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The nurse is caring for a client and family who are awaiting the results of a diagnostic test. Which nursing action best demonstrates therapeutic nonverbal communication?
- A. The nurse listens to the client's frustration of waiting for test results.
- B. The nurse smiles and rubs the client's shoulder as the client expresses frustration at waiting for the test results.
- C. The nurse is silent while carrying out nursing duties.
- D. The nurse shrugs the shoulders when asked when testing results will return.
Correct Answer: B
Rationale: A smile and rub of the client's shoulder is a nonverbal gesture that the nurse understands the client's situation. Listening to client frustration is an activity that reflects verbal communication because, therapeutically, there is a response. Silence can be therapeutic when the attention is with the client, not the nursing duties. Shrugging the shoulders can be perceived as indifferent and not caring.
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Advocacy and support are activities associated with which learning style?
- A. Cognitive
- B. Cultural
- C. Psychomotor
- D. Affective
Correct Answer: D
Rationale: The affective learner learns best when presented with information that appeals to feelings, beliefs, and values. Cognitive learners process information best by listening to or reading facts and descriptions. The psychomotor learner prefers to learn by doing. There is no learning style classified as cultural.
An experienced nurse is evaluating a new nurse to the unit who is providing discharge instructions to an adult client. The experienced nurse views the following: The new nurse approaches and decreases the volume on the television and then sits beside the client, presenting the information to the client and spouse. The new nurse states, 'You are to take ciprofloxacin 250 mg, two tablets b.i.d. A regular diet is ordered, and you are to follow up with your physician in 2 weeks. Here is printed information on the medication ordered.' The new nurse obtains appropriate signatures and leaves. Which point would the experienced nurse address?
- A. The nurse should use shorter sentences when teaching.
- B. The nurse should improve professionalism and stand.
- C. The nurse should minimize medical terms when teaching.
- D. The nurse should continue with the same method without changes.
Correct Answer: C
Rationale: When teaching adult clients, it is best to minimize technical terms and medical jargon ('b.i.d.' for example) whenever able. The nurse used appropriate sentence length. Sitting beside the client is appropriate, and it is best to reduce noise and distraction by decreasing the volume of the television. With minimal change, the new nurse can improve with teaching skills.
The nurse is instructing a client in a crowded semiprivate room. The nurse approaches and moves equipment to allow for a comfortable conversation. At which distance should the nurse stand?
- A. Within 1 feet
- B. 2 to 3 feet
- C. At least 5 feet
- D. Over 6 feet
Correct Answer: B
Rationale: Proxemics refers to the use of space when communicating. Most Americans feel comfortable when individuals are 2 to 3 feet away.
The nurse is caring for a client who has been diagnosed with a cerebral vascular accident and displays expressive aphasia. In which manner does the nurse best promote communication?
- A. Ask the client open-ended questions and allow time for a response.
- B. Give the client a tablet and pencil to use.
- C. Provide the client with a speaking valve.
- D. Use a picture board with common responses.
Correct Answer: D
Rationale: For clients with aphasia, it is most helpful to have a picture board with responses to convey meaning. This decreases some frustration and allows the client to have some control over care. Asking a client with expressive aphasia open-ended questions is not the best option because the client is unable to give lengthy responses. Depending on the client's degree of aphasia, closed-ended questions may be appropriate. A speaking valve is useful for a client who has a tracheostomy or one who has had laryngectomy.
The nurse cares for multiple ethnic populations. Which of the following examples best demonstrates a facility adhering to The Joint Commission requirements that healthcare workers facilitate communication with all clients?
- A. The facility requires a family member of a client who does not speak the dominant language be present to discuss healthcare issues with a health care provider and member of social service.
- B. Language dictionaries are placed in the facility library with open access for staff.
- C. The facility requests bilingual staff and community members to voluntarily provide contact information for interpreter services.
- D. The facility subscribes to an online interpreting service.
Correct Answer: C
Rationale: It is a requirement of The Joint Commission that agencies develop a system to provide aids and services to any client with literacy needs and also to provide language interpreting and translation services. The best way to demonstrate this requirement is by reaching out to staff and community members to provide personal interpreting services. It is not appropriate to require a family member, if available, to be present. The other options may be helpful in communicating with clients, but personal services are optimal.