CH. 6 - Communication & Relationships

True or false communication between two people is called one-sided communication because one side gives communication and the other side receives the communication

False

True or false communication is the process of informing

False

True or false interpreting information is not a part of the communication but is a part of listening

False

True or false people will let you know how well you are communicating by giving you feedback

True

True or false shared meaning refers to two people deciding what another person meant

False

You enter your patients' room and find him sitting in a chair with his eyes closed. He has a grimace on his face and is holding his body rigidly. You asked me if he is feeling OK, and he says, "yes, I'm fine. Really." Which of the following best explains the situation in terms of communication?

A. He is communicating to you that he's fine

B. His verbal and nonverbal messages are congruent

C. His verbal and nonverbal messages are incongruent

D. He is sarcastic, but is understandable

C

You are helping bathe a 27-year-old female patient who has had back surgery. Of the following, which is the best way to communicate your respect for the fact that you are "invading" her personal space?

A. Pull the curtain so no one can see you or the patient while you help her with her bath

B. Pull the curtains give her a dry towel and tell her she can use it to cover up

C. Pull the curtains and ask her how you can help her

D. Pull the curtains and tell her to wash her face and hands, then you will wash her back, and then she can finish

C

You ask an LPN on your team to interview a patient being admitted for surgery. You walk by the room and observe that the nurse is seated on the chair while the patient is seated on the bed. She is leaning forward slightly. By her body position you would conclude that

A. She is conducting the interview in an appropriate manner

B. She is too casual and should not be sitting

A

Your patient has an infected wound with a lot of dead tissue called the eschar that is preventing healing. The doctor plans to do pride the wound, which means to remove the dead tissue. You go in to prepare the patient for the procedure, which is done right at the bedside. Which of the following is the best way to communicate what will happen?

A. The doctor is going to cut away all the black, dead skin

B. The doctor is going to debride the eschar

C. The doctor is going to remove dead tissue so the wound can heal

D. The doctor is going to clean the wound

C

The language used in communication has a significant impact on how that communication is received. which of the following statements can be used as a guide for communicating a plan of care to your teenage patient and her family?

A. Speak to all of them as mature adults

B. Speak to the teenager in common, widely acceptable slang terms to put her at ease

C. Use the correct medical terminology when describing the plan to all of them

D. Use common every day language to describe the plan

D

Acceptable, polite communication styles between professionals and their patients very greatly among different cultures. Acceptable styles also very within cultures. When approaching a patient from a cultural background other than your own, you should?

A. Maintain distance and avoid direct eye contact to be on the safe side

B. Observe how the family interacts and take your cues from that

C. Ask another professional from that cultural background for advice if possible

D. Find out information about the culture from a different source such as permanent website or text

B,C,D

Nonverbal language can be expressive. As a nurse in a human being, you may experience negative feelings towards a patient, even though you try to overcome it, and you can strongly convey this negativity by your attitude. Which of the following is the best course of action for you should you find you have negative feelings towards a patient?

A. Asked to be reassigned

B. Maintain a greater distance between you and the patient which will provide a buffer for your feelings

C. Be aware of the attitude you display by exhibiting open, focused, nonverbal communication

D. Communicate your feelings to the patient in a non-judge mental manner

C

Active listening is?

A. Hearing with the patient has to say and then providing direction or advice

B. Hearing what the patient has to say and then expressing your feelings about the content

C. Hearing what the patient has to say, being attentive to nonverbal messages, and providing feedback

D. Hearing with a patient has to say, being attentive to nonverbal messages, and providing an interpretation to the patient

C

The joint commission recommends which type of shift to shift reporting?

A. A recorded Report so the oncoming staff can listen to specific information again if needed

B. A group report we are all oncoming staff are in a room with all of the off going staff

C. A bedside report where on coming staff and off going staff go to each patient's room together

D. No shift report because it is a violation of HIPPA

C

Match the following statements. Assume you need to talk with an aide about addressing change that has not been done.

1. "you need to understand that your work reflects on me"

2. "I want to talk with you about Mrs. G's dressing change. It was supposed to have been change two hours ago"

3. "I'm going to change Mrs. G's dressing, I see you didn't get to it. did you get busy"

Answers:

A. Assertive

B. Avoidant

C. Aggressive

1. C

2. A

3. B

An exchange of information, feelings, needs, and preferences between two people

communication process

to complete the communication process, a return message is sent by the receiver of the original communication to indicate the message has been received, process, and comprehended

feedback

Mutual understanding of the meaning of a message

shared meaning

The conscious use of words, either spoken or written

Verbal communication

The communication revealed through facial expressions, posture, body position, behavior, gestures, touch, and general appearance

nonverbal communication

Facial expressions, posture, body position, behavior, touch, and general appearance

body language

Agreement between verbal and nonverbal communications

congruent

The distance, or personal space, people place between themselves and others

proxemics

Using all the senses to interpret verbal and nonverbal messages is called _________

active listening

________________ is patient centered and promotes a greater understanding of a patient's needs, concerns, and feelings

Therapeutic communication

Words can have two layers of meaning. ____1______ refers to the literal meaning, whereas _____2_____ refers to the emotional associations attached to a word

1. denotative meaning

2. connotative meaning

Two people are said to have a _________ when their relationship is characterized by mutual trust and understanding

rapport

The ability to identify intellectually (not emotionally) with the experience, feelings, thoughts, or attitudes of others is called _________

Empathy

_________ is the inability to speak or understand language

aphasia

Today is your first day on an Alzheimer's unit in a long-term care facility. Which of the following is the best way to begin to establish a connection with your patients?

Smile at the patients

Multiple areas of the brain are involved with all forms of communication. Which of the following is the likely outcome if your patient has a stroke that affects the left frontal love (Broca's area)?

Loss of movement in muscles that control speech

Which communication form will be compromised if your patient has a stroke that affects the occipital lobe?

loss of vision

Which communication form will be compromised if your patient has a stroke that affects the parietal lobes?

Loss of ability to perceive touch

When communicating with patients of various ages, it is important to match your communication strategies to the patients'...

developmental stage

when communicating with older adults, it is important to be aware of

Any impairments in vision or hearing

Chronic pain issues

Dementia that interferes with communication

Environmental distractions

When caring for a patient in clinical, you are aware that he only response with "yes" or "no" when you talk to him. What strategies could you use to better communicate with this patient

Use open-ended questions when eliciting information from him

Communication between two people is called one-sided communication because one side gives communication and the other side receives the communication

false

Communication is the process of informing

false

Interpreting information is not part of communication but is a part of listening

false

People will let you know how well you are communicating by giving you feedback

true

Shared meaning refers to two people deciding what another person meant

false

You enter your patient's room and find him sitting in a chair with his eyes closed. He has a grimace on his face and is holding his body rigidly. You ask him if he is feeling okay, and he says, "Yes, I'm fine. Really." Which of the following best explains this situation in terms of communication?

His verbal and nonverbal messages are incongruent

You are helping bathe a 27-year-old female patient who has had back surgery. Of the following, which is the best way to communicate your respect for the fact that you are "invading" her personal space?

Pull the curtains and ask how you can help her

You ask an LPN on your team to interview a patient being admitted for surgery. You walk by the room and observe that the nurse is seated on the chair while the patient is seated on the bed. She is leaning forward slightly. By her body position you would conclude that

she is conducting the interview in an appropriate manner

Your patient has an infected wound with a lot of dead tissue called eschar that is preventing healing. The doctor plans to debride the wound, which means to remove the dead tissue. You go in to prepare the patient for the procedure, which is done right at the bedside. Which of the following is the best way to communicate what will happen?

"The doctor is going to remove dead tissue so the wound can heal"

The language used during communication has a significant impact on how that communication is received. Which of the following statements can be used as a guide for communicating a plan of care to your teenage patient and her family?

Use common, everyday language to describe the plan

Acceptable, polite communication styles between professionals and their patients vary greatly among different cultures. Acceptable styles also vary within cultures. When approaching a patient from a cultural background other than your own, you should

Observe how the family interacts and take your cues from that

Ask another professional from that cultural background for advice, if possible

Find out information about that culture from a different source, such as a pertinent Web site or text

Nonverbal language can be expressive. As a nurse and a human being, you may experience negative feelings toward a patient, even though you try to overcome it, and you can strongly convey this negativity by your attitude. Which of the following is the best course of action for you should you find you have negative feelings toward a patient?

Be aware of the attitude you display by exhibiting open, focused, nonverbal communication

Active listening is

hearing what the patient has to say, being attentive to nonverbal messages, and providing feedback

The Joint Commission recommends which type of shift-to-shift reporting?

A bedside report where on-coming and off-going staff go to each patient's room together

"You need to understand that your work reflects on me."

agressive

"I want to talk with you about Mrs. G's dressing change. It was supposed to have been changed 2 hours ago."

Assertive

"I'm going to change Mrs. G's dressing; I see you didn't get to it. Did you get busy?"

Avoidant

Using the DESC communication method as a guide, explain why describing the behavior is important as the first step.

The first step is to describe the behavior. Focusing on describing the behavior—rather than judging it, belittling it, or complaining about it—keeps the discussion objective rather than subjective. It keeps the comments from becoming personal because you are not talking about the person.

In the DESC method, the E stands for "Explain." What needs to be explained and why?

The impact of the behavior is what needs to be explained. This is important because an individual may not know or fully understand the consequences of his or her behavior. It will force him or her to evaluate the behavior in light of its impact on others.

Stating the desired outcome is the third step in the DESC communication method. Explain why you think this is important.

By stating the desired outcome, the other person does not have to wonder what you want him or her to do. It keeps the conversation open, with both parties understanding what the expected outcome will be, which increases the likelihood of it occurring.

The C step of the DESC method is optional, depending on the circumstances. Explain what the C step is and why it may be needed.

The C step is the consequences step. It may be needed if the person fails to be convinced that the behavior should change.

How should you position the computer screen when you are obtaining information from the patient that must be entered into the electronic health record?

So that you can look at the patient and make eye contact as he or she answers

What is the reason for positioning the screen in this manner?

To prevent depersonalizing the patient and focusing on the computer, not on the patient, allowing you to promote trust and project caring

Repeat the same words back to the patient

reflection

Discourages answering questions with one or two words

open-ended questions or statements

relate in different words the heart of what a patient said

restatement (validation)

Provide relevant data

giving information

Helps patients explore options when making decisions

looking at alernatives

Using pauses of up to several minutes without verbalizing

using silence

relate the important points

summarizing

Helps to verify that the message sent was what was intended

seeking clarification

Encourages initiation or elaboration of a conversation

providing general leads

Shows concern and willingness to help

offering self

Which of the following are barriers to communication?

Using clichés

Asking personal, probing questions

Being frank about disapproval

Standing over a seated person

A patient expresses fears about her upcoming surgery. The nurse responds, "You really don't have to worry. You have a great doctor and everything will turn out fine." Why is this statement a barrier to communication?

It diminishes the patient's concerns

It is equivalent to telling the patient to not talk about her fears

How can you communicate in an urgent situation?

Use the SBAR format, allow your voice to reflect the urgency of the situation, and make sure your movements are purposeful and focused

A patient on your unit is very angry and hard to care for. She frequently belittles her caretakers. You have taken care of her for 2 days and ask the nurse manager to assign the patient to someone else. The nurse manager does as you ask, but the nurse she chooses comes to you and says, "This isn't fair at all! She is your patient, and you are dumping her on me!" Which of the following alternatives is the best way to begin to resolve this conflict?

Tell the nurse privately that you needed an emotional break from the patient

. The language used during communication has a significant impact on how that communication is received. Which of the following statements can be used as a guide for communicating a plan of care to your teenage patient and her family?

"I have to be home on time for my kids. If you're late, I get nervous and worried."

"I've put up with this for a long time now. I'm going to speak with the nurse manager about this."

Your patient had spine surgery 2 days ago and is scheduled for discharge tomorrow. He has been taking narcotic pain relievers every 4 hours around the clock. You note that the patient has not had a bowel movement since surgery. You know that the narcotics can be constipating and you think it would be best if the problem is handled prior to the patient leaving for home. There is no order on the chart for a laxative. From the following possible actions, choose which you think represents the most focused and necessary thing(s) for you to do as you prepare to call the doctor for a verbal order for a laxative.

Gather information about the patient's usual bowel habits; ask if he feels constipated and if he has used laxatives in the past

Downward communication is communication with people you supervise

true

When you communicate effectively and professionally, you are role modeling, too.

true

As a team leader, you have a responsibility to tell the people you supervise about your facility policies and procedures

true

When assigning tasks to a team, you should explain how one task relates to another even if two different people are doing the tasks separately. This is called "job rationale"

true

The shift-to-shift report is so important that The Joint Commission has made it a patient safety goal

true

It is important for the shift report to be standardized in a facility, but it is important that the nurses coming on duty have plenty of time to ask questions

false

giving reports to the oncoming shift is considered confidential

true

select a sequence to present each patient's report so you will be less likely to forget something

true

The basis of the nurse-patient relationship is

trust

you are interviewing a new patient who is being admitted to the psychiatric unit. You technique in this interview will largely be

nondirective, with many open-ended questions

Communicating with the hearing impaired can be a challenge. Which of the following techniques has been identified as helpful

Facing the person and getting his or her attention before starting to communicate

Speaking to the patient, not the interpreter, if there is one present

Eliminating background noise or other distractions

You are assigned to care for a female patient with severe vision impairment. How can you best communicate with her?

Identify yourself when you enter the room

Avoid raising the volume of your voice

Before leaving the room, ask if she needs anything and tell her you are leaving