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Chapter 003-3

Chapter 3
Answers for Review Questions
1. Answer: c
Pain is the referent that initiated the communication process. The interaction between the
patient and his wife was the result of the patient's pain as was the concern of the patient's spouse.
The call light could be considered a channel through which the patient's interaction with the
nurse began.
LO: 3.1
Blooms: Analyzing
NCLEX Client Needs: Psychosocial Integrity: Therapeutic Communication
2. Answers: a, b, c, d
Timing of a conversation dramatically influences the receptivity of the receiver. The
educational level of those seeking to communicate has an impact on the type of language and
technical terminology that can be used in conversation. Using more than one mode of
communication can enhance the effectiveness of a message. Making sure the environment is
devoid of excess noise and distraction can facilitate a greater understanding of shared
LO: 3.1
Blooms: Remembering
NCLEX Client Needs: Psychosocial Integrity: Therapeutic Communication
3. Answer: b
Grimacing is a common nonverbal sign of pain. Sharing an observation encourages the patient
to elaborate on nonverbal communication. Asking the patient whether something is lost indicates
that the nurse has not attended to the nonverbal cues of the patient. It is important to do an
assessment of the patient before initiating any interventions.
LO: 3.2
Blooms: Applying
NCLEX Client Needs: Psychosocial Integrity: Therapeutic Communication
4. Answer: a
Feedback is the most effective way to avoid misinterpretation of a message. It helps ensure
that the message sent is perceived by the receiver in a way that is consistent with the intention of
the sender. Writing down conversational highlights is a form of documentation that can still be
misinterpreted unless feedback is sought. Avoid making assumptions regarding cultural
differences. Verifying a patient's emotional state provides insight into a patient's state of mind,
but it does not ensure accurate interpretation of a conversation.
LO: 3.1
Blooms: Understanding
NCLEX Client Needs: Psychosocial Integrity: Therapeutic Communication
5. Answer: b
Nonverbal communication is the more accurate mode of conveying feelings. When a patient's
verbal and nonverbal cues are incongruent, it is important to explore observations made by the
nurse to discern the true feelings of the patient. Written notes, implied inferences, and spoken
words do not provide the opportunity for observing nonverbal cues.
LO: 3.2
Blooms: Analyzing
NCLEX Client Needs: Psychosocial Integrity: Therapeutic Communication
6. Answer: a
Only essential information supplied in short, succinct sentences can be comprehended by
adults who are extremely anxious. The source of this patient's anxiety is already stated to be the
surgery, so the nurse need not elaborate on it. Postoperative teaching is best completed well in
advance of surgery and reinforced after completion of the procedure. Multimedia DVDs are not
effective teaching tools immediately before surgery. They may be helpful for a patient to watch
at least 24 hours before a scheduled procedure to allow time for elaboration on topics not totally
understood by the patient. Nurses must always check with the patient to verify that critical
information is understood regardless of what form of communication has been used.
LO: 3.5
Blooms: Applying
NCLEX Client Needs: Psychosocial Integrity: Therapeutic Communication
7. Answer: c
It is important for the nurse to immediately communicate that sharing personal contact
information with patients is inappropriate and violates professional role boundaries. Asking
“why” questions and changing the subject are nontherapeutic. Neither action will discourage the
patient from further infringing on the nurse's personal right to privacy. Reporting the interaction
to a supervisor may be helpful for preventing other nurses from experiencing similar requests;
however, the first action taken by the nurse should be to maintain professional role boundaries.
LO: 3.3
Blooms: Applying
NCLEX Client Needs: Safe and Effective Care Environment: Management of Care
8. Answer: c
Asking open-ended questions allows patients to share freely on a subject. “Why” questions,
using closed-ended questions, and giving advice are all nontherapeutic communication
techniques that limit patient reflection and sharing on topics of concern.
LO: 3.7
Blooms: Applying
NCLEX Client Needs: Psychosocial Integrity: Therapeutic Communication
9. Answer: d
Nurses demonstrate professionalism by adhering to institutional dress codes that require
minimal accessorizing and cosmetic use. Wearing distinctive clothing is not linked to skills
confidence. Clothing choices often reflect the economic resources of an individual, and make-up
use by a hospitalized patient is a personal preference that should be honored.
LO: 3.2
Blooms: Applying
NCLEX Client Needs: Psychosocial Integrity: Therapeutic Environment
10. Answer: b
Young adults who require their parents' presence for routine care are exhibiting regression,
which is behavior consistent with earlier stages of development. Patients in denial refuse to see
the reality of their situation. Repression is storing painful feelings in the unconscious, causing
them to be temporarily forgotten. Displacement transfers emotional energy away from the actual
source of stress to an unrelated object or person.
LO: 3.8
Blooms: Understanding
NCLEX Client Needs: Health Promotion and Maintenance: Developmental Stages and