CHAPTER 08: COMMUNICATION AND THE NURSE-PATIENT RELATIONSHIP {Williams: deWit's Fundamental Concepts and Skills for Nursing, 5th Edition}

C HAPTER 08: C OMMUNICATION AND THE
N URSE -P ATIENT R ELATIONSHIP
Williams: deWit's Fundamental Concepts and Skills for Nursing, 5th
Edition




MULTIPLE CHOICE


1. The nurse is aware that the purpose of therapeutic communication is to:
a. gather as much information as possible about the patient’s problem.
b. direct the patient to communicate about his deepest con cerns.
c. focus on the patient and the patient needs to facilitate interaction.
d. gain specific medical information and history of illness.



ANS: C



Therapeutic communication is a conversation that is focused on the
patient and promotes understanding between the sender and the
receiver.



DIF: Cognitive Level: Comprehension REF: p. 102
OBJ: Theory #4 TOP: Therapeutic Communication
KEY: Nursing Process Step: Planning MSC: NCLEX:
Psychosocial Integrity: coping and adaptation



2. The practical nursing studen t who is engaged in a therapeutic
communication with a patient will have the most difficult y with the
technique of:

, a. closed questions.
b. restating.
c. using general leads.
d. silence.



ANS: D



The use of silence is the hardest for most students to develop because
it makes them uncomfortable, so they tend to end it prematurely.



DIF: Cognitive Level: Comprehension REF: p. 102
OBJ: Theory #31 TOP: Silence KEY: Nursing
Process Step: Implementation MSC: NCLEX:
Psychosocial Integrity: coping and adaptation



3. To convey the intervention of active listening, the nurse would:
a. maintain eye contact by staring at the patient.
b. prompt the patient when the patient stops talking for a moment.
c. make a conscious effort to block out other sounds in the immediate
environment.
d. write down remarks on a clipboard to facilitate later topics of
conversation.



ANS: C



An active listener maintains eye contact without staring, gives the
patient full attention, and makes a conscious effort to block out other
sounds and distractions.

, DIF: Cognitive Level: Comprehension REF: p. 101
OBJ: Theory #3 TOP: Active Listening KEY: Nursing
Process Step: Implementation MSC: NCLEX:
Psychosocial Integrity: coping and adaptation



4. When the nurse enters the room, the patient is laughing ou t loud at
something on TV. The patient stops and apologizes for the laughter,
saying, “I guess I ought not be laughing at all since I am stuck here with
two broken legs.” The nurse can use evidence -based information when she
responds:
a. “Laughter is nearl y a lways a cover -up for anxiet y when facing a
long rehabilitation.”
b. “Long periods of laughter decrease the amount of ox ygen available
to your body for healing.”
c. “Laughter in a hospital is often distracting and depressing to other
patients nearby.”
d. “Laughter trul y is the best medicine as it has a positive effect on the
immune system.”



ANS: D



Hasen and Hasen (2009) found that laughter and appropriate use of
humor decreased stress and anxiet y and had a positive effect on the
immune system.



DIF: Cognitive Level : Application REF: p. 101 OBJ:
Clinical Practice #2 TOP: Use of Laughter KEY: Nursing
Process Step: Implementation MSC: NCLEX:
Psychosocial Integrity: coping and adaptation

, 5. When interacting with an elderl y patient, the nurse would enhance
communication by:
a. speaking slowl y in order to allow the patient to process the
message.
b. addressing him by his first name to encourage a therapeutic
relationship.
c. standing in the doorway rather than entering the room to give the
elderl y patient more privacy.
d. speaking in simple sentences, as if to a child.



ANS: A



When interacting with an elderl y person, the nurse should try not to
speak too quickl y or expect an immediate answer because the elderl y
take more time to process the message. Do not use baby talk or speak
to them as if they were children.



DIF: Cognitive Level: Comprehension REF: p. 101
OBJ: Theory #2 TOP: Communication KEY: Nursing
Process Step: Implementation MSC: NCLEX:
Psychosocial Integrity: coping and adaptation



6. When the nurse observes a resident in a long -term facilit y pounding his
fists on his legs and grinding his teeth, the nurse will validate her
perception of the patient’s non -verbal expression of anger by:
a. documenting that the patient was agitated and appeared angry.
b. asking the male nursing assistant if it is his perception that the
patient appears angry.
c. accessing the nursing care plan to ascertain if there is a nursing
diagnosis relative to anger.