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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.
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The nurse is caring for a client who is hard of hearing. The nurse is in the room during a discussion between the client and health care provider. At the end of the discussion, the client asks the nurse to further explain certain terms used by the health care provider. In explaining the terms, which role has the nurse assumed?
- A. Educator
- B. Caregiver
- C. Collaborator
- D. Delegator
Correct Answer: A
Rationale: In this scenario, the nurse will assume the role of educator by explaining information provided during the client/health care provider discussion. The nurse as educator provides client teaching regarding the plan of care, medications, or prescribed tests and procedures. The nurse as a caregiver performs health-related activities that the client is unable to perform independently due to illness. The nurse as a collaborator works with others to achieve a common goal, such as sharing or exchanging information with other health care professionals (dietitians, physical therapists, or respiratory therapists). The nurse as a delegator assigns tasks to someone else such as another nurse, a nursing assistant, or other unlicensed assistive personnel (UAP).
The nurse is providing therapeutic communication while changing a client's linen. The client states, 'Every time I urinate, I still feel the need to urinate again. This is so disappointing.' The nurse states, 'You don't feel that you are emptying your bladder.' Which communication technique has the nurse used?
- A. Open-ended questioning
- B. Paraphrasing
- C. Reflecting
- D. Broad opening
Correct Answer: B
Rationale: Paraphrasing restates what the client is saying to demonstrate listening. This communication technique also allows the client to offer further information on the subject. Open-ended questioning provides an open-ended question for the client to provide further information. Reflecting states the content back to the client and confirms that the nurse is following the conversation. A broad opening starts the interaction and relieves tension before addressing other issues.
Which of the following is a positive interpretation of body language?
- A. Clenched jaw
- B. Tilt of head
- C. Arms crossed
- D. Rubbing nose
Correct Answer: B
Rationale: An example of a positive interpretation of body language is the tilt of the head. Negative examples of body language include a clenched jaw, crossed arms, and rubbing the nose.
Which of the following nurse statements is completed in the working phase of the nurse-client relationship?
- A. Tell me about your religious beliefs during this season of the year.
- B. I will put a chair in the bathroom so you can begin personal care. I will return to assist you as needed.
- C. I understand that you are feeling anxious about going home. Let me assess you before we talk.
- D. Let's talk about a way to assist you to a standing position so you can walk in the hall.
Correct Answer: B
Rationale: During the working phase of the nurse-client relationship, the nurse and the client puts the mutually developed plan into action. Each person shares in performing the task that leads to the desired outcome, which supports the client's independence. In the introductory phase, the nurse should be gathering information regarding religious beliefs. In the terminating phase, the client may feel apprehensive about assuming independent activity or self-care. Developing the plan with activities such as assisting to a standing position to walk in the hall is completed in the introductory phase.
Which of the following means of comprehending new information best describes a cognitive learner?
- A. The learner learns through information that appeals to feelings.
- B. The learner likes to learn by doing
- C. The learner learns by combining three styles of learning
- D. The learner processes information by listening to facts
Correct Answer: D
Rationale: The cognitive learner processes information best by listening to or reading facts and descriptions. The affective learner is more attuned to learning when presented with information that appeals to feelings. The psychomotor learner typically likes to learn by doing. A combination of the three styles tends to optimize learning, although most people favor one style of learning.