Foundations Of Nursing 6th Edition by Barbara Lauritsen Christensen – Test Bank
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Sample
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Christensen: Foundations of Nursing, 6th Edition
Chapter 03: Communication
Test Bank
MULTIPLE CHOICE
1. Although
the patient denies pain, the nurse observes the patient breathing rapidly with
clenched fists and facial grimacing. The nurse’s best response to these
observations is:
|
a. |
“I am glad you are feeling
better and have no discomfort.” |
|
b. |
“Where do you hurt?” |
|
c. |
“What you are saying and
what I am observing don’t seem to match.” |
|
d. |
“It makes me uncomfortable
when you are not honest with me.” |
ANS: C
The nonverbal communication should be clarified to prevent
miscommunication.
DIF: Cognitive Level: Analysis
REF: Page
45
OBJ: 2
TOP:
Communication
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
2. The
nurse considers the feelings and needs of a patient by stating, “I know you are
concerned about your surgery tomorrow. How can I help you?” This type of
communication is:
|
a. |
intrusive. |
|
b. |
aggressive. |
|
c. |
closed. |
|
d. |
assertive. |
ANS: D
Assertive communication takes a patient’s feelings and needs
into account, yet honors the patient’s rights as an individual.
DIF: Cognitive Level:
Analysis
REF: Page
39 OBJ:
4
TOP:
Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
3. If
the nurse aggressively says to a patient, “Why couldn’t you have asked me to
give you your pain medication when I was in here earlier?” the patient is most
likely to feel:
|
a. |
angry. |
|
b. |
that his needs are met. |
|
c. |
humiliated and unworthy. |
|
d. |
that his request will be
granted. |
ANS: C
Aggressive communication is highly destructive. Although anger
may eventually come, the patient most likely feels humiliated first.
DIF: Cognitive Level: Application
REF: Page
39
OBJ: 7
TOP:
Communication
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity
4. Therapeutic
communication:
|
a. |
facilitates the formation
of a positive nurse-patient relationship. |
|
b. |
manipulates the patient. |
|
c. |
assigns the patient a
passive role. |
|
d. |
requires the patient to
accept what the nurse says. |
ANS: A
A positive nurse-patient relationship is facilitated by
therapeutic communication.
DIF: Cognitive Level:
Comprehension REF: Page
40
OBJ: 10
TOP:
Communication
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
5. If a
nurse sits in a chair near the patient’s bed, leans forward to hear what the
patient is saying, and does not interrupt, the nurse is demonstrating:
|
a. |
support. |
|
b. |
caring. |
|
c. |
active listening. |
|
d. |
interest. |
ANS: C
When demonstrating active listening, the nurse must give his or
her full attention and make an effort to understand both the verbal and
nonverbal message.
DIF: Cognitive Level:
Application
REF: Page
41
OBJ: 5
TOP: Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
6. A
therapeutic communication technique that requires a great deal of skill and is
not used as frequently as other communication techniques is:
|
a. |
touch. |
|
b. |
silence. |
|
c. |
listening. |
|
d. |
summarizing. |
ANS: B
Silence is an extremely effective therapeutic communication
skill that is frequently underused because the nurse feels uncomfortable
applying it.
DIF: Cognitive Level:
Analysis
REF: Page
41
OBJ: 5
TOP:
Communication
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
7. A
patient does not speak English; therefore, the nurse cannot use words to
provide comfort during a painful procedure. Another intervention that may
provide comfort is:
|
a. |
silence. |
|
b. |
listening. |
|
c. |
touch. |
|
d. |
restating. |
ANS: C
Holding the hand of a non–English-speaking patient is effective
and comforting.
DIF: Cognitive Level:
Analysis
REF: Page
42 OBJ:
9
TOP:
Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
8. A
patient states, “I do cocaine when I feel things are out of my control.” The
nurse who responds by asking, “What else does cocaine do for you?” is using the
communication skill of:
|
a. |
summarization. |
|
b. |
restating. |
|
c. |
showing acceptance. |
|
d. |
stating observations. |
ANS: C
Acceptance is the willingness to listen and respond to what the
patient is saying without passing judgment.
DIF: Cognitive Level:
Analysis
REF: Page
42 OBJ:
5
TOP:
Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
9. A
patient states, “I’m really strung out about this pregnancy.” The nurse who
responds by asking, “What about this pregnancy worries you?” is using the
technique of:
|
a. |
closed inquiry. |
|
b. |
restating. |
|
c. |
open-ended question. |
|
d. |
minimal encouraging. |
ANS: C
Open-ended questions convey interest and do not require a
specific response.
DIF: Cognitive Level:
Analysis
REF: Pages 44-45 OBJ: 5
TOP:
Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
10. A
grieving young widow cries out, “Why was my husband killed? Why wasn’t it me?”
The best response from the nurse would be:
|
a. |
stating “You need to be
strong for your children.” |
|
b. |
silently placing her hand
on the widow’s arm. |
|
c. |
asking if there is anyone
the widow needs to have notified. |
|
d. |
stating “You are feeling
overwhelmed about your husband’s death.” |
ANS: B
The ability to listen and assist those who are newly grieving
through the use of silence and a quiet presence is very effective. Stating “You
need to be strong for your children.” is a cliché. Asking if there is anyone
the widow needs to have notified and stating “You are feeling overwhelmed about
your husband’s death.” are not therapeutic in this immediate grieving time.
DIF: Cognitive Level:
Analysis
REF: Page
41 OBJ:
5
TOP:
Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
11. A
nurse assessing a patient with a nursing diagnosis of impaired verbal
communication is aware that the least number of defining characteristics for
this diagnosis is:
|
a. |
one. |
|
b. |
two. |
|
c. |
three. |
|
d. |
four. |
ANS: A
If one or more of the defining characteristics is present, a
nursing diagnosis of impaired verbal communication can be determined.
DIF: Cognitive Level: Analysis
REF: Page
51
OBJ: 8
TOP:
Communication
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity
12. When
communicating with an unresponsive patient, the communication technique the
nurse should use is to:
|
a. |
avoid speaking directly to
the patient. |
|
b. |
assume verbal stimuli are
heard. |
|
c. |
speak in a loud voice. |
|
d. |
use simple words. |
ANS: B
A person interacting with an unresponsive patient should assume
all sounds and verbal stimuli have the potential of being heard by the patient.
DIF: Cognitive Level:
Application
REF: Page
53
OBJ: 10
TOP:
Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
13. If in
response to the patient statement, “I am upset about all this lab work” the
nurse responds, “You’re upset?” this is an example of:
|
a. |
an open-ended question. |
|
b. |
reflecting. |
|
c. |
restating. |
|
d. |
paraphrasing. |
ANS: C
Restating is one of the most effective methods of therapeutic
communication to encourage the patient to offer more information.
DIF: Cognitive Level:
Analysis
REF: Page
45 OBJ:
5
TOP:
Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
14. One
of the main characteristics of therapeutic communication is that it:
|
a. |
allows the patient a
passive role. |
|
b. |
uses only verbal
communication. |
|
c. |
involves the patient as a
person. |
|
d. |
is directive. |
ANS: C
Therapeutic communication actively involves the patient in all
areas of the nursing process.
DIF: Cognitive Level:
Comprehension REF: Page 40
OBJ: 10
TOP:
Communication
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
15. The
nurse should avoid standing at the bedside with the patient lying in bed
because the nurse may be construed as demonstrating:
|
a. |
interest. |
|
b. |
power. |
|
c. |
caring. |
|
d. |
support. |
ANS: B
Standing at the bedside with the patient in bed may imply that
the nurse has the power.
DIF: Cognitive Level:
Application
REF: Page
46
OBJ: 8
TOP: Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
16. A
nurse actively avoids the use of one-way communication because the major
problem is that:
|
a. |
the receiver is in control. |
|
b. |
feedback is provided to the
sender. |
|
c. |
participation is not equal. |
|
d. |
the communication is
unstructured. |
ANS: C
One-way communication is seldom effective because the sender is
in control and gets very little feedback from the receiver.
DIF: Cognitive Level:
Analysis
REF: Page
37 OBJ:
7
TOP:
Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
17. When
nursing actions cause the nurse to violate the personal space of the patient,
the nurse can reduce the discomfort of the patient by:
|
a. |
approaching the interaction
in a professional manner. |
|
b. |
distracting the patient
with jokes and humor. |
|
c. |
asking another nurse to be present
at the bedside. |
|
d. |
assuring the patient that
all people dislike invasion of personal space. |
ANS: A
The intimate zone can cause uneasiness for both patient and
nurse; therefore, approach the interaction in a professional manner.
DIF: Cognitive Level:
Application
REF: Page
46
OBJ: 8
TOP:
Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
18. The
best method for a literate, English-speaking patient on a ventilator to
communicate his or her needs would be:
|
a. |
eye blinking for “yes” and
“no.” |
|
b. |
magic slate or paper and
pencil. |
|
c. |
computer. |
|
d. |
message board or cards. |
ANS: B
Writing devices are preferred as they do not limit the patient’s
messages compared to a message board or cards. Eye blinks are tiring and
time-consuming. Computers require space and the ability to type.
DIF: Cognitive Level:
Application
REF: Page 52, Boxes 3-6 and 3-7
OBJ: 10
TOP: Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
19. A
patient roughly asks the nurse to bring him some ice cream. An assertive
response by the nurse is:
|
a. |
“You are hungry and want a snack.” |
|
b. |
“I can do that in 10
minutes when I finish my rounds.” |
|
c. |
“Maybe I can get one of the
aides to bring you something in a while.” |
|
d. |
“Call the nursing station
and ask them to have the kitchen bring whatever you want.” |
ANS: B
Assertiveness is the most effective style of communication to be
responsive to the patient and set limits.
DIF: Cognitive Level:
Application
REF: Pages 39-40 OBJ: 4
TOP: Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
20. A
nurse tells a patient, “This PM you are going for an abdominal A&P, an
H&H, as well as an IV pyelogram. Please sign these consent forms.” The use
of medical jargon can cause:
|
a. |
understanding. |
|
b. |
speed in communication. |
|
c. |
misinterpretation. |
|
d. |
clarity in the message. |
ANS: C
Jargon is terminology unique to people in a special type of work
and is not understood by everyone. Although jargon does speed communication and
is clear to those who know it, it may be misinterpreted and not understood by
all people.
DIF: Cognitive Level:
Analysis
REF: Page
37 OBJ:
8
TOP: Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
21. During
a complete assessment, which type of questioning is not usually conducive to
fostering communication?
|
a. |
Open-ended |
|
b. |
Focused |
|
c. |
Closed |
|
d. |
Clarifying |
ANS: C
Closed questions are types of questions that the nurse may
choose to use that are not usually conducive to fostering communication.
DIF: Cognitive Level:
Analysis
REF: Page
42 OBJ:
8
TOP:
Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
22. A
patient states, “My husband has told me how he feels about my having a
mastectomy.” The nurse nods and says, “Go on.” This is an example of:
|
a. |
clarifying. |
|
b. |
restating. |
|
c. |
focusing. |
|
d. |
minimal encouraging. |
ANS: D
The nurse uses minimal encouraging to lead the patient to
provide more information.
DIF: Cognitive Level: Analysis
REF: Page 41, Table 3-2
OBJ:
5
TOP: Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
23. When
communicating with an older adult, the nurse can enhance communication by
speaking in a:
|
a. |
rapid manner to accommodate
the patient’s short attention span. |
|
b. |
lower voice tone to
accommodate hearing loss. |
|
c. |
simple manner as if
speaking to a child. |
|
d. |
loud voice directly at ear
level. |
ANS: B
Older adults lose their ability to hear higher-frequency sound.
Speaking in a lower tone enhances communication. Speaking overly loud and as if
to a child may be irritating and demeaning. Rapid speech may be difficult for
older adults to understand.
DIF: Cognitive Level:
Analysis
REF: Page 49, Box 3-4
OBJ:
9
TOP: Physiological factors affecting communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
24. Maintaining
eye contact for 2 to 6 seconds during communication:
|
a. |
keeps the nurse’s attention
on the conversation. |
|
b. |
counteracts shyness in the
patient. |
|
c. |
indicates continuous
focused attention. |
|
d. |
assesses if the patient is
involved in the conversation. |
ANS: C
Maintaining eye contact for 2 to 6 seconds involves the person
in what is being said, is indicative of continued interest, and conveys to the
patient an accepting attitude.
DIF: Cognitive Level:
Application
REF: Page
37 OBJ:
2
TOP:
Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
25. Recognizing
that a patient experiencing stress most likely feels vulnerable, the nurse
intervenes by:
|
a. |
using technical language. |
|
b. |
directing the conversation. |
|
c. |
modifying communication
methods. |
|
d. |
offering all the
information. |
ANS: C
When the patient is experiencing stress, the nurse should modify
communication methods.
DIF: Cognitive Level: Application
REF: Page
50
OBJ: 10
TOP:
Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
26. A
nurse communicates with a patient by maintaining eye contact and through the
use of touch. The nurse is demonstrating the use of what type of communication?
|
a. |
Verbal |
|
b. |
Persuasive |
|
c. |
Directive |
|
d. |
Nonverbal |
ANS: D
Messages transmitted without the use of words (either oral or written)
constitute nonverbal communication. Nonverbal cues include tone and rate of
voice, volume of speech, eye contact, physical appearance, and use of touch.
DIF: Cognitive Level:
Analysis
REF: Page
37 OBJ:
5
TOP:
Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
27. A
nurse frequently looks at her watch when giving a patient a bed bath. The
message that is most likely conveyed to the patient is that the nurse:
|
a. |
desires to spend more time
with the patient. |
|
b. |
is anxious to listen to the
patient’s concerns. |
|
c. |
is feeling hurried. |
|
d. |
likes her watch. |
ANS: C
Frequently looking at one’s watch while interacting with a
patient conveys to the patient that the nurse is in a hurry and really has no
desire to spend time with him or her.
DIF: Cognitive Level:
Analysis
REF: Page
38 OBJ:
8
TOP:
Gestures KEY:
Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
28. When
listening to a patient, the nurse demonstrates disinterest and coldness by:
|
a. |
tightly crossing her arms. |
|
b. |
uncrossing her arms. |
|
c. |
uncrossing her legs. |
|
d. |
facing the patient. |
ANS: A
The way that an individual sits, stands, and moves is called
posture. Posture has the potential to convey warmth and acceptance or distance
and disinterest. An open posture is demonstrated with a relaxed stance with
uncrossed arms and legs while facing the other individual. A slight shift in
body position toward an individual, a smile, and direct eye contact are all
consistent with open posturing and convey warmth and caring. Closed posture is
a more formal, distant stance, generally with the arms, and possibly the legs,
tightly crossed. A person will often interpret closed posture as disinterest,
coldness, and even nonacceptance.
DIF: Cognitive Level:
Analysis
REF: Page
38 OBJ:
8
TOP:
Posture
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
29. When
listening to a patient, the nurse demonstrates warmth and acceptance by:
|
a. |
tightly crossing her arms. |
|
b. |
uncrossing her arms. |
|
c. |
tightly crossing her legs. |
|
d. |
facing away from the
patient. |
ANS: B
The way that an individual sits, stands, and moves is called
posture. Posture has the potential to convey warmth and acceptance or distance
and disinterest. An open posture is demonstrated with a relaxed stance with
uncrossed arms and legs while facing the other individual. A slight shift in
body position toward an individual, a smile, and direct eye contact are all
consistent with open posturing and convey warmth and caring. Closed posture is
a more formal, distant stance, generally with the arms, and possibly the legs,
tightly crossed. A person will often interpret closed posture as disinterest,
coldness, and even nonacceptance.
DIF: Cognitive Level:
Analysis
REF: Page
38 OBJ:
5
TOP: Posture
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
30. A
nurse caring for a pediatric patient is most likely to be perceived as
nonthreatening by:
|
a. |
tightly crossing her arms. |
|
b. |
maintaining an open posture. |
|
c. |
maintaining a tense
posture. |
|
d. |
standing at the bedside. |
ANS: B
Standing at the bedside looking down at the patient in the bed
places the nurse in a position of authority and control. The patient is likely
to experience this as intimidating and condescending. Whenever possible, the
nurse should be level with the patient; this is especially important with
pediatric patients. Sitting at the bedside in a relaxed and open posture is one
example.
DIF: Cognitive Level:
Analysis
REF: Page
38
OBJ: 5
TOP:
Posture
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
31. A
nurse is caring for a patient who is experiencing excruciating pain and
requires frequent administration of analgesics. The nurse demonstrates
aggressive communication when stating:
|
a. |
“Please let me know when
you start to have pain.” |
|
b. |
“Let’s practice some guided
imagery.” |
|
c. |
“Let’s try repositioning
you.” |
|
d. |
“I will only medicate you every
4 hours.” |
ANS: D
Aggressive communication is when a person interacts with another
in an overpowering and forceful manner to meet their own personal needs at the
expense of the other. By only medicating a patient every 4 hours for
excruciating pain, the nurse meets their own needs at the expense of the
patient.
DIF: Cognitive Level:
Analysis
REF: Page
39 OBJ:
7
TOP:
Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
32. A
nurse is caring for a newly admitted diabetic patient. When performing the
initial assessment, the nurse demonstrates use of a closed question when
stating:
|
a. |
“What time do you take your
insulin?” |
|
b. |
“How do you feel about
taking insulin?’ |
|
c. |
“Tell me about your support
system.” |
|
d. |
“How do you feel about
having diabetes?” |
ANS: A
Much of the information gathered from a patient comes from
questioning them directly. A closed question is focused and seeks a particular
answer. For example, when interviewing a newly admitted patient with diabetes,
the nurse asks, “What time do you take your insulin?” A specific question with
a specific answer is a typical closed question, which generally requires only
one or two words in response.
DIF: Cognitive Level:
Analysis
REF: Page
42 OBJ:
7
TOP: Closed
questioning
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
33. A
nurse is caring for a patient experiencing respiratory distress. The physician
places an endotracheal tube. The most appropriate nursing diagnosis for this
patient is:
|
a. |
ineffective coping. |
|
b. |
risk for infection. |
|
c. |
altered nutrition: less
than body requirements. |
|
d. |
impaired verbal
communication. |
ANS: D
Because of the placement of an endotracheal tube, the patient is
unable to speak. The nursing diagnosis of impaired verbal communication is most
appropriate.
DIF: Cognitive Level: Application
REF: Page
51
OBJ: 9
TOP: Nursing
diagnosis
KEY: Nursing Process Step: Diagnosis
MSC: NCLEX: Psychosocial Integrity
34. A
nurse examines whether patient interventions have been appropriate and expected
outcomes have been met. The nurse is demonstrating which step of the nursing
process?
|
a. |
Assessment |
|
b. |
Planning |
|
c. |
Implementation |
|
d. |
Evaluation |
ANS: D
A nurse evaluates the effectiveness of interventions based on
the patient’s ability to meet established goals and outcomes.
DIF: Cognitive Level:
Analysis
REF: Page
51 OBJ:
9
TOP: Nursing
process
KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Evaluation
35. Which
question below is open-ended?
|
a. |
“Are you going to Europe
this fall?” |
|
b. |
“Are you sailing to
Europe?” |
|
c. |
“What are you most looking
forward to in Europe?” |
|
d. |
“Have you been to Europe
before?” |
|
e. |
“Where in Europe are you going?” |
ANS: C
Only the question “What are you most looking forward to in
Europe?” allows an unlimited answer.
DIF: Cognitive Level:
Analysis
REF: Pages 44-45 OBJ: 7
TOP: Open-ended communication
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
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