Chapter 024

Potter & Perry: Fundamentals of Nursing, 7th Edition
Test Bank
Chapter 24: Communication
MULTIPLE CHOICE
1. The client tells the nurse that he understands most of the information but still has
questions concerning the medication after the nurse has provided the client with
information regarding the treatment plan for the diagnosis the. This response is an
example of:
1. Referent
2. Receiver
3. Channel
4. Feedback
ANS: 4
This response is an example of feedback. Feedback is the message returned by the
receiver. The referent motivates one person to communicate with another, such as a time
schedule. This is not an example of a referent. The receiver is the person who receives
and decodes the message. This question is not asking about the receiver, but rather the
response. Channels are means of conveying and receiving messages through visual,
auditory, and tactile senses. This response is not an example of a channel.
DIF: A
REF: 343
OBJ: Comprehension
TOP: Nursing Process: Implementation/Evaluation
MSC: NCLEX test plan designation: Safe, Effective Care Environment
2. The nurse is in the process of conducting an admission interview with the client. At one
point in the discussion, the client has provided information that the nurse would like to
clarify. The nurse employs the technique of clarification as indicated by the response:
1. Im not sure that I understand what you mean by that statement.
2. The ECG records information about your hearts electrical activity.
3. Lets look at the problem you have had with your medication when you were
home.
4. Whats your biggest concern related to your hospitalization at the moment?
ANS: 1
Im not sure that I understand what you mean by that statement is correct. Clarifying is
when the nurse checks whether understanding is accurate by restating an unclear message
to clarify the senders meaning, or by asking the other person to restate the message,
explain further, or give an example of what the person means. This response indicates the
nurse wants to clarify what the client is saying so he or she can have an accurate
understanding of what the client means. The ECG records information about your
hearts electrical activity is an example of providing information, not clarification.
Lets look at the problem you have had with your medication when you were home is
an example of focusing, not clarification. Whats your biggest concern related to your
hospitalization at the moment is an example of sharing empathy.
Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.
Test Bank
24-2
DIF: A
REF: 354
OBJ: Comprehension
TOP: Nursing Process: Evaluation
3. The faculty member is reviewing a process recording with the student nurse. The student
has been working with a client who has had an amputation of the lower left leg and is
emotionally fragile. The student receives positive feedback from the faculty member for
the following response made to the client:
1. Why are you so upset today?
2. Im sure that everything will be all right.
3. You shouldnt cry. The wound will heal soon.
4. It must be very difficult to have this happen to you.
ANS: 4
It must be very difficult to have this happen to you is an example of using the
therapeutic communication technique of sharing empathy. Why are you so upset today?
is an example of a nontherapeutic communication technique of asking for explanations.
Im sure that everything will be all right is an example of a nontherapeutic
communication technique of giving false reassurance. You shouldnt cry. The wound
will heal soon is an example of a nontherapeutic communication technique of giving
disapproval.
DIF: A
REF: 353
OBJ: Comprehension
4. When reaching over the side rails to take a clients blood pressure, he draws back. To
promote effective communication, the nurse should first:
1. Tell the client that the blood pressure can be taken at a later time
2. Rotate the nurses who are assigned to take the clients blood pressure
3. Continue to perform the blood pressure assessment quickly and quietly
4. Apologize for startling the client and explain the need for touching the client
ANS: 4
Nurses often have to enter a clients personal space to provide care. The nurse should
convey confidence, gentleness, and respect for privacy. This response demonstrates
respect and provides information so the client can understand the need for personal
contact. Telling the client that the blood pressure can be taken at a later time does not
promote effective communication. Rotating the nurses who are assigned to take the
clients blood pressure impedes the nurses ability to form a therapeutic, helping
relationship. Continuing to perform the procedure quickly and quietly may send a
negative nonverbal message. It also does not promote effective communication.
DIF: A
REF: 343
OBJ: Comprehension
TOP: Nursing Process: Implementation
Test Bank
24-3
5. Communication involves both active listening and body language working together. The
nurse actively listens to the client and:
1. Sits facing the client
2. Keeps the arms and legs crossed
3. Leans back in the chair away from the client
4. Avoids eye contact as much as is physically possible
ANS: 1
Active listening means to be attentive to what the client is saying both verbally and
nonverbally. A nonverbal skill to facilitate attentive listening is to sit facing the client.
This posture gives the message that the nurse is there to listen and is interested in what
the client is saying. For active listening, the arms and legs should be uncrossed. This
posture suggests that the nurse is open to what the client says. For active listening, the
nurse should lean toward the client. This posture conveys that the nurse is involved and
interested in the interaction. For active listening, the nurse should establish and maintain
intermittent eye contact. This conveys the nurses involvement in and willingness to listen
to what the client is saying.
DIF: A
REF: 344
OBJ: Comprehension
6. During the assessment phase of the nursing process, the nurse may uncover data that help
to identify communication problems. An example of this information is:
1. Extreme dyspnea or shortness of breath
2. Urinary frequency and pain
3. Chronic stomach pain
4. Lack of appetite
ANS: 1
An extremely breathless person must use oxygen to breathe rather than speak. Urinary
frequency may interrupt conversation but is not a communication problem. Chronic
stomach pain would not be a communication problem. The patient with chronic pain is, to
some degree, used to the pain. A lack of appetite is not a communication problem.
DIF: A
REF: 349
OBJ: Comprehension
TOP: Nursing Process: Assessment
7. When a nurse tells an advanced nurse practitioner that her client is slipping a little in
reference to hemodynamic pressures, The nurse is using:
1. Brevity
2. Relevance
3. Pacing and control.
4. Connotative meaning
ANS: 4
Test Bank
24-4
The connotative meaning is the shade or interpretation of a words meaning influenced by

the thoughts, feelings, or ideas people have about the word. Slipping a little in
reference to hemodynamic pressures is an example of using connotative meaning. Brevity
means that communication is simple, brief, and direct. This is not an example of using
brevity. Relevance means the message is relevant or important to the situation at hand.
This is not an example of using relevance. Pacing and control mean speaking slowly
enough to enunciate clearly and not changing subjects rapidly. This is not an example of
using pacing and control.
DIF: A
REF: 344
OBJ: Comprehension
8. A client is admitted for a CAT scan (diagnostic test) of the cranium. As the nurse explains
this diagnostic test, the client moves away from the nurse. This is an example of what
influencing factor in communication?
1. Gender
2. Environment
3. Space and territoriality
4. Sociocultural background
ANS: 3
Territoriality is the need to gain, maintain, and defend ones right to space. The client
who moves away from the nurse during a conversation is demonstrating the influence of
space and territoriality on communication. This not an example of gender influencing
communication. This is not an example of environment influencing communication.
Noise, temperature extremes, distractions, and lack of privacy are examples of
environmental factors that may influence communication. Although people do maintain
varying distances between each other depending on their culture, this is not an example
of sociocultural background influencing communication, as cultural orientation is not
mentioned in this situation.
DIF: A
REF: 345
OBJ: Comprehension
9. The nurse will often display empathy in communication with clients. Of the following
responses by the nurse, which one best conveys empathy?
1. Good morning. How did you sleep last night?
2. I can understand your concern about learning to inject yourself.
3. Do you mean you would like to talk to the new family nurse practitioner?
4. Can you describe to me what the pain in your abdomen feels like right now?
ANS: 2
Test Bank
24-5
I can understand your concern about learning to inject yourself is correct. Empathy is
the ability to understand and accept another persons reality, to accurately perceive
feelings, and to communicate this understanding to others. Good morning. How did you
sleep last night? is asking a question. It does not convey empathy. Do you mean you
would like to talk to the new family nurse practitioner? is asking a question to clarify the
clients meaning. It does not convey empathy. Can you describe to me what the pain in
your abdomen feels like right now? is asking a relevant question that may focus on a
particular topic. It is not an example of empathy.
DIF: A
REF: 353
OBJ: Comprehension
10. In working with a client who is newly diagnosed with diabetes mellitus, the nurse
provides feedback to the client on her progress in learning the treatment regimen. Of the
following, the nurse demonstrates the use of therapeutic communication by stating:
1. I believe that you have come a long way in learning how to manage your care.
2. It didnt look like you were ever going to be able to get the injection technique.
3. Check your blood sugar unless you really want to come back to the hospital
again.
4. You dont appear to have any real interest in managing your daily dietary intake.
ANS: 1
In stating, I believe that you have come a long way in learning how to manage your
care the nurse is demonstrating the use of therapeutic communication by sharing hope.
The nurse is pointing out that personal growth can come from illness experiences. It
didnt look like you were ever going to be able to get the injection technique is a
negative statement. The nurse should not state observations that might embarrass or anger
the client. Check your blood sugar unless you really want to come back to the hospital
again does not demonstrate the use of therapeutic communication. It implies disapproval
and is an aggressive, threatening type of response. You dont appear to have any real
interest in managing your daily dietary intake is not a therapeutic statement. It is
negative and aggressive in nature. If it is a true observation, it is one the nurse should not
state as it could anger the client.
DIF: A
REF: 353
OBJ: Comprehension
11. Ive never told anyone this information about my son, is an example of a parent:
1. Identifying problems
2. Building trust
3. Clarifying roles
4. Revealing
ANS: 2
Test Bank
24-6
This response is an example of trust. Trusting another person involves risk and
vulnerability, but it also fosters open, therapeutic communication and enhances the
expression of feelings, thoughts, and needs. This statement is not an example of
revealing. Although the parent may have provided information that was never before
revealed, in this statement the parent is indicating there is trust between himself or herself
and the nurse practitioner. This statement is not clarifying roles of the nurse and client.
This statement is not an example of identifying problems and goals.
DIF: A
REF: 348
OBJ: Comprehension
12. Discussing the clients follow-up dietary needs immediately after the surgery when the
client is experiencing discomfort is an error in:
1. Pacing
2. Intonation
3. Timing and relevance
4. Denotative meaning
ANS: 3
Discussing follow-up dietary needs immediately after surgery when the client is
experiencing discomfort is an error in timing and relevance. The client is less likely to be
able to pay attention and comprehend instruction when in pain, and immediately after
surgery, discussing follow-up dietary needs would seem irrelevant. Pacing has to do with
the speed of conversation. This is not an example of an error in pacing. Intonation is the
tone of voice used. This is not an example of an error in intonation. Denotative meaning
is when a single word can have several meanings. This is not an example of an error in
denotative meaning.
DIF: A
REF: 3744
OBJ: Comprehension
13. The nurse is aware of the clients zones of personal space when planning interactions.
The zone of personal space and touch that extends the greatest amount from an individual
is the:
1. Social zone
2. Personal zone
3. Consent zone
4. Vulnerable zone
ANS: 1
The social zone extends the greatest amount from an individual in personal space and
touch. It is a distance of 4 to 12 feet. Permission is not needed for touch in the social
zone. The personal zone is 18 inches to 4 feet. The consent zone of touch requires
permission. The vulnerable zone is in the consent zone of touch. Because the vulnerable
zone implies special care is needed, permission is required.
Test Bank
24-7
DIF: A
REF: 348
OBJ: Comprehension
TOP: Nursing Process: Planning
14. Throughout the nursing process communication is used. During the evaluation phase,
communication is specifically used by the nurse to:
1. Delegate activities to other staff members
2. Validate the clients health and wellness needs
3. Acquire both verbal and nonverbal client feedback
4. Document expected outcomes and planned interventions
ANS: 3
The nurse and client determine whether the plan of care has been successful by
evaluating the client communication outcomes established during planning. This process
involves acquiring verbal and nonverbal feedback. Delegation is not the purpose of
communication in the evaluation phase of the nursing process. Delegation is more likely
to be used in the implementation phase of the nursing process. Validation of the clients
needs is not why the nurse specifically uses communication in the evaluation phase of the
nursing process. Validation of the clients needs is often determined when data are
gathered during the assessment phase of the nursing process. Documenting expected
outcomes and planned interventions is part of the planning phase of the nursing process,
not the evaluation phase.
DIF: A
REF: 344
OBJ: Comprehension
15. There are a number of variables that may influence the clients communication with the
health care team. Which of the following is an example of an interpersonal variable?
1. Postoperative discomfort
2. An extremely warm room
3. A talkative roommate
4. A loud television
ANS: 1
Interpersonal variables are factors within both the sender and receiver that influence
communication. An example of an interpersonal variable is postoperative discomfort. An
extremely warm room is an example of an environmental variable that may affect
communication. A talkative roommate is an example of an environmental variable that
may affect communication because of the lack of privacy and distraction. Noise, such as
a loud television, is an example of an environmental variable that may affect
communication.
DIF: A
REF: 343-344
OBJ: Comprehension
Test Bank
24-8
16. A helping relationship is being established between nurse and client. In addressing the
client, the nurse should:
1. Use the clients first name
2. Touch the client right away to establish contact
3. Sit far enough away from the clients personal space
4. Always knock and pause before entering the clients room
ANS: 4
Common courtesy is part of professional communication. To practice courtesy, the nurse
says hello and goodbye, knocks on doors before entering, and uses self-introduction.
Knocking on doors is important in addressing the client. Because using last names is
respectful in most cultures, nurses usually use the clients last name in the initial
interaction, and then use the first name if the client requests it. Touching the client right
away would not be an appropriate action in establishing a helping relationship. It would
more likely be interpreted as invading the clients personal space. Sitting far enough away
from the client is important in that the nurse should not enter the clients personal space
when establishing a helping relationship. However, leaning toward the client conveys that
the nurse is involved and interested in the client. Knocking on the door before entering
the clients room would be the first step in addressing the client properly.
DIF: A
REF: 348
OBJ: Comprehension
17. In using communication skills with clients, the nurse evaluates which response as being
the most therapeutic?
1. Why dont you stick to the special diet?
2. I noticed that you didnt eat lunch. Is something wrong?
3. I think you need to find another physician thats better than this one.
4. We cant continue talking about your problems; its time for your bath.
ANS: 2
The nurse who is sharing an observation, I noticed that you didnt eat lunch. Is
something wrong? is using the most therapeutic response. Sharing observations often
helps the client communicate without the need for extensive questioning, focusing, or
clarification. Why dont you stick to the special diet? is an example of a nontherapeutic
response. It is asking for an explanation. Why questions can cause resentment,
insecurity, and mistrust. I think you need to find another physician thats better than this
one. is not a therapeutic response. It is giving a personal opinion. Changing the subject,
We cant continue talking about your problems; its time for your bath, is not
therapeutic.
DIF: A
REF: 352
OBJ: Comprehension
Test Bank
24-9
18. When dealing with toddlers or preschoolers what communication technique may be used
most effectively?
1. Using analogies to explain health-related ideas
2. Allowing manipulation of equipment to be used
3. Moving quickly and minimizing contact to avoid distress
4. Focusing on what other children on the unit may have been doing
ANS: 2
Allowing toddlers and preschoolers to touch and examine objects that will come in
contact with them is an effective communication technique. Toddlers and preschoolers
are unable to understand analogies. Sudden movements can be frightening. Children
often prefer to make the first move in interpersonal contacts. Focusing on what other
children have done is not an effective communication technique for toddlers or
preschoolers. Communication should be focused on the child.
DIF: A
REF: 350
OBJ: Comprehension
19. When working with a client with aphasia, the nurse may attempt to enhance
communication by:
1. Using visual cues
2. Speaking loudly
3. Using open-ended questions
4. Communicating through a speech therapist
ANS: 1
The nurse may enhance communication for a client with aphasia by using visual cues
(e.g., words, pictures, and objects) when possible. The nurse should not shout or speak
too loudly to enhance communication with a person who has aphasia. The nurse should
ask simple questions that require yes or no answers to enhance communication with
the client who has aphasia. Using a speech therapist is not the primary way to enhance
communication with a client who has aphasia. The nurse can use communication
techniques to facilitate communication and to develop a helping relationship with the
client. The speech therapist may help the client to learn new ways or to relearn how to
communicate.
DIF: A
REF: 357
OBJ: Comprehension
20. Which of the following statements best reflects the clients positive feedback to the
nurses question, Do you understand how to check your blood sugar?
1. Nodding affirmatively
2. I test it 4 times a day.
3. Yes, I understand how to do it.
4. Demonstrating a fingerstick to the nurse
Test Bank
24-10
ANS: 4
Feedback is the message the receiver returns. It indicates whether the receiver understood
the meaning of the senders message. Demonstrating the technique is the best way to
show the nurse an understanding of the process. The other options either nonverbally or
verbally indicate understanding; they are not as conclusive as showing understanding.
DIF: C
REF: 343
OBJ: Analysis
21. Which of the following nursing statements is the best example of the communication tool
of clarification?
1. Please say that again.
2. I dont think I understand.
3. What did you mean by that?
4. Can you give me an example?
ANS: 4
To check whether understanding is accurate, ask the other person to rephrase it, explain
further, or give an example of what the person means. By asking for an example, the
nurse is best able to determine the meaning of the clients statement. The other options
either simply ask the client to repeat the statement or state that the nurse needs further
information.
DIF: C
REF: 354
OBJ: Analysis
22. Which of the following is the single most negative factor affecting a nurses credibility?
1. Deficient technical skills
2. Unethical or illegal behavior
3. Lack of caring and empathy
4. Poor nurse-client communication
ANS: 4
Breakdown in communication is a top contributor to errors in the workplace and
threatens professional credibility. The remaining options affect credibility but not to the
extent that poor communication does.
DIF: C
REF: 340
OBJ: Analysis
23. The best communicator is the nurse who:
1. Thinks critically
2. Is a good listener
3. Is comfortable talking
Test Bank
24-11
4. Empathizes with the client

ANS: 1
Nurses who develop good critical thinking skills make the best communicators. The
remaining options identify components of good communication.
DIF: C
REF: 340-341
OBJ: Analysis
24. Which of the following statements shows the best attempt by a nurse to overcome
personal biases?
1. So how does that make you feel?
2. Most people really like Dr. Jones.
3. I know how that must frighten you.
4. How much did the medication help your pain?
ANS: 1
People often assume that others think, feel, act, react, and behave as they would in similar
circumstances. They tend to distort or ignore information that goes against their
expectations, preconceptions, or stereotypes. This statement clearly shows the nurse
attempting to assist the client in expressing his or her personal feelings. The remaining
options all make a presumption about the clients feelings or attitudes.
DIF: C
REF: 341
OBJ: Analysis
25. A close, effective nurse-client relationship impacts interpersonal communication most by
facilitating:
1. Client education regarding health-related issues
2. The accurate interpretation of shared information
3. A free exchange of information between client and nurse
4. The clients expression of physical and emotional needs
ANS: 2
The more the sender and receiver have in common and the closer the relationship, the
more likely they will accurately perceive one anothers meaning and respond accordingly.
The remaining options are outcomes of an effective nurse-client relationship but they do
not impact communication as directly.
DIF: C
REF: 340
OBJ: Analysis
26. Mentally reviewing the steps of a complicated nursing procedure before entering the
clients room is an example of:
1. Nonverbal communication
Test Bank
24-12
2. Interpersonal communication
3. Intrapersonal communication
4. Transpersonal communication
ANS: 2
A type of intrapersonal communication, self-instructions, provides a mental rehearsal for
difficult tasks or situations so individuals are able to deal with them more effectively.
Interpersonal communication is one-to-one interaction between the nurse and another
person that often occurs face to face while transpersonal communication is interaction
that occurs within a persons spiritual domain. Nonverbal communication includes all
five senses and everything that does not involve the spoken or written word.
DIF: A
REF: 342
OBJ: Comprehension
27. The nurse can best detect that a client needs clarification of the information provided on a
special diet by:
1. Asking the client frequently if they have any questions
2. Assessing the clients nonverbal cues that suggest confusion
3. Providing the client with written supportive materials on the diet
4. Requesting that the client rephrase the information in his or her own words
ANS: 2
You determine the need for clarification by watching the listener for nonverbal cues that
suggest confusion or misunderstanding. The remaining options are means of reinforcing
or evaluating the listeners understanding of the information.
DIF: C
REF: 354
OBJ: Analysis
28. The nurse observes a client with head bowed and hands folded seemingly in prayer. The
nurse recognizes this as an example of:
ANS: 4
Transpersonal communication is interaction that occurs within a persons spiritual
domain. Many persons use prayer, meditation, guided reflection, religious rituals, or other
means to communicate with their higher power. Intrapersonal communication, self-talk
or self-instruction provides a mental rehearsal for difficult tasks or situations so
individuals are able to deal with them more effectively. Interpersonal communication is
one-to-one interaction between the nurse and another person that often occurs face to face
while nonverbal communication includes all five senses and everything that does not
involve the spoken or written word.
Test Bank
24-13
DIF: A
REF: 342
OBJ: Comprehension
29. The nurse is discussing discharge instructions with a client who was recently diagnosed
with type 1 diabetes mellitus and is now taking insulin. The nurse recognizes this as an
example of:
ANS: 2
Interpersonal communication is one-to-one interaction between the nurse and another
person that often occurs face to face. Transpersonal communication is interaction that
occurs within a persons spiritual domain while intrapersonal communication, self-talk or
self-instruction provides a mental rehearsal for difficult tasks or situations so individuals
are able to deal with them more effectively. Nonverbal communication includes all five
senses and everything that does not involve the spoken or written word.
DIF: A
REF: 342
OBJ: Comprehension
30. A nurse provides a brief but concise orientation to the use of the rooms telephone and
television to a newly admitted older client experiencing abdominal pain. The clients
daughter later reports that her father attempted to call her but was never shown how to
use the telephone. The most likely cause for the clients apparent lack of knowledge
retention is:
1. Admission to the hospital has caused mild confusion that is not atypical in older
clients
2. The pain was distracting him from focusing on the information when it was
provided
3. He is experiencing forgetfulness regarding newly introduced nonessential
information
4. The nurse did not take adequate time to explain the use of either the telephone or
the television
ANS: 2
Timing is critical in communication. Even though a message is clear, poor timing
prevents it from being effective. Do not begin routine teaching when a client is in severe
pain or emotional distress. Although the other options may affect client retention of
information, the scenario did not provide reason to believe that any of the options rather
than poor timing was the primary factor.
DIF:
REF: 344
OBJ: Analysis
Test Bank
24-14

31. An older client who appears confused after discussing his new diagnosis of Parkinsons
disease shares with the nurse that, I didnt understand much of what you said. The
nurse determines that the most likely cause of the clients failure to understand is that:
1. The conversation included unfamiliar medical terminology
2. The client is in denial concerning the diagnosis of Parkinsons disease
3. The nurses choice of timing for the client education was poor
4. The etiology of the condition is too complicated for this client to understand
ANS: 1
Medical jargon (technical terminology used by health care providers) sounds like a
foreign language to clients unfamiliar with the health care setting. Limiting use of
medical jargon to conversations with other health team members will improve
communication. The remaining options may have contributed to the problem, but the
more common problem deals with inappropriate use of jargon.
DIF: C
REF: 344
OBJ: Analysis
TOP: Nursing Process: Planning/Implementation
32. The nurse shares with a client diagnosed with bipolar disorder who is in the manic phase
that, The CNA will be in 20 minutes to complete your ADLs. This nurse-initiated
communication will likely result in client confusion or noncompliance because:
1. The timing of the conversation was poorly chosen
2. The client was not actively involved in the decision-making process
3. The conversation relied on terms familiar only to health care providers
4. The nurse assumed that the client would accept the nursing assistants help
ANS: 3
Medical jargon (technical terminology used by health care providers) sounds like a
foreign language to clients unfamiliar with the health care setting. Limiting use of
medical jargon to conversations with other health team members will improve
communication. The remaining options may contribute to client confusion and/or
noncompliance, but the heavy reliance on unfamiliar terms is the most likely primary
cause in this situation.
DIF: C
REF: 344
OBJ: Analysis
33. The nurse sits on a chair alongside a clients bed to discuss the postoperative nursing care
the client will receive. The therapeutic outcome of sitting beside the client is that:
1. The nurse-client relationship will be strengthened
2. The client will feel less threatened by the nurses presence
3. The nurse can appear more relaxed during the conversation
Test Bank
24-15
4. The nurse and client will be equal participants in the conversation

ANS: 1
Looking down on a person establishes authority, whereas interacting at the same eye level
indicates equality in the relationship. While the remaining options may be correct in some
situations, the primary benefit of the nurse sitting is to convey to the client that both are
equal contributors to the conversation.
DIF: C
REF: 345
OBJ: Analysis
34. The nurse enters a clients room and finds her crying softly. The most therapeutic
statement the nurse can make at this time is to ask:
1. Are you alright?
2. Why are you crying?
3. What can I do to help you?
4. Is being hospitalized upsetting you?
ANS: 2
Sounds have several interpretations: crying may communicate happiness, sadness, or
anger. The nurse needs to validate such nonverbal messages with the client to interpret
them accurately. Although the other options may elicit information regarding the clients
tears, they make assumptions or attempt to provide generalized comfort without first
establishing the cause of the tears.
DIF: C
REF: 345
OBJ: Analysis
35. Supporting a client by holding onto her elbow while accompanying her as she ambulates
around the nursing unit is considered social touching and so would typically:
1. Be considered nonthreatening by the client
2. Not require the clients permission
3. Be viewed as therapeutic by the nurse
4. Not be needed unless the client was ataxic
ANS: 2
A persons hands, arms, shoulders, and back are considered social zones and typically do
not cause a client emotional discomfort if touched, and so permission to do so is not
generally required. Nurses frequently move into clients personal space because of the
nature of caregiving. You need to convey confidence, gentleness, and respect for privacy,
especially when your actions require intimate contact or involve a clients vulnerable
zone. The remaining options do not necessarily deal with a clients social touching zone.
DIF: C
REF: 353-354
OBJ: Analysis
Test Bank
24-16
36. When meeting for the first time, the home health nurse smiles warmly and shakes the
clients hand. The nurse-client relationship is in the:
1. Working phase
2. Orientation phase
3. Termination phase
4. Preinteraction phase
ANS: 2
When the nurse and client meet and get to know one another, they are engaged in the
orientation phase of the nurse-client relationship. The remaining options are phases that
occur either before or after the orientation phase.
DIF: C
REF: 346
OBJ: Analysis
37. The nurse recognizes that a clients sense of personal control is most therapeutically
impacted when:
1. The client attends a self-help/support group
2. The nurse encourages the client to make menu selections
3. The client views a video on the use of a personal glucose monitor
4. The nurse provides instructions on a patient-controlled analgesic (PCA) pump
ANS: 4
Personal control over the situation contributes to emotional comfort. Pain control is a
very basic need, and by providing the client with the power to control that pain, the need
has been therapeutic. The remaining options contribute to personal control but not on the
same elemental level as pain control.
DIF: C
REF: 348
OBJ: Analysis
38. Which of the following statements made by a nurse best reflects an understanding of the
therapeutic value of perceived client control?
1. The client was very interested in the information about support groups.
2. The client fell right to sleep when I told her the procedure was canceled.
3. Research has shown that clients are less stressed when told what to expect.
4. I always include the client in on any decisions regarding their nursing care.
ANS: 3
Research has shown that personal control over a situation contributes to emotional
comfort. By informing the client of expectations, the clients personal sense of control is
increased and emotional stress should then be decreased. The remaining options show an
understanding of emotional comfort but do not express an understanding of the origin of
that comfort.
Test Bank
24-17
DIF: C
REF: 348
OBJ: Analysis
39. Which of the following statements made by a nurse most reflects a poor understanding of
trustworthiness regarding nurse-client communication in response to a clients report that,
I dont like the night shift nurse?
1. How can I meet your needs and expectations on dayshift?
2. Tell me more about why you dislike the night shift nurse.
3. Can you give me an example of why you are dissatisfied?
4. The nurse on night shift has your well being in mind always.
ANS: 2
To foster trust, the nurse communicates warmth and demonstrates consistency, reliability,
honesty, competence, and respect. Sharing personal information or gossiping about others
sends the message you cannot be trusted and damages interpersonal relationships. The
nurse appears to be gossiping by the way the client is encouraged to discuss what the
night shift nurse is doing. The remaining options show varying degrees of addressing the
clients statement.
DIF: C
REF: 348
OBJ: Analysis
40. Which of the following statements made by a nurse most reflects the best understanding
of the effect assertiveness has on interpersonal communication?
1. Can anyone help; Im feeling overwhelmed today?
2. I think we need to tell the doctors to write more legibly.
3. I will need some help with that complicated dressing change.
4. You will need to do the admission assessments today because Im so busy.
ANS: 3
Assertiveness conveys a sense of self-assurance while also communicating respect for the
other person. Assertive responses often contain I messages, such as I want, I need,
I think, or I feel, but in a fashion that is not demeaning or demanding. The remaining
options are not the best examples because some lack an explanation of the nurses actual
needs while others are not respectfully stated.
DIF: C
REF: 348
OBJ: Analysis
41. The nurse identifies the nursing diagnosis risk for injury for a client who is unable to
verbally communicate effectively. The primary risk for injury occurs because the client:
1. Lacks the ability to tell the staff what he or she needs
2. Cannot notify the staff when he or she has fallen
3. Is not able to effectively use the call bell to communicate
Test Bank
24-18
4. Displays impatience when needs are not met effectively

ANS: 1
The client who cannot communicate effectively will often have difficulty expressing
needs and responding appropriately to the environment. A client who is unable to speak is
at risk for injury unless the nurse identifies an alternate communication method. The
remaining options relate to potential outcomes of ineffective verbal communication but
not to the risk for injury.
DIF: C
REF: 351
OBJ: Analysis
42. Which of the following statements made by a nurse reflects a need for further instruction
regarding communicating with the older adult client?
1. Children and the elderly have the same communication barriers.
2. If I tell him why he needs to know something, hell usually listen.
3. Hearing deficits can certainly make communication a challenge.
4. I always try to have family around when I talk with an elderly client.
ANS: 1
Even though some older adults have communication barriers, you need to communicate
with them on an adult level and avoid patronizing or speaking in a condescending
manner. Older adults do not necessarily have the same barriers as children. The remaining
options reflect interventions and/or statements that are not inappropriate and so do not
require further instructions.
DIF: C
REF: 356-357
OBJ: Analysis
MULTIPLE RESPONSE
1. Which of the following critical thinking attitudes contributes to an effective nurse-client
relationship? (Select all that apply.)
1. Fairness
2. Guarded
3. Curiosity
4. Creativity
5. Perseverance
6. Self-confidence
ANS: 1, 3, 4, 5, 6
Test Bank
24-19
Curiosity motivates the nurse to communicate and know more about a person.
Perseverance and creativity are also attitudes conducive to communication because they
motivate the nurse to communicate and identify innovative solutions. A self-confident
attitude is important because the nurse who conveys confidence and comfort while
communicating more readily establishes an interpersonal, helping-trust relationship.
Risk-taking rather than a guarded attitude is important because colleagues sometimes
question the suggested nursing interventions. At the same time, an attitude of fairness
goes a long way in the ability to listen to both sides of any discussion.
DIF: C
REF: 340-341
OBJ: Analysis
2. The nurse realizes that the cancer support group for breast cancer clients will be most
effective if the group: (Select all that apply.)
1. Is not too large
2. Is similar in age
3. Members feel valued
4. Communicates freely
5. Shares a common culture
6. Meets in a comfortable place
ANS: 1, 3, 4, 6
Small groups are more effective when they are a workable size and have an appropriate
meeting place, suitable seating arrangements, and cohesiveness and commitment among
group members. Group participants need to feel accepted, feel able to communicate
openly and honestly, and actively listen to others in the group. Similarity in age and
similarity in culture are not necessary criteria for a successful group interaction.
DIF: C
REF: 342
OBJ: Analysis
3. The nurse is preparing a community outreach program on stress management. The nurse
realizes that speaking in public requires some specific adaptations regarding: (Select all
that apply.)
1. Makeup
2. Clothing attire
3. Vocal inflection
4. Voice projection
5. Physical gesturing
6. Making eye contact
ANS: 3, 4, 5, 6
Public communication requires special adaptations in eye contact, gestures, voice
inflection, and use of media materials to communicate messages effectively. Makeup and
clothing need to be appropriate but do not require specific adaptations.
Test Bank
24-20
DIF: C
REF: 342
OBJ: Analysis
4. Which of the following are reasons for communication during the assessment phase of
the nursing process? (Select all that apply.)
1. Providing information to the client
2. Obtaining information from the client
3. Establishment of the nurse-client relationship
4. Identification of the clients physical health needs
5. Mutual goal setting regarding client health needs
6. Identification of clients emotional health
ANS: 1, 2, 4, 5, 6
The reasons for communication include information exchange, goal achievement,
problem resolution, and expression of feelings. The initiation of the nurse-client
relationship is not considered a facet of assessment communication.
DIF: C
REF: 349
OBJ: Analysis

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Potter & Perry: Fundamentals of Nursing, 7th Edition

The connotative meaning is the shade or interpretation of a words meaning influenced by

4. Empathizes with the client

TOP: Nursing Process: Evaluation

4. The nurse and client will be equal participants in the conversation

4. Displays impatience when needs are not met effectively

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