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96 Cards in this Set

  • Front
  • Back
W1. Communication is...
A lifelong process that is an essential part of pt-centered nursing care.
W2. For the nurse to be able to relate to others, he or she must have the ability to: (5 points)
1. Take the initiative in establishing and maintaining communication.
2. Be authentic (one's self).
3. Respond appropriately to the other person.
4. Have a sense of mutuality.
5. Believe that the nurse-pt relationship is a partnership with equal participants.
W3. Perceptual biases are??
Human tendencies that interfere with accurately perceiving and interpreting messages from others.
W4. List some challenging communication situations that nurses may encounter.
1. Silent or withdrawn ppl.
2. Sad/depressed with slow mental/motor processes.
3. Angry, confrontational and cannot listen
4. Uncooperative and resent being asked
5. Talkative or lonely
6. Demanding
7. Frightened or anxious
8. Vision or hearing difficulties
9. Language barriers
10. Confused
11. Sexually inappropriate
W5. This level of communication occurs within an individual.
INTRAPERSONAL
W6. This level of communication is one-to-one interaction between a nurse and another person.
Interpersonal
W7. This level of communication is interaction that occurs within a person's spiritual domain.
Transpersonal
W8. Level of communication that occurs with a small number of persons.
Small group
W9. Level of communication that requires interaction with an audience.
Public
W10. Referent
Motivates one person to communicate with another.
W11. Sender
Person who encodes and delivers the message.
W12. Receiver
Person who decodes the message.
W13. Message
Content of the communication.
W14. Channels
Means of conveying and receiving messages through the senses
W15. Feedback
Indicates whether the receiver understood the meaning of the sender's message.
W16. Interpersonal variables.
Factors within both the sender and receiver that influence communication.
W17. Environment
Setting for the sender-receiver interaction.
W18. Verbal communication
Code that conveys specific meaning through the combination of words
W19. Connotative meaning
Interpretation of a word's meaning influenced by the thoughts and feelings that people have about the word
W20. Intonation
Tone of voice
W21. Timing
When a pt expresses an interest in communicating
W22. Pacing
Thinking before speaking and developing an awareness of the rhythm of your speech.
W23. Clarity and brevity
Simple, brief, and direct.
W24a. Symbolic communication

W24b. Metacommunication
a. The verbal and nonverbal symbolism used by others to convey meaning such as art and music.

b. Refers to all factors that influence communications
W25. Identify the four zones of personal space.
a. Intimate zone (0-18 inches)
b. Personal zone (18in - 4 ft)
c. Social zone (9-12 ft)
d. Public zone (12 ft and greater)
W26. ID the four zones of touch.
1. Social zone (permission not needed)
2. Consent zone (special care needed)
3. Intimate zone (great sensitvity needed)
4. Vulnerable zone
W27* What are the four goal-directed phases that characterize nurse-pt relationship.
Preinteraction, Orientation, Working, Termination
W27. Preinteraction phase.
Occurs before meeting the patient (review data, talk to caregivers, anticipate health concerns, plan enough time for interaction).
W28. Orientation phase.
When the nurse and pt meet and get to know one another (set the tone for the relationship, expect to be tested and closely observed, clarify the roles of the pt and the nurse.)
W29. Working phase.
When the nurse and the pt work together to solve problems and accomplish goals (help the pt to express feelings; self-exploration, set goals, take action, self-disclosure, and confrontation used appropriately.)
W30. Termination phase.
During the ending of the relationship (termination is near, goal achievement, relinquishing responsibility, transition to other caregivers as needed.)
W31. Nurse-family relationship.
Many nursing situations, esp. those in community and home care settings, require the nurse to form helping relationships with entire families.
W32. Nurse-health care team relationship.
Communication with other members of the health care team affects pt safety and the work environment.
W33. Nurse-community relationship.
Many nurses form relationships with community groups by participating in local organizations, volunteering for community service, or becoming politically active. To be effective change agents, nurses need to establish relationships with their communities.
W34. Elements of professional communication.
1. Courtesy
2. Use of names
3. Trustworthiness
4. Autonomy and responsibility
5. Assertiveness
W35a. Autonomy.

W35b. Assertiveness.
a. Being self-directed and independent in accomplishing goals and advocating for others.
b.Expressing feelings and ideas without judging or hurting others.
36. List the contextual factors that influence communication.
a. Physical & emotional factors
b. Developmental factors
c. Sociocultural factors
d. Gender
37. Gender influences communication. Explain how communication differs in regard to gender.

a. Male

b. Female
a. Men tend to use less verbal communication but are more likely to initiate communication and address issues more directly.

b. Women disclose more personal information and use more active listening.
W38. The primary diagnosis used to describe the pt with limited or no ability to communicate is:
Impaired verbal communication (state in which the individual's experiences are decreased, delayed, or absent or the person has an ability to receive, process, transmit, and use symbols.)
W39. ID the defining characteristics of the Dx of "limited or no ability to communicate."
Defining characteristics are the inability to articulate words, inappropriate verbalization, difficulty forming words, and difficult in comprehending.
W40. ID the related factors that contribute to the Dx of "limited or no ability to communicate."
Related factors can be physiological, mechanical, anatomical, psychological, cultural, or developmental in nature.
W41. List the goals and outcomes for the pt with the above diagnosis.
1. Pt initiates conversation about the Dx.
2. Pt is able to attend to appropriate stimuli.
3. Pt conveys clear and understandable messages with team.
4. Pt will express increased satisfaction with the process.
W42. Active listening
Being attentive to what the pt is saying both verbally and nonverbally.
W43. Sharing observations
Helps the pt communicate without the need for extensive questioning.
W44. Sharing empathy
Ability to understand and accept another person's reality.
W45. Sharing hope
"Sense of possibility"
W46. Sharing humor
Coping strategy to adjust to stress
W47. Sharing feelings
Subjective feelings that result from one's thoughts and perceptions.
W48. Using touch
Most potent form of communication
W49. Using silence
Useful when ppl are confronted with decisions that require much thought.
W50. Providing information
Pts have the right to know about their health status and what is happening in their environment.
W51. Clarifying
Restating an unclear or ambiguous message.
W52. Focusing
Used to center on key elements or concepts of the message
W53. Paraphrasing
Restating an unclear or ambiguous message
W54. Asking relevant questions
Seeking information needed for decision making
W55. Summarizing
Concise review of key aspects of an interaction
W56. Self-disclosure
Subjectively true, personal experiences about self that are intentionally revealed to another.
W57. Confrontation
Helping the pt become aware of inconsistencies in his or her feelings, attitudes, beliefs and behaviors.
W58. "Why don't you and John get married?" exemplifies...
Asking personal questions.
W59. "If I were you, I'd put your mother in a nursing home." exemplifies...
Giving personal opinions
W60. "Let's not talk about your problems with the insurance company. It's time for you walk." exemplifies.
Changing the subject
W61. "Older adults are always confused" exemplifies.
Autonomic responses.
W62. "Don't worry; everything will be all right." exemplifies.
False reassurance.
W63. "I'm so sorry about your mastectomy; it must be terrible to lose a breast." exemplifies.
Sympathy
W64. "Why are you so anxious?" exemplifies.
Asking for explanations.
W65. "You shouldn't even think about assisted suicide; it is not right." exemplifies.
Approval/Disapproval
W66. No one here would intentionally lie to you, exemplifies.
Defensive responses.
W67. "Things are bad, and there's nothing I can do about it," exemplifies.
Passive responses.
W68. "How can you say you didn't sleep a wink? You were snoring all night long."
Arguing.
W69. What techniques do you use with pts who CANNOT SPEAK CLEARLY.
Listen attentively, do not interrupt, ask simple questions, allow time, use visual cues, do not shout, use communication aids.
W70. What techniques do you use with pts who are COGNITIVELY IMPAIRED.
Use simple sentences, ask one question at a time, allow time for pt to respond, be an attentive listener, include family and friends.
W71. What techniques do you use with pts who are HEARING IMPAIRED.
Check for hearing aids, reduce environmental noise, get pt's attention, face the pt, do not chew gum, speak in a normal voice, rephrase, provide sign language.
W72. What techniques do you use with pts who are VISUALLY IMPAIRED.
Check for glasses, ID yourself, speak in a normal tone, do not rely on gestures or nonverbal comm, use indirect lighting, use 14-font print.
W73. What techniques do you use with pts who are UNRESPONSIVE.
Call the pt by name, verbally and by touch; speak to pt as though the pt can hear; explain all procedures; provide orientation.
W74. What techs do you use with pts who DO NOT SPEAK ENGLISH.
Speak to the pt in normal tone, establish a method to signal the desire to communicate, provide an interpreter, avoid using family members, develop communication aids.
W75. ID what the process recording analysis reveals.
1. Determine whether he encourages openness and allow the pt to "tell his story" expressing both thoughts and feelings.
2. Identify any missed verbal or nonverbal cues or conversational themes.
3. Examine whether nursing responses blocked or facilitated the pt's efforts to communicate.
4. Determine whether nursing responses were positive and supportive or superficial and judgmental.
5. Examine the type and number of questions asked.
6. Determine the type and number of therapeutic communication techniques used.
7. Discover any missed opportunities to use humor, silence, or touch.
W76. In demonstrating the method for deep breathing exercises, the nurse places his or her hands on the pt's abdomen to explain diaphragmatic movement. This technique involves the use of which communication element?
1. Referent
2. Message
3. Feedback
4. Tactile Channel
4. Means of conveying and receiving messages through visual, auditory, and tactile senses.
Which statement about nonverbal communication is correct?
1. The nurses's verbal messages should be reinforced by nonverbal cues.
2. It is easy for a nurse to judge the meaning of a pt's facial expression.
3. The physical appearance of the nurse rarely influences nurse-patient interaction.
4. Words convey meanings that are usually more significant than nonverbal communication.
1. Awareness of the tone of verbal response and the nonverbal behavior results in further exploration.
The term referring to the sender's attitude toward the self, the message, and the listener is:
1. Denotative meaning
2. Metacommunication
3. Connotative meaning
4. Nonverbal communication
3. Meaning of a word's meaning influenced by the thoughts, feelings, or ideas ppl have about the word.
W79. The referent in the communication process is:
1. Information shared by the sender
2. The means of conveying messages
3. That which motivates the communication
4. The person who initiates the communication
3. Motivates one person to communicate with the other.
W80. A nurse is conducting an admission interview with a patient. To maintain the pt's territoriality and maximize communication, the nurse should sit:
1. 4-12 feet from the pt.
2. 0-18 inches from the pt.
3. 12 ft or more from the pt
4. 18 inches to 4 feet from the pt.
4. Personal zone when taking a pt's history.
C1. The nurse summarizes the conversation with the pt to determine if the pt has understood him or her. This is what element of the communication process?
1. Referent
2. Channel
3. Environment
4. Feedback
4. Feedback
C2. Mrs. Jones states that she gets anxious when she thinks about giving herself insulin. How do you use your understanding of intrapersonal communication to help with this?
1. Provide her the opportunity to practice drawing up insulin.
2. Coach her to give herself positive messages about her ability to do this.
3. Bring her written material that clearly describes the steps of insulin administration
4. Use therapeutic communication to help her express her feeling about giving herself an injection
2. Coach her to give herself positive message about her ability to do this.
C3. The nurse has a pt who is short of breath and calls the health care provider using SBAR (Situation-Background-Assessment-Recommendation) to help with the communication. What does the nurse first address?
1. The respiratory rate is 28.
2. The pt has a history of lung cancer.
3. The pt is short of breath.
4. He or she requests an order for a breathing treatment.
3. The pt is SOB.
C4. You are caring for Mr. Smith, who is facing amputation of his leg. During the orientation phase of the relationship, what would you do?
1. Summarize what you have talked about in the previous sessions.
2. Review his medical record and talk to other nurses about how he is acting.
3. Explore his feelings about losing his leg.
4. Talk with him about his favorite hobbies
4. Talk with him about his favorite hobbies.
C5. The nurse states, "When you tell me that you're having a hard time living up to expectations, are you talking about your family's expectations?" The nurse is using which therapeutic communication technique?
1. Providing info
2. Clarifying
3. Focusing
4. Paraphrasing
2. Clarifying
C6. Which of the following statements would be most likely to block communication?
1. "You look kind of tired today?"
2. "Why do you always put so much salt on your food?"
3. "It sounds like this has been a hard time for you."
4. "If you use your oxygen when you walk, you may be able to walk farther."
2.
C7. You are caring for an 80-year old woman, and you ask her a question while you are across the room washing your hands . She does not answer. What is your next action?

1. Leave the room quietly since she evidently does not want to be bothered right now.
2. Repeat the question in a loud voice, speaking very slowly.
3. Move to her bedside, get her attn, and repeat the question while facing her.
4. Bring her a communication board so she can express her needs.
3. Move to her bedside, get her attn....
C8. You ask another nurse how to collect a laboratory specimen. The nurse raises her eyebrows and ask, "Why don't you figure it out?" What would be the best response?
1. Say nothing and walk away. Find a different nurse to help you.
2. "When you brush me off like that, it takes me even longer to do my job."
3. "Why do you always put me down like that?"
4. "I guess I just enjoy having you make fun of me."
2.
C9. When the nurse takes the pt's nursing Hx, he or she sits:
1. Next to the pt.
2. 4-12 feet from the pt.
3. 18 in - 4 feet from the pt.
4. 12 inches to 3 feet from the pt.
3.
C10. When working with an older adult, the nurse remembers to avoid:
1. Touching the pt.
2. Allowing the pt to reminisce
3. Shifting quickly from subject to subject.
4. Asking the pt how he or she feels.
3.
C11. The statement that best explains the role of collaboration with others for the pt's plan of care is which of the following?

1. The professional nurse consults the health care provider for direction in establishing goals for patients.
2. The prof nurse depends on the latest literature to complete an excellent care plan for pts.
3. The prof nurse works independently to plan and deliver care and does not depend on other staff for assistance.
4. The prof nurse works with colleagues and the pt's family to provide combined expertise in planning care.
4.
C12. ID behaviors that foster the development of trust (Select all that apply):
1. Answer the call light promptly.
2. Call the pt by first name unless requested otherwise.
3. Do all the care as quickly as possible and leave the room so the pt can rest.
4. Answer questions honestly.
5. Demonstrate competence when doing treatments
1.
C13. A pt with limited English proficiency is going to be discharged on new med. How does the nurse complete the discharge teaching?
1. Uses a dictionary to give directions for medication administration.
2. Explains the directinos to the pt's 14-year-old daughter.
3. Obtains an interpreter to facilitate communication of medication information
4. Uses a picture board and visual aids to communicate medication administration information
3. Obtains an interpreter.
C14. Your pt has just been told that she has cancer, and she is crying. Which actions facilitate therapeutic communication?

1. Turning on the TV for her fave show
2. Pulling the curtain to provide privacy
3. Offering to discuss info about her condition
4. Asking her why she is crying
5. Sitting quietly by her bed and hold her hand
2, 3, 5
Mr. Sakda emigrated from Thailand. When taking care of him, you note that he looks relaxed and smiles but seldom looks at you directly. How do you respond?
1. Use therapeutic communication to assess for increased anxiety.
2. Sit down and position yourself closer so you are at eye level.
3. Deflect your eyes downward to show respect.
4. Continue to maintain eye contact
3.