ANSWERSHEET
TEST BANK
Communication in Nursing 10th Edition
Julia Balzer Riley
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Table of Contents
Chapter 1: Responsible, Assertive, Caring Communication in Nursing
Chapter 2: The Client-Nurse Relationship: A Helping Relationship
Chapter 3: Solving Problems Together
Chapter 4: Understanding Each Other: Communication and Culture
Chapter 5: Demonstrating Warmth
Chapter 6: Showing Respect
Chapter 7: Being Genuine
Chapter 8: Being Empathetic
Chapter 9: Using Self-Disclosure
Chapter 10: Being specific
Chapter 11: Asking Questions
Chapter 12: Expressing Opinions
Chapter 13: Using Humor
Chapter 14: Embracing the Spiritual Journey of Health Caring, Meaning Making
Chapter 15: Requesting Support
Chapter 16: Overcoming Evaluation Anxiety
Chapter 17: Working with Feedback
Chapter 18: Using Relaxation technique
Chapter 19: Incorporating Imagery in Professional Practice and Self-Care
Chapter 20 Incorporating Positive Self-Talk
Chapter 21: Learning to Work Together in Groups
Chapter 22: The Changing World of Electronic Communication
Chapter 23: Learning Confrontation skills
Chapter 24: Refusing Unreasonable Requests
Chapter 25: Communicating Assertively and Responsibly with Distressed Clients and Colleagues
Chapter 26: Communicating Assertively and Responsibly with Aggressive Clients and Colleagues
Chapter 27: Communicating Assertively and Responsibly with Unpopular Clients
Chapter 29: Communicating at the End-of-Life
Chapter 30: Continuing the Commitment
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Balzer Riley: Communication in Nursing, 10th Edition
Chapter 1: Responsible, Assertive, Caring Communication in Nursing
Test Bank
Multiple Choice
1. Which statement describes the affective aspect of learning effective
communication strategies?
a. “The nurse should use clear, direct statements using objective words.”
b. “The nurse uses body language that is congruent with the verbal message.”
c. “The nurse believes that positive communication strategies build confidence.”
d. “The nurse practices assertive and responsible communication strategies.”
ANS:C
Learning involves three domains: the cognitive aspects (understanding and meaning),
affective aspects (feelings, values, and attitudes), and psychomotor aspects (physical
capability).Learning basic communication skills involves the cognitive domain; building
confidence through a belief in the value and impact of positive communication is the
affective domain; and putting skills into action is the psychomotor domain.DIF:
Comprehension REF: p. 13 TOP: Integrated Process: Communication and
Documentation MSC: Psychosocial Integrity
2. The nurse manager asks the staff nurse to work an extra shift. Which response by
the staff nurse is assertive and based on rational beliefs?
a. “I don’t want you upset, so I will work extra.”
b. “Why do I always have to cover extra shifts?”
c. “I am not able to work an extra shift.”
d. “If you can’t find anyone else, I will do it.”
ANS:C
The staff nurse may turn down even a reasonable request; an assertive response avoids
irrational beliefs. Irrational beliefs occur as a result of being anxious about assertiveness
or focusing on possible negative outcomes.DIF: Analysis REF: p. 8 TOP: Integrated
Process: Communication and Documentation MSC: Safe and Effective Care
Environment: Management of Care
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3. A nurse manager offers a staff nurse a choice between working 8- or 12-hour
shifts. Which statement, if made by the staff nurse, is nonassertive and may result in a
frustrated response from the nurse manager?
a. “I want to decide the shifts for all of the other staff nurses.”
b. “Do whatever you want. It doesn’t really matter to me.”
c. “Thank you for offering me a choice. I prefer 12-hour shifts.”
d. “You will never be able to give me what I really want to work.”
ANS:B
A statement that allows others to make decisions for a person is an example of a
nonassertive style of communication; the response of others to a nonassertive statement
may include disrespect, guilt, anger, or frustration. Statements that make choices for
others or that are accusations are examples of aggressive styles of communication; the
response of others to an aggressive statement may include hurt, defensiveness, or
humiliation. A statement that allows making one’s own decisions is an example of
assertive style of communication; the response of others to an assertive statement may
include mutual respect.DIF: Analysis REF: p. 7 TOP: Integrated Process: Communication
and Documentation MSC: Safe and Effective Care Environment: Management of Care
4. The nurse is providing care to a patient who was admitted with heart failure. The
patient has not been following the prescribed diet or taking the prescribed
medications. Which type of communication approach is most important for the nurse
to use with this patient to facilitate a change in self-care behavior?
a. Authoritative, honest, and outright communication
b. Assertive, responsible, and caring communication
c. Aggressive, sympathetic, and realistic communication
d. Positive, expert, and focused communication
ANS:B
Communication must be technically responsible, assertive, and caring to facilitate a
change in behavior.DIF: Knowledge/Comprehension REF: p. 13 TOP: Integrated
Process: Communication and Documentation MSC: Psychosocial Integrity
5. Which are examples of a nurse who is communicating responsibly? (Select all
that apply)
a. The nurse uses profanity to respond to a client who is intoxicated and verbally
abusive.
b. The nurse helps a client talk to family members about discontinuing
chemotherapy.
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c. The nurse uses interpersonal strategies to help a client develop methods of coping.
d. The nurse provides a client’s health information to a close relative who is visiting.
e. The nurse listens carefully to the client’s concern about inadequate pain relief.
ANS:B, C, E
A nurse who communicates responsibly will perform the role of a client advocate, will
consider the world of the client and the client’s family, and will naturally focus on the
nursing process and problem-solving process. The nurse is responsible for maintaining
the professional conduct of the relationship. Examples of unprofessional conduct would
include breaching client confidentiality or verbally abusing a client.DIF: Application
REF: pp. 11-12 TOP: Integrated Process: Communication and Documentation MSC:
Psychosocial Integrity
6. According to Swanson’s theory, there are five caring processes, one of which is
“being with.” Which of the responses by the nurse portrays an understanding of the
concept of “being with” a client?
a. The nurse charting in the room to spend more time with the client
b. The nurse wearing locator badge so you can quickly respond any time patient
would call front desk and ask to page you
c. The nurse requesting one-on-one nurse staffing
d. The nurse being emotionally present to the client
ANS:D
Caring is an essential ingredient in life and must characterize the nurse–client
relationship…. Consider Swanson’s five caring processes (Swanson, 1993):1)
Maintaining belief—sustaining faith in the capacity of others to transition and have
meaningful lives2) Knowing—striving to understand events as they have meaning in the
life of the other3) Being with—being emotionally present to the other4) Doing for—
doing for others what they would do for themselves if possible5) Enabling—facilitating
the capacity of others to care for themselves and family members (Tonges and Ray, 2011,
p. 375)DIF: Application REF: p. 11 TOP: Integrated Process: CaringMSC: Physiological
Integrity: Basic Care and Comfort
7. According to Swanson’s theory, there are five caring processes, one of which is
“knowing.” What are the other four?
a. Communication, assertiveness, responsibility, and caring
b. Maintaining belief, being with, doing for, and enabling
c. Understanding, action, information, and comfort
d. Maintaining belief, being with, enabling, and supporting
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ANS:B
Caring is an essential ingredient in life and must characterize the nurse–client
relationship…. Consider Swanson’s five caring processes (Swanson, 1993):1)
Maintaining belief—sustaining faith in the capacity of others to transition and have
meaningful lives2) Knowing—striving to understand events as they have meaning in the
life of the other3) Being with—being emotionally present to the other4) Doing for—
doing for others what they would do for themselves if possible5) Enabling—facilitating
the capacity of others to care for themselves and family members (Tonges and Ray, 2011,
p. 375)DIF: Knowledge/Comprehension REF: p. 6 TOP: Integrated Process: CaringMSC:
Safe and Effective Care Environment: Management of Care
8. The charge nurse informs a staff nurse that it is her turn to float to another unit.
Which response by the staff nurse is aggressive?
a. “I had such a bad experience last time. Please send another nurse instead of me.”
b. “I will miss working with you today, but I understand that it is my turn to float.”
c. “I will not survive on the other unit. The staff are always too busy to help me.”
d. “I will float, but you’ll be sorry. You cannot handle emergencies without me.”
ANS:D
An aggressive response is forceful and confrontational; the person using an aggressive
approach will place his or her needs first and respect for others is lacking. A nonassertive
response is apologetic; the person frequently puts himself or herself down. An assertive
response is clear, direct, confident, and honest.DIF: Analysis REF: p. 7 TOP: Integrated
Process: Communication and Documentation MSC: Safe and Effective Care
Environment: Management of Care
9. A client has high blood pressure and needs to learn about a low-sodium diet.
Which question if asked by the client would be an indirect request for information?
a. “How should I prepare food without adding salt?”
b. “What will I do to make food taste better?”
c. “What diet changes are needed to control my blood pressure?”
d. “What foods should I avoid that are high in sodium?”
ANS:B
Indirect requests for information are not obvious, and the meaning must be interpreted by
the nurse. “What will I do to make food taste better?” is an indirect request for
information; the nurse must interpret this question as a request for information about a
low-sodium diet. The other questions are direct requests for information on a low-sodium
diet.DIF: Application REF: p. 6 TOP: Integrated Process: Communication and
Documentation MSC: Physiological Integrity: Basic Care and Comfort
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10. The nurse plans to delegate a client’s personal hygiene to a nursing assistant.
Which statement if made by the nurse to the nursing assistant is assertive?
a. “Would you mind helping the client with a bath when you have time? If not, I will
skip my lunch and do it myself.”
b. “You never get your work done and are always on the phone. You need to help the
client right now with a bath, or I will write you up.”
c. “The client needs help with bathing. I want you to assist the client now, and you
can go to lunch when you are finished.”
d. “I have important work to complete this morning. You will assist the client with a
bath. Do not take a break until you have finished.”
ANS:C
An assertive statement is clear, direct, and respectful; the nurse should use assertive
rights, avoid irrational beliefs, and use the Describe Express Specify Consequence script
to formulate an assertive response.Describe: “The client needs help with bathing.”
Express and Specify: “I want you to assist the client now.”Consequence: “You can go to
lunch when you are finished.”The other statements are nonassertive or aggressive:“Would
you mind helping the client with a bath when you have time? If not, I will skip my lunch
and do it myself.” is nonassertive, hesitant, and apologetic.“You never get your work
done and are always on the phone. You need to help the client right now with a bath, or I
will write you up.” is aggressive, blaming, and negative.“I have important work to
complete this morning. You will assist the client with a bath. Do not take a break until
you have finished.” is aggressive, sarcastic, uncaring, and superior.DIF: Analysis REF: p.
6 TOP: Integrated Process: Communication and Documentation MSC: Safe and Effective
Care Environment: Management of Care
11. A hospital nurse is concerned about the demands of providing safe care to clients
who are seriously ill. The nurse manager should suggest which intervention to
effectively help the nurse balance the demanding work in the hospital setting?
a. Delegate more tasks to the unlicensed nursing personnel on the unit.
b. Request a transfer to another nursing care unit with patients who are stable.
c. Write down stories in a journal about how caring makes a difference for patients.
d. Use an assertive communication style for every patient–nurse interaction.
ANS:C
Caring is the moral ideal that guides nurses through the caregiving process. Although
there is satisfaction in being technologically competent, that satisfaction is not as lasting
as the satisfaction derived from meaningful moments of connection with clients, family,
and colleagues.DIF: Application REF: p. 13 TOP: Integrated Process: CaringMSC: Safe
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and Effective Care Environment: Management of Care
12. Which nonverbal action(s) would be consistent with an assertive style of
communication? (Select all that apply)
a. Relaxed posture
b. Established eye contact
c. Hands placed on hips
d. Distant, soft voice
e. Mask-like facial expression
ANS:A, B
Assertive styles of communication that are nonverbal include a relaxed stance and eyes
that are warm, in contact, and frank. Aggressive styles of communication that are
nonverbal include expressionless, cold, narrowed, or staring eyes and hands placed on
hips. A weak, distant, soft voice is a nonassertive style of nonverbal communication.DIF:
Comprehension REF: pp. 11-12 TOP: Integrated Process: Communication and
Documentation MSC: Psychosocial Integrity
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Balzer Riley: Communication in Nursing, 10th Edition
Chapter 2: The Client-Nurse Relationship: A Helping Relationship
Test Bank
Multiple Choice
1. The nurse cares for a patient who has just been diagnosed with lung cancer.
Which statement by the nurse is therapeutic?
a. “You sound really frightened about your diagnosis of cancer.”
b. “You will get better because the treatment will be started this week.”
c. “I think you should take a vacation and try to forget about the cancer.”
d. “An apple a day will keep the doctor away.”
ANS:A
Reflecting helps the patient to clarify feelings and is a therapeutic communication
technique. Reassuring (i.e., “you will be okay”) negates fears and feelings of the patient.
Getting advice (i.e., declaration to the patient of what the nurse thinks) negates the worth
of the patient as a mutual partner in decision making. Making stereotyped responses (i.e.,
trite, meaningless verbal expressions) negates the significance of the patient’s
communication.DIF: Analysis REF: p.25 TOP: Integrated Process: Communication and
Documentation MSC: Psychosocial Integrity
2. The home health nurse cares for a patient who is diagnosed with chronic
obstructive pulmonary disease. Which response(s) and behavior(s) by the nurse
would indicate that bonding between nurse and patient has occurred? (Select all that
apply)
a. Expects the patient to meet the goals for exercise as determined by the nurse.
b. Listens to the patient describe the feelings of anxiety related to severe dyspnea.
c. Develops teaching plan based on the learning preferences of the patient.
d. Refrains from touching the patient unless performing physical assessment
techniques.
e. Requests that the patient wait to ask questions until the end of the home visit.
f. Learns the names of the patient’s family members and close friends and
neighbors.
ANS:B, C, F
Responses and behaviors of the nurse that indicate bonding between the nurse and the
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patient include listening to verbalization of the patient’s feelings, asking for the patient’s
input on learning styles and needs, and listening to the patient talk about support persons.
Other indicators (responses and behaviors by the nurse) of bonding include touching a
patient for reassurance when appropriate, including the patient in the plan of care (and
developing goals), and encouraging inquiries from the patient.DIF: Application REF: p.
27 TOP: Integrated Process: CaringMSC: Psychosocial Integrity
3. The nurse cares for a client who is scheduled for a breast biopsy. Which is the
main purpose of the client–nurse relationship?
a. To develop a mutually satisfying experience for the client and nurse.
b. To assist the client in achieving and maintaining optimal health.
c. To provide excellent client service and improve quality of care.
d. To allow the client to receive important health information.
ANS:B
The client–nurse relationship is established primarily to help the client achieve and
maintain optimal health. The client–nurse relationship is entered for the benefit of the
client but is more effective if the relationship is mutually satisfying. The ability to
communicate clearly and with compassion is central to excellent customer (or client)
service. The client is not just a passive receiver of health information; the client–nurse
relationship refers to the interaction between the nurse and the client.DIF: Knowledge
REF: pp. 19-20 TOP: Integrated Process: Communication and Documentation MSC:
Psychosocial Integrity
4. While admitting a patient to the medical unit, the nurse should take which action?
a. Demonstrate human caring by hugging the patient for brief intervals.
b. Disclose shared intimate details with other healthcare providers.
c. Maintain a physical distance of at least 3 to 4 feet at all times.
d. Develop the plan of care and measurable objectives with the patient.
ANS:D
The patient and nurse should develop the plan of care together; attainment of objectives
should be evaluated with the patient. Nurses may have strong feelings for their patients
and express caring, but the nurse should maintain adequate objectivity and perspective to
provide therapeutic assistance. Patients should have a sense of privacy, and
confidentiality should be maintained. The nurse should not share intimate patient details
with others.DIF: Application REF: p. 23 TOP: Integrated Process: CaringMSC:
Psychosocial Integrity
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