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The patient says, 'My marriage is just great. My spouse and I usually agree on everything.' The nurse observes the patient's foot moving continuously as the patient twirls a shirt button. What type of communication is the patient presenting?
- A. Clear
- B. Mixed
- C. Precise
- D. Inadequate
Correct Answer: B
Rationale: Mixed messages involve the transmission of conflicting or incongruent messages by the speaker. The patient's verbal message that all is well in the relationship is modified by the nonverbal behaviors denoting anxiety. Data are not present to support the choice of the verbal message being clear, explicit, or inadequate.
You may also like to solve these questions
Which benefits are most associated with the use of telehealth? (Select all that apply.)
- A. Cost savings for patients
- B. Maximization of care management
- C. Access to services for patients in rural areas
- D. Prompt reimbursement by third-party payers
- E. Rapid development of trusting relationships with patients
Correct Answer: A,B,C
Rationale: Use of telehealth technologies has shown that they can maximize health and improve disease management skills and confidence with the disease process. Many rural patients have felt disconnected from services; telehealth technologies can solve these problems. Although telehealth's improved health outcomes regularly show cost savings for payers, one significant barrier is the current lack of reimbursement for remote patient monitoring by third-party payers. Telehealth is not associated with rapid development of trusting relationships.
A patient with severe depression states, 'God is punishing me for my past sins.' What is the nurse's best response?
- A. Why do you think that?'
- B. You sound very upset about this.'
- C. You believe God is punishing you for your sins?'
- D. If you feel this way, you should talk to a member of your clergy.'
Correct Answer: B
Rationale: The nurse reflects on the patient's comment, a therapeutic technique to encourage sharing for perceptions and feelings. The incorrect responses reflect probing, closed-ended comments, and giving advice, all of which are nontherapeutic.
A patient tells the nurse, 'I don't think I will ever get out of here.' Select the nurse's most therapeutic response.
- A. Don't talk that way. Of course, you will leave here.
- B. Keep up the good work and you certainly will.
- C. You don't think you're making progress?
- D. Everyone feels that way sometimes.
Correct Answer: C
Rationale: By asking if the patient does not believe that progress has been made, the nurse is reflecting by putting into words what the patient is hinting. By making communication more explicit, issues are easier to identify and resolve. The remaining options are nontherapeutic techniques. Telling the patient not to 'talk that way' is disapproving. Saying that everyone feels that way at times minimizes feelings. Telling the patient that good work will always result in success is falsely reassuring.
A nurse interacts with a newly hospitalized patient. Which nursing statement reflects the communication technique of 'offering self'?
- A. I've also had traumatic life experiences. Maybe it would help if I told you about them.
- B. Why do you think you had so much difficulty adjusting to this change in your life?
- C. I hope you will feel better after getting accustomed to how this unit operates.
- D. I'd like to sit with you for a while to help you get comfortable talking to me.
Correct Answer: D
Rationale: Offering self' is a technique that should be used in the orientation phase of the nurse-patient relationship. Sitting with the patient, an example of 'offering self,' helps build trust and conveys that the nurse cares about the patient. Two incorrect responses are ineffective and nontherapeutic. The other incorrect response is therapeutic but an example of 'offering hope.'
A patient says to the nurse, 'I dreamed I was stoned. When I woke up, I felt emotionally drained, as though I hadn't rested well.' Which comment would be appropriate if the nurse seeks clarification?
- A. It sounds as though you were uncomfortable with the content of your dream.
- B. I understand what you're saying. Bad dreams leave me feeling tired, too.
- C. So, all in all, you feel as though you had a rather poor night's sleep?
- D. Can you give me an example of what you mean by 'stoned'?
Correct Answer: D
Rationale: The technique of clarification is therapeutic and helps the nurse examine the meaning of the patient's statement. Asking for a definition of 'stoned' directly asks for clarification. Restating that the patient is uncomfortable with the dream's content is parroting, a nontherapeutic technique. The other responses fail to clarify the meaning of the patient's comment.