Solutions
NURS 272 Final Exam 441 COMPLETE
Solutions
Broad opening statement - ANSWER Opening statement or question to begin rapport.
EX: Nurse: Good morning Mr. Smith. How are you feeling today? (Said with presence
and eye contact)
clarification - ANSWER Seeking to make clear that which is not meaningful or that
which is vague
EX: Nurse: "Im not sure that I follow..."
Restatement - ANSWER repeating the main idea expressed
EX: Client: "I hate this hospital." Nurse: "You hate this hospital"
Paraphrasing - ANSWER transforming the clients words into the nurses words, keeping
the meaning intact
Reflection - ANSWER Directing back to the client feelings, ideas, or questions
Summarization - ANSWER organizing and summing up that which has gone before
EX: Nurse: "During the past hour, you and I have discussed......"
Using silence - ANSWER utilizing absence of verbal communication
Offering General Leads - ANSWER giving encouragement to continue. Includes
nonverbal such as head nodding and paralanguage such as "uh huh".
EX: Nurse: "Go on." "And then....." "Tell me...."
Making or sharing observations - ANSWER verbalizing what is perceived
EX: Nurse: "You're trembling...."
Giving recognition - ANSWER acknowledging, indicating awareness
Nurse: "I see that you have fixed your hair today."
Offering self - ANSWER making oneself available
,NURS 272 Final Exam 441 COMPLETE
Solutions
Nurse: "I will stay with you until your daughter gets here."
Encouraging description of perception - ANSWER encouraging patient to describe how
he sees the situation & its meaning for him
Nurse: "What is your understanding about what the doctor just shared with you? What
does this mean for you & your family right now?"
Encouraging comparison - ANSWER asking that similarities and differences be noted
Nurse: "How is this pain compared to what you experienced last night?"
Focusing - ANSWER concentrating on a single specific point
Exploring - ANSWER delving further into a subject or idea
EX: Nurse: "Tell me more about how you are feeling now"
Giving information - ANSWER making available the facts that the patient needs
Nurse: "It is unlikely that you will be able to go home until you have finished these new
tests that your doctor told you about."
Verbalizing the implied - ANSWER voicing what the client has hinted at or suggested
Client: "I can't talk to you or anyone. It's a waste of time."
Nurse: "Do you feel that no one understands?"
Seeking validation - ANSWER searching for mutual understanding
Nurse: "You seem to be feeling better now after your bath." Or "I believe you are telling
me that......."
Acknowledge - ANSWER Acknowledging what the client has said
Nurse: "im sorry"
Sharing - ANSWER Sharing your personal experiences AS APPROPRIATE. Use
sparingly and
only when appropriate. This technique must be used for the client's benefit and
not to meet the nurse's needs. *Can easily be a block*
,NURS 272 Final Exam 441 COMPLETE
Solutions
Closing - ANSWER statements at the end of an interaction that close in a meaningful
way
therapeutic communication - ANSWER communication that is goal directed and focused
dialogue between nurse and patient. involves exchange of ideas, feelings, and attitudes
related to desired heath outcomes.
characteristics and purpose of therapeutic communication - ANSWER 1. client centered
2. goal directed
3. defined rules and boundaries
4. individualized strategies: nurse adjusts approaches as needed
5. nonjudgemental
timing of therapeutic communication - ANSWER 1. emotional readiness: low readiness
2. energy conservation: remember Maslow
characteristics of verbal communication - ANSWER 1. words are symbols used to think
about ideas, share, and validate meaning. letters are symbols of vocalizations
2. differences influence communication
3. paralanguage
4. slang/jargon
paralanguage - ANSWER vocalic behaviors that communicate meaning along with
verbal behavior
characteristics of nonverbal communication - ANSWER 1. body language often conveys
true emotions
2. cultural/gender differences
3. cues/facial expressions (posture, rhythm of moves, gestures, stance, eye contact)
4. clothing/grooming (tells about mental status, SES, etc)
active listening - ANSWER 1. hear client message: beyond listening
2. decode its meaning
3. provide feedback concerning nurse's understanding of message
4. SOLER
SOLER - ANSWER demonstrate active listening.
S: sit square or at an angle so you face person
O: open posture, not crossing arms/legs
L: lean forward a bit
E: eye contact to comfort of patient
R: relax, no fidgeting
Questions to start therapeutic communication - ANSWER open-ended, closed, focused,
, NURS 272 Final Exam 441 COMPLETE
Solutions
open ended questions - ANSWER open to interpretation. start with how, what, where,
where but NEVER use why
closed questions - ANSWER yes or no info. start with do, will, can
focused questions - ANSWER limiting, but answer is more than yes or no
communication assessment - ANSWER 1. verbal: fluency, accents, organization2. 2.
written: able to write/read? how much/what level/how well
3. nonverbal
4. environment: hospital, clinic, LTC, community, home, etc
communication considerations with infants - ANSWER nonverbal, gentle motion,
parents are partners, slow and soft voice, sit level or hold in arms
communication considerations with toddlers (1-3) - ANSWER brief and clear, simple
complete sentences in their words, no baby talk, show hands, allow some choices,
address parents first
communication considerations with preschoolers (3-5) - ANSWER simple words, brief
and concrete explanations, play therapy for explanations, provide choices, attending
posture, jokes
communication considerations with school age (5-10) - ANSWER include in care and
explanations, draw pics, use their words, privacy
communication considerations with 11+ - ANSWER abstract thinking used but minimal,
humor, privacy, state limits of confidentiality, allow decisions, attending posture, active
listening
communication considerations with elderly - ANSWER -use correct titles
-include in conversation
-use normal voice/mannerisms (unless hearing impaired)
-touch-appropriate
-decreased energy level
communication considerations with visually impaired - ANSWER -let them know when
entering/leaving
-use normal voice
-explain touching before done
-orient to evironmet
-stay in visual field if partial vision
-ambulate with them holding your arm