Test Bank for Communication in Nursing 10th Edition by
Julia Balzer Riley 9780323871457 Chapter 1-30
Complete Guide.
A Filipino American patient had a nursing diagnosis of situational low self-esteem
related to poor social skills as evidenced by lack of eye contact. Interventions were used
to raise the patients self-esteem, but after 3 weeks, the patients eye contact did not
improve. What is the most accurate analysis of this scenario?
a. The patients eye contact should have been directly addressed by role-playing to
increase comfort with eye contact.
b. The nurse should not have independently embarked on assessment, diagnosis, and
planning for this patient.
c. The patients poor eye contact is indicative of anger and hostility that were
unaddressed.
d. The nurse should have assessed the patients culture before making this diagnosis
and plan. - ANS: D
The amount of eye contact a person engages in is often culturally determined. In some
cultures, eye contact is considered insolent, whereas in others eye contact is expected.
Asian Americans, including persons from the Philippines, often prefer not to engage in
direct eye contact.
When a female Mexican American patient and a female nurse sit together, the patient
often holds the nurses hand. The patient also links arms with the nurse when they walk.
The nurse is uncomfortable with this behavior. Which analysis is most accurate?
a. The patient is accustomed to touch during conversation, as are members of many
Hispanic subcultures.
b. The patient understands that touch makes the nurse uncomfortable and controls the
relationship based on that factor.
c. The patient is afraid of being alone. When touching the nurse, the patient is
reassured and comforted.
d. The patient is trying to manipulate the nurse using nonverbal techniques. - ANS: A
The most likely answer is that the patients behavior is culturally influenced. Hispanic
women frequently touch women they consider to be their friends. Although the other
options are possible, they are less likely.
A Puerto Rican American patient uses dramatic body language when describing
emotional discomfort. Which analysis most likely explains the patients behavior? The
patient:
,a. has a histrionic personality disorder.
b. believes dramatic body language is sexually appealing.
c. wishes to impress staff with the degree of emotional pain.
d. belongs to a culture in which dramatic body language is the norm. - ANS: D
Members of Hispanic American subcultures tend to use high affect and dramatic body
language as they communicate. The other options are more remote possibilities.
During an interview, a patient attempts to shift the focus from self to the nurse by asking
personal questions. The nurse should respond by saying:
a. Why do you keep asking about me?
b. Nurses direct the interviews with patients.
c. Do not ask questions about my personal life.
d. The time we spend together is to discuss your concerns. - ANS: D
When a patient tries to focus on the nurse, the nurse should refocus the discussion
back onto the patient. Telling the patient that interview time should be used to discuss
patient concerns refocuses discussion in a neutral way. Telling patients not to ask about
the nurses personal life shows indignation. Saying that nurses prefer to direct the
interview reflects superiority. Why questions are probing and non-therapeutic.
Which principle should guide the nurse in determining the extent of silence to use during
patient interview sessions?
a. A nurse is responsible for breaking silences.
b. Patients withdraw if silences are prolonged.
c. Silence can provide meaningful moments for reflection.
d. Silence helps patients know that what they said was understood. - ANS: C
Silence can be helpful to both participants by giving each an opportunity to contemplate
what has transpired, weigh alternatives, and formulate ideas. A nurse breaking silences
is not a principle related to silences. It is inaccurate to say that patients withdraw during
long silences or that silence helps patients know that they are understood. Feedback
helps patients know they have been understood.
A patient is having difficulty making a decision. The nurse has mixed feelings about
whether to provide advice. Which principle usually applies? Giving advice:
a. is rarely helpful.
b. fosters independence.
c. lifts the burden of personal decision making.
d. helps the patient develop feelings of personal adequacy. - ANS: A
, Giving advice fosters dependence on the nurse and interferes with the patients right to
make personal decisions. It robs patients of the opportunity to weigh alternatives and
develop problem-solving skills. Furthermore, it contributes to patient feelings of personal
inadequacy. It also keeps the nurse in control and feeling powerful.
A school age child tells the school nurse, Other kids call me mean names and will not sit
with me at lunch. Nobody likes me. Select the nurses most therapeutic response.
a. Just ignore them and they will leave you alone.
b. You should make friends with other children.
c. Call them names if they do that to you.
d. Tell me more about how you feel. - ANS: D
The correct response uses exploring, a therapeutic technique. The distracters give
advice, a non-therapeutic technique.
A patient with acute depression states, God is punishing me for my past sins. What is
the nurses most therapeutic response?
a. You sound very upset about this.
b. God always forgives us for our sins.
c. Why do you think you are being punished?
d. If you feel this way, you should talk to your minister. - ANS: A
The nurse reflects the patients 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 non-therapeutic.
A patient says to the nurse, I dreamed I was stoned. When I woke up, I felt emotionally
drained, as though I hadnt rested well. Which response should the nurse use to clarify
the patients comment?
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 you feel as though you did not get enough quality sleep last night?
d. Can you give me an example of what you mean by stoned? - ANS: D
The technique of clarification is therapeutic and helps the nurse examine the meaning of
the patients statement. Asking for a definition of stoned directly asks for clarification.
Restating that the patient is uncomfortable with the dreams content is parroting, a non-
therapeutic technique. The other responses fail to clarify the meaning of the patients
comment.
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