Exam (elaborations)
NUR 380: EXAM 3
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NUR 380: EXAM 3 Ch. 16: Communicating Ch. 17: Teaching Ch. 31: Asepsis and Infection Prevention Ch. 32: Safety
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NUR 380: EXAM 3The nurse explains to a client that he will need to have a bowel prep before going to his
esophagogastroscopy. On what should the nurse focus to improve communication skills?
1. Pace
2. Intonation
3. Simplicity
4. Clarity - ANS Simplicity
Simplicity includes the use of commonly understood words, brevity, and completeness. A "bowel
prep" may be completely meaningless to a client but saying that the client needs to drink a gallon of
laxative-like medication gets the point across better. Esophagogastroscopy is a complicated word.
Using words like "small camera looking down your throat into your stomach" will make much more
sense to the client.
The nurse observes during a dressing change that the client's wound has become infected. When
asked by the client how the wound looks, the nurse says "it looks fine" but the nurse's facial
expression does not support the response. Which aspect of communication should this nurse
improve?
1. Adaptability
2. Credibility
3. Timing and relevance
4. Clarity and brevity - ANS Adaptability
Adaptability is adjusting tone of speech and facial expression to match the spoken message. Clearly,
if the nurse's face does not match the words, the client will identify a problem with the situation.
A spouse arrives to visit a client who is currently receiving cardiopulmonary resuscitation. Which
statement should the nurse make to the spouse?
1. "I know you're worried about your loved one. I'm sure this is a difficult situation for you. Do you
have any questions right now?"
2. "Your spouse's heart stopped. All these people are here to help get it started."
,3. "Your spouse's physician will be here shortly and explain all of the medication and treatment that
your spouse is receiving right now."
4. "Is there someone you would like to call? I'm sure this is a scary situation and you may feel more
comfortable if someone were with you during this time." - ANS "Your spouse's heart stopped. All
these people are here to help get it started."
Clarity and brevity provide a message that is simple and clear. The other statements do not explain
what is occurring with the client and would be inappropriate.
The nurse enters a client's room and finds that the telephone is lying in the client's lap, tissues are
wadded up on the bed, and the client's eyes are red and watery. What is the best response by the
nurse?
1. "Can I hang that phone up for you?"
2. "Well, it's a beautiful day outside. Let's open the blinds."
3. "Has your doctor been in to talk to you yet?"
4. "You look upset. Is there anything you'd like to talk about?" - ANS "You look upset. Is there
anything you'd like to talk about?"
Nonverbal communication, or body language, often tells the nurse more about what a person is
feeling than what is actually said. The interpretation of such observations requires validation with
the client.
A client who has been sullen and withdrawn since receiving the news of having cancer asks for
assistance with a shower. Which comment by the nurse is the most appropriate?
1. "If you look better, you might feel better."
2. "Taking a shower might wash away some of that gloom and doom."
3. "This is a positive sign. I'll be right back with your supplies."
4. "Your spouse will be glad to see that you're feeling better." - ANS "This is a positive sign. I'll be
right back with your supplies."
How a person dresses or looks may be an indicator of how the person feels. A change in grooming
habits may signal that the client is feeling better.
,The nurse is working in a pediatric clinic and has to explain a nebulizer treatment to a child. Which
approach should the nurse use?
1. Give the child's parent a full explanation, but make sure the child hears what is said.
2. Let the child handle the equipment first, then demonstrate on the child's doll.
3. Start the treatment, but make sure that the parent is there to comfort the child if she becomes
afraid.
4. Make sure that the physician is available for questions. - ANS Let the child handle the equipment
first, then demonstrate on the child's doll.
The knowledge of the client's developmental stage will allow the nurse to modify the message
accordingly. The use of dolls and games with simple language may help explain a procedure to a
child.
The nurse is giving a demonstration of new equipment to the rest of the staff. Which level of
proximity should the nurse use?
1. Intimate
2. Personal
3. Social
4. Public - ANS Social
Social distance is characterized by a clear, visual perception of the whole person and generally 4-12
feet in distance. Social distance is important in accomplishing the business of the day. It is expedient
in communicating with several people at the same time or within a short time, which would be the
case in this situation.
The nurse must perform a catheterization on a male client. Which zone of proximity should the
nurse use for this intervention?
1. Personal distance
2. Intimate distance
3. Social distance
4. Public distance - ANS Intimate distance
, Intimate distance is characterized by body contact and used frequently by nurses when they are
required to perform a procedure. Distance in this category is touching to 1.5 feet
A client grimaces and responds "I'm fine" when asked by the nurse to describe a level of pain. Which
communication factor is the client struggling with?
1. Territoriality
2. Environment
3. Congruence
4. Attitude - ANS Congruence
In congruent communication, the verbal and nonverbal aspects of the message match. Saying the
pain level is "fine," but then showing with facial grimacing that it is not, would be in conflict.
The nurse is working with an elderly male client on a medical unit. Which statement demonstrates
elderspeak by the nurse?
1. "It's time for us to go to physical therapy."
2. "I think it would be better if you were planning to go to a nursing home after discharge."
3. "Your children must really love their dad."
4. "Your wife must be having trouble adjusting to your illness." - ANS "It's time for us to go to
physical therapy."
Elderspeak is a speech style, similar to baby talk that gives a message of dependence and
incompetence to older adults. Characteristics of elderspeak include inappropriate terms of
endearment, inappropriate plural pronoun use ("It's time for us to go to physical therapy"), tag
questions, and slow, loud speech.
A client has just lost a second baby to preterm complications. Which statement demonstrates the
best therapeutic response for the nurse to make?
1. "Don't be so sad. You can always try again."
2. "Didn't your doctor advise you about genetic counseling?"
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