual's opportunities to practice communication skills. The nurse needs to develop a rapport with each group in order to effectively communicate. The nurse would communicate with infants nonverbally and with a gentle voice that is soothing.

Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Health Promotion and MaintenanceHints:

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13. d. A teaching group.Learning Objective:26-5. Identify types of groups helpful in promoting health and comfort.Feedback:Incorrect: Rationale: The major purpose of a teaching group is to impart information to the participants.

Cognitive Level: KnowledgeNursing Process: PlanningClient Need: Health Promotion and MaintenanceCorrect: Rationale: The major purpose of a teaching group is to impart information to the participants.

Cognitive Level: KnowledgeNursing Process: PlanningClient Need: Health Promotion and MaintenanceIncorrect: Rationale: The major purpose of a teaching group is to impart information to the participants.

Cognitive Level: KnowledgeNursing Process: PlanningClient Need: Health Promotion and MaintenanceIncorrect: Rationale: The major purpose of a teaching group is to impart information to the participants.

Cognitive Level: KnowledgeNursing Process: PlanningClient Need: Health Promotion and MaintenanceHints:

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14. a. Therapy groups.Learning Objective:26-5. Identify types of groups helpful in promoting health and comfort.Feedback:Incorrect: Rationale: Therapy groups work toward self-understanding, more satisfactory ways of handling stress, and changing patterns of behavior toward health.

Cognitive Level: KnowledgeNursing Process: AssessmentClient Need: Health Promotion and MaintenanceIncorrect: Rationale: Therapy groups work toward self-understanding, more satisfactory ways of handling stress, and changing patterns of behavior toward health.

Cognitive Level: KnowledgeNursing Process: AssessmentClient Need: Health Promotion and MaintenanceCorrect: Rationale: Therapy groups work toward self-understanding, more satisfactory ways of handling stress, and changing patterns of behavior toward health.

Cognitive Level: KnowledgeNursing Process: AssessmentClient Need: Health Promotion and MaintenanceIncorrect: Rationale: Therapy groups work toward self-understanding, more satisfactory ways of handling stress, and changing patterns of behavior toward health.


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15. b. The American Nurses Association.Learning Objective:26-5. Identify types of groups helpful in promoting health and comfort.Feedback:Incorrect: Rationale: Social support for Alcoholics Anonymous is best given outside of the work environment.

Cognitive Level: KnowledgeNursing Process: AssessmentClient Need: Health Promotion and MaintenanceIncorrect: Rationale: Social support for groups such as Weight Watchers is best given outside of the work environment.

Cognitive Level: KnowledgeNursing Process: AssessmentClient Need: Health Promotion and MaintenanceCorrect: Rationale: The American Nurses Association is a type of group that nurses would participate in that is related to their professional career.

Cognitive Level: KnowledgeNursing Process: AssessmentClient Need: Health Promotion and MaintenanceIncorrect: Rationale: Social support for a political organization is best given outside of the work environment.


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16. a. Helps people achieve goals.Learning Objective:26-4. Identify features of effective groups.Feedback:Correct: Rationale: Groups exist to assist others to achieve goals that would be unattainable by individual effort alone.


Cognitive Level: KnowledgeNursing Process: AssessmentClient Need: Health Promotion and Maintenance.Incorrect: Rationale: Groups exist to assist others to achieve goals that would be unattainable by individual effort alone.



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17. b. Reasons for disagreements are examined.Learning Objective:26-4. Identify features of effective groups.Feedback:Correct: Rationale: In an effective group, members contribute toward the achievement of goals and maintain cohesion. In ineffective groups, leadership claims credit for accomplishments, members are afraid of making mistakes, and disagreements are ignored.

Cognitive Level: ApplicationNursing Process: AssessmentClient Need: Psychosocial IntegrityIncorrect: Rationale: In an effective group, members contribute toward the achievement of goals and maintain cohesion. In ineffective groups, leadership claims credit for accomplishments, members are afraid of making mistakes, and disagreements are ignored.



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18. a. Communication, decision making, and power.Learning Objective:26-4. Identify features of effective groups.Feedback:Correct: Rationale: Effective groups have many attributes. Three examples are communication, decision making, and power.

Cognitive Level: KnowledgeNursing Process: EvaluationClient Need: Health Promotion and MaintenanceIncorrect: Rationale: Effective groups have many attributes. Three examples are communication, decision making, and power.



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19. c. “I am concerned about the fluctuation in the client's blood pressure since the client started taking the new medication.” and a."I really wish that you told me about the changes you had noted with the client while walking the client to the bathroom. It is important for me to know as soon as you notice a change so that I can further assess the client at that point."Learning Objective:26-7. State why effective communication is imperative among health professionals.Feedback:Correct: Rationale: The "I" statements encourage discussion. Concern is expressed about the client's blood pressure and is correlated with an event. Concern is also expressed about a missed opportunity to assess the client when a change was noted by the caregiver. Pointing out that the primary health provider did not order food for the client may be taken as an aggressive statement, especially if the tone is accusative. Many emotions may be expressed by the nurse (surprise, anger, frustration, disbelief, etc.) as the nurse aggressively questions the caregiver about the omitted blood pressure readings.

Cognitive Level: AnalysisNursing Process: ImplementationClient Need: Psychosocial IntegrityHints:

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20. d. Giving common adviceLearning Objective:26-7. State why effective communication is imperative among health professionals.Feedback:Incorrect: Rationale: Giving common advice is telling the client what to do. Such responses deny the client’s right to be an equal partner. Stereotyping negates the uniqueness of an individual. Being defensive prevents the client from expressing true concerns. Challenging responses indicate that the physician is not considering the client’s feelings.

Cognitive Level: ApplicationNursing Process: ImplementationClient Need: Psychosocial IntegrityIncorrect: Rationale: Giving common advice is telling the client what to do. Such responses deny the client’s right to be an equal partner. Stereotyping negates the uniqueness of an individual. Being defensive prevents the client from expressing true concerns. Challenging responses indicate that the physician is not considering the client’s feelings.

Cognitive Level: ApplicationNursing Process: ImplementationClient Need: Psychosocial IntegrityIncorrect: Rationale: Giving common advice is telling the client what to do. Such responses deny the client’s right to be an equal partner. Stereotyping negates the uniqueness of an individual. Being defensive prevents the client from expressing true concerns. Challenging responses indicate that the physician is not considering the client’s feelings.

Cognitive Level: ApplicationNursing Process: ImplementationClient Need: Psychosocial IntegrityCorrect: Rationale: Giving common advice is telling the client what to do. Such responses deny the client’s right to be an equal partner. Stereotyping negates the uniqueness of an individual. Being defensive prevents the client from expressing true concerns. Challenging responses indicate that the physician is not considering the client’s feelings.


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21. c. “I am worried about the client's blood pressure. It is not decreasing even with the new antihypertensive medication.”Learning Objective:26-7. State why effective communication is imperative among health professionals.Feedback:Incorrect: Rationale: “I am worried about the client's blood pressure. It is not decreasing even with the new antihypertensive medication” uses an “I” statement, which is assertive communication and is clear and direct. The message includes only the necessary information. “That new medication you prescribed for the client is ineffective” contains inflammatory language (“ineffective” and “you prescribed”). “Can we talk about the client?” and “Excuse me. I think we need to talk about the client's blood pressure” do not provide the health care provider with specific information and could stimulate defensive behaviors.

Cognitive Level: AnalysisNursing Process: AssessmentClient Need: Safe and Effective Care EnvironmentCorrect: Rationale: “I am worried about the client's blood pressure. It is not decreasing even with the new antihypertensive medication” uses an “I” statement, which is assertive communication and is clear and direct. The message includes only the necessary information. “That new medication you prescribed for the client is ineffective” contains inflammatory language (“ineffective” and “you prescribed”). “Can we talk about the client?” and “Excuse me. I think we need to talk about the client's blood pressure” do not provide the health care provider with specific information and could stimulate defensive behaviors.

Cognitive Level: AnalysisNursing Process: AssessmentClient Need: Safe and Effective Care EnvironmentIncorrect: Rationale: “I am worried about the client's blood pressure. It is not decreasing even with the new antihypertensive medication” uses an “I” statement, which is assertive communication and is clear and direct. The message includes only the necessary information. “That new medication you prescribed for the client is ineffective” contains inflammatory language (“ineffective” and “you prescribed”). “Can we talk about the client?” and “Excuse me. I think we need to talk about the client's blood pressure” do not provide the health care provider with specific information and could stimulate defensive behaviors.

Cognitive Level: AnalysisNursing Process: AssessmentClient Need: Safe and Effective Care EnvironmentIncorrect: Rationale: “I am worried about the client's blood pressure. It is not decreasing even with the new antihypertensive medication” uses an “I” statement, which is assertive communication and is clear and direct. The message includes only the necessary information. “That new medication you prescribed for the client is ineffective” contains inflammatory language (“ineffective” and “you prescribed”). “Can we talk about the client?” and “Excuse me. I think we need to talk about the client's blood pressure” do not provide the health care provider with specific information and could stimulate defensive behaviors.

Cognitive Level: AnalysisNursing Process: AssessmentClient Need: Safe and Effective Care EnvironmentHints:

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22. b. “You seem upset. Do you want to talk to me about the test results?”Learning Objective:26-1. Describe factors influencing the communication process.Feedback:Incorrect: Rationale: The physician, in delivering important news to the client, should have taken time to sit with her to discuss the results of the test. In telling the client that the test was “negative,” the physician did not clarify what “negative” actually meant. Using medical jargon without an explanation can lead to misinterpretation of the message by the client. The nurse does not know specifically what the client is sobbing about and asks the client an open-ended question so the client can talk.

Cognitive Level: ComprehensionNursing Process: PlanningClient Need: Psychosocial IntegrityIncorrect: Rationale: The physician, in delivering important news to the client, should have taken time to sit with her to discuss the results of the test. In telling the client that the test was “negative,” the physician did not clarify what “negative” actually meant. Using medical jargon without an explanation can lead to misinterpretation of the message by the client. The nurse does not know specifically what the client is sobbing about and asks the client an open-ended question so the client can talk.

Cognitive Level: ComprehensionNursing Process: PlanningClient Need: Psychosocial IntegrityCorrect: Rationale: The physician, in delivering important news to the client, should have taken time to sit with her to discuss the results of the test. In telling the client that the test was “negative,” the physician did not clarify what “negative” actually meant. Using medical jargon without an explanation can lead to misinterpretation of the message by the client. The nurse does not know specifically what the client is sobbing about and asks the client an open-ended question so the client can talk.

Cognitive Level: ComprehensionNursing Process: PlanningClient Need: Psychosocial IntegrityIncorrect: Rationale: The physician, in delivering important news to the client, should have taken time to sit with her to discuss the results of the test. In telling the client that the test was “negative,” the physician did not clarify what “negative” actually meant. Using medical jargon without an explanation can lead to misinterpretation of the message by the client. The nurse does not know specifically what the client is sobbing about and asks the client an open-ended question so the client can talk.

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23. a. IntimateLearning Objective:26-1. Describe factors influencing the communication process.Feedback:Correct: Rationale: Intimate-distance communication is characterized by body contact and heightened sensations of body heat and smell. Personal space is less overwhelming than intimate space. Social-distance and public-distance communication take place within personal space greater than 4 feet.

Cognitive Level: ComprehensionNursing Process: AssessmentClient Need: Physiological IntegrityIncorrect: Rationale: Intimate-distance communication is characterized by body contact and heightened sensations of body heat and smell. Personal space is less overwhelming than intimate space. Social-distance and public-distance communication take place within personal space greater than 4 feet.



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24. a. Encourage the client to verbalize concerns and feelings, and then do health teaching when the client is able to listen.Learning Objective:26-1. Describe factors influencing the communication process.Feedback:Correct: Rationale: When clients are anxious and upset, they have difficulty focusing, especially on new information. The nurse needs to prioritize the client’s presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Since the nurse is unaware of the issue and is not knowledgeable of the client’s work situation, it is false reassurance to tell the client that the matter can be handled at work. This also belittles the client’s independence and self-efficacy, as does recommending problem solving.

Cognitive Level: ApplicationNursing Process: ImplementationClient Need: Psychosocial IntegrityIncorrect: Rationale: When clients are anxious and upset, they have difficulty focusing, especially on new information. The nurse needs to prioritize the client’s presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Since the nurse is unaware of the issue and is not knowledgeable of the client’s work situation, it is false reassurance to tell the client that the matter can be handled at work. This also belittles the client’s independence and self-efficacy, as does recommending problem solving.




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ch.26 Pre-Test

Documents

Transcript of ch.26 Pre-Test