Chapter 03: Communication
Yoost & Crawford: Fundamentals of Nursing: Active Learning for Collaborative
Practice, 3RD Edition
MULTIPLE CHOICE
1. The nurse is caring for an adult patient with a recent below-the-knee amputation. During shift
report, the nurse reports that the patient has urinated in the bed multiple times since the
surgery. The nurse knows which defense mechanism best describes this behavior?
a. Compensation
b. Denial
c. Rationalization
d. Regression
ANS: D
Regression is the return to an earlier developmental stage as a means of avoiding unpleasant
or unacceptable thoughts. The adult patient recently lost a limb and reverted to bedwetting as
a coping mechanism. Compensation refers to a strategy that uses a personal strength to
counterbalance a weakness or a feeling of inadequacy. Refusing to accept a fact or reality as
truth is termed denial. Rationalization is the act of suggesting a different explanation for one
that is painful, negative, or unacceptable.
2. A female patient is admitted to the emergency department after being raped by a neighbor.
The patient refuses to discussNheRcS
tU INmst
ircu GTances
B. sOurrounding the event with the sexual assault
nurse examiner. The nurse identifies that the patient is utilizing which defense mechanism?
a. Suppression
b. Sublimation
c. Displacement
d. Rationalization
ANS: A
Suppression is the conscious decision to conceal unacceptable or painful thoughts. The patient
refuses to talk about the rape possibly because of the emotional and physical pain associated
with the act. Sublimation is the rechanneling of unacceptable impulses into socially acceptable
activities. Displacement is an unconscious defense mechanism used to avoid conflict and
anxiety by transferring emotions from one object to another object that produces less anxiety.
Rationalization is the act of suggesting a different explanation for one that is painful, negative,
or unacceptable.
3. A patient calls the nurse to report the smell of cigarette smoke in the bathroom. The nurse
recognizes that this component of the communication process is identified by which term?
a. Channel
b. Referent
c. Message
, DAWIT
d. Feedback
ANS: B
The elements of the communication process include a referent (i.e., event or thought initiating
the communication), a sender (i.e., person who initiates and encodes the communication), a
receiver (i.e., person who receives and decodes, or interprets, the communication), the
message (i.e., information that is communicated), the channel (i.e., method of
communication), and feedback (i.e., response of the receiver).
4. The nurse manager sends an e-mail to the nursing staff as a reminder for a scheduled monthly
meeting. In doing so, the nurse manager understands that e-mail could result in which issue?
a. It is usually slower than other methods of communication.
b. It has the potential for miscommunication.
c. It cannot be used to deliver vital information.
d. It is especially effective because of the absence of nonverbal cues.
ANS: B
A message is the content transmitted during communication. Messages are transmitted
through all forms of communication, including spoken, written, and nonverbal modalities.
Electronic communication in the form of information referencing, e-mail, social networking,
and blogging can quickly contribute to a person‘s knowledge, providing patients and health
care professionals with vital information. However, the potential for miscommunication
exists, in part because nonverbal cues are not apparent.
5. The nursing student has been assigned to help feed patients at lunch time. Which nursing
intervention would be most effective when assisting a blind patient to eat a meal?
a. Speak loudly to ensure that the patient understands.
b. Describe the food arrangement using the numbers on a clock.
c. Tell the patient what is on the plate since he has lost the sense of smell.
d. Encourage the patient to eat faster so that the task will be done.
ANS: B
An important factor to remember when caring for visually impaired or blind patients is that
they are rarely hearing impaired. Typically, blind patients have heightened auditory and
olfactory senses. Communication with blind patients can be characterized as anticipatory in
nature, meaning that the nurse should alert visually impaired patients of potential hazards or
object locations to provide necessary information and safe care. For example, the nurse may
inform the visually impaired patient that the meat entrée is in the 6 o‘clock position and the
coffee cup is at 2 o‘clock on the tray. This system may be helpful in orienting blind patients to
their hospital rooms or informing them of where their food is on a plate or tray.
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