Test Bank for Neeb's Mental Health Nursing, 5th Edition

Chapter 2. Basics of Communication Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Which question by the nurse would gain the most information from a patient experiencing a marital crisis? 1. “Do you hate your spouse?” 2. “Do you get along with your in-laws?” 3. “Do you talk out your problems with your spouse?” 4. “What is it like at home with your spouse?” ____ 2. The mother of a young patient with schizophrenia seeks out the nurse and begins to cry. The mother expresses concern over her daughter’s behavior. The nurse’s best response to this woman is: 1. “What is it that concerns you the most?” 2. “Well, you know, that is part of the illness.” 3. “Here is a book on schizophrenia. This will help you.” 4. “Are you afraid your daughter will always be like this?” ____ 3. Linda is pacing the floor and appears extremely anxious. The day-shift nurse approaches Linda in an attempt to lessen her anxiety. The most therapeutic statement by the nurse would be: 1. “How about watching a football game?” 2. “Tell me how you are feeling today.” 3. “What do you have to be upset about now?” 4. Ignore the patient. ____ 4. A patient states, “I don’t know what the pills are for or why I am taking them, so I don’t want them.” What therapeutic communication would best help this patient? 1. Ask for what you need 2. Silence 3. Using general leads 4. Giving information ____ 5. To practice effectively in mental health, the nurse should be able to: 1. Solve his or her own personal problems without assistance from others. 2. Comfortably point out patient shortcomings and provide advice about how to improve. 3. Bring patients and coworkers into compliance with societal rules and norms. 4. Demonstrate therapeutic communication. Completion Complete each statement. 6. Communication has three parts including the sender, the message, and the _____________. 7. When appropriate, the nurse can use _____________________ as part of an interaction when there is no talking. This can communicate support. Copyright © 2019 F. A. Davis Company 8. A theory of communication that emphasizes the three ways to communicate—hearing, seeing, and touching—is called ___________ ______________. 9. Expressive, receptive, and global are types of _______________. Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 10. A nurse is working with a patient and attempts to communicate effectively with the patient. Techniques the nurse can use to help communication include (select all that apply): 1. Clarifying terms. 2. Remaining silent. 3. Asking open-ended questions. 4. Offering false reassurance. 5. Discouraging the person from expressing feelings that are unacceptable. ____ 11. The three components of communication are (select all that apply): 1. Impairment. 2. Message. 3. Sender. 4. Receiver. 5. Therapeutic. ____ 12. Nurses understand that when caring for patients with mental illnesses, a nurse’s communication is (select all that apply): 1. An active process that includes participating and listening and speaking. 2. A complex activity. 3. Exchanging information. 4. Verbal and nonverbal. 5. A one-way path from nurse to patient. 6. Advising. ____ 13. The patient is concerned about his doctor and what the doctor has prescribed. The nurse making rounds notices the patient sitting on the side of the bed in deep thought. The nurse comes into the room and the patient begins to tell the nurse his concerns about a new order. The nurse advises the patient, “If I were you, I would find another doctor.” How does this statement by the nurse block communication (select all that apply)? 1. It tells the patient that his concerns are not valid. 2. It gives the idea that the nurse’s values are the correct ones. 3. It sounds judgmental. 4. It sets the stage for expectations that the patient may not be able to meet. 5. It discourages yes or no answers. 6. It blocks the patient from telling the nurse what his concerns are. ____ 14. The following types of patients require adaptive communication techniques (select all that apply): 1. A patient who is blind 2. A patient who has aphasia Copyright © 2019 F. A. Davis Company 3. 4. 5. 6. A patient with schizophrenia A patient who is elderly A patient with dysphagia A patient who has language differences from the staff ____ 15. Which of the following are characteristics of assertive communication (select all that apply)? 1. Statements begin with the word “you.” 2. Statements deal with thoughts and feelings. 3. It is a form of blaming. 4. It puts responsibility for the interaction on the other person. 5. It is a technique of personal empowerment. 6. It is self-responsible. Copyright © 2019 F. A. Davis Company Chapter 2. Basics of Communication Answer Section MULTIPLE CHOICE 1. ANS: 4 Page: 21 Integrated Processes: Nursing Process: Implementation Content Area: Mental Health: Therapeutic Communication Cognitive Level: Comprehension Client Need: Psychosocial Integrity: Therapeutic Communication Chapter 2: Basics of Communication; Therapeutic Communication Feedback 1 This is a closed-ended question. These are forms of questions that make it possible for a one-word “yes” or “no” answer. They discourage the patient from giving full answers to the questions. “Hate” is judgmental and makes an assumption for the marital crisis. 2 This is a closed-ended question. These are forms of questions that make it possible for a one-word “yes” or “no” answer. They discourage the patient from giving full answers to the questions. 3 This is a closed-ended question. These are forms of questions that make it possible for a one-word “yes” or “no” answer. They discourage the patient from giving full answers to the questions. 4 This is an open-ended question which encourages expression of feelings rather than a yes/no answer. Use of open-ended questions facilitate more open communication. PTS: 1 2. ANS: 1 REF: Chapter 2: Basics of Communication; Therapeutic Communication Page: 21 Integrated Processes: Nursing Process: Implementation Content Area: Mental Health: Psychotic Disorders: Therapeutic Nursing Process Cognitive Level: Application Client Need: Psychosocial Integrity: Therapeutic Communication Chapter 2: Basics of Communication; Therapeutic Communication Feedback 1 2 3 4 This is an open-ended question allowing the mother to explain why she is upset. This minimizes the problem, implying the mother’s feelings are not special. Changing the subject sends the message to the mother that the nurse does not care or that this problem is not worthy of the nurse’s time. This is a closed-ended question and makes an assumption of why the mother is upset. PTS: 1 3. ANS: 2 REF: Chapter 2: Basics of Communication; Therapeutic Communication Copyright © 2019 F. A. Davis Company Page: 21 Integrated Processes: Caring Content Area: Mental Health: Communication Cognitive Level: Synthesis Client Need: Psychosocial Integrity: Stress Management Chapter 2: Basics of Communication; Therapeutic Communication 1 2 3 4 Feedback Although this is an open-ended question, it changes the subject and does not deal with the anxiety. To keep open communication with the patient, the nurse should ask open-ended questions that will facilitate discussion. Although this is an open-ended question, it belittles the patient and implies that the patient’s feelings are not special. Ignoring the patient is not therapeutic communication and will make the anxiety worse. PTS: 1 4. ANS: 4 REF: Chapter 2: Basics of Communication; Therapeutic Communication Page: 19–20 Integrated Processes: Teaching/Learning Content Area: Mental Health: Therapeutic Communication Cognitive Level: Application Client Need: Psychosocial Integrity: Therapeutic Communication/Health Promotion and Maintenance: Principles of Teaching/Learning Chapter 2: Basics of Communication; Therapeutic Communication; Techniques of Therapeutic/Helping Communication 1 2 3 4 Feedback Asking for what you need requires the user to start the sentence with the words “I want” or “I need,” which is not needed in this instance. Although silence can be therapeutic, it is not appropriate for this situation. The patient does not need time to collect thoughts; an answer is needed in the form of patient teaching. Although general leads are therapeutic, they are not appropriate in this instance. Saying “Yes” or “Go on” is not best because the patient has already stated the need: “I don’t know what the pills are for and why I am taking them.” Giving information relates to the helping relationship because it involves a form of patient teaching, which is what this patient needs. PTS: 1 REF: Chapter 2: Basics of Communication; Therapeutic Communication; Techniques of Therapeutic/Helping Communication 5. ANS: 4 Page: 16 Integrated Processes: Communication and Documentation Copyright © 2019 F. A. Davis Company Content Area: Mental Health: Therapeutic Nursing Process Cognitive Level: Application Client Need: Psychosocial Integrity: Therapeutic Communication Chapter 2: Basics of Communication; Techniques of Therapeutic/Helping Communication 1 2 3 4 Feedback The goal in mental health is for the nurse to be the “tool” for ensuring positive interpersonal relationships with patients, not solve problems without assistance. The goal in mental health is for the nurse to be the “tool” for ensuring positive interpersonal relationships with patients, not pointing out shortcomings. Giving advice is a block or barrier to therapeutic communication. The goal in mental health is for the nurse to be the “tool” for ensuring positive interpersonal relationships with patients, not to make people comply with societal rules and norms. Good communication skills are essential for working in mental health. Therapeutic communication is the appropriate use of verbal and nonverbal communication skills that cements the relationship with patients and ultimately promotes their healing. PTS: 1 REF: Chapter 2: Basics of Communication; Techniques of Therapeutic/Helping Communication COMPLETION 6. ANS: receiver Page: 14 Feedback: One of the challenging parts of communicating with others is that the process requires three parts: a sender, a message, and a receiver. Communication is not just about getting the message out; it also involves how the message is received. Integrated Processes: Communication and Documentation Content Area: Mental Health: Communication Cognitive Level: Knowledge Client Need: Psychosocial Integrity: Therapeutic Communication Chapter 2: Basics of Communication; Communication Theory PTS: 1 7. ANS: REF: Chapter 2: Basics of Communication; Communication Theory silence Page: 23 Feedback: Silence allows the nurse and the patient time to collect their thoughts. It is a therapeutic technique of communication and demonstrates patience and acceptance. Integrated Processes: Caring/Communication and Documentation Content Area: Mental Health: Therapeutic Communication Cognitive Level: Comprehension Client Need: Psychosocial Integrity: Therapeutic Communication Copyright © 2019 F. A. Davis Company Chapter 2: Basics of Communication; Therapeutic Communication; Techniques of Therapeutic/Helping Communication PTS: 1 REF: Chapter 2: Basics of Communication; Therapeutic Communication; Techniques of Therapeutic/Helping Communication 8. ANS: neurolinguistic programming Page: 16 Feedback: Neurolinguistic programming (NLP) was developed by John Grinder and Richard Bandler. NLP can assist the health-care provider in communicating more effectively with the patient, which in turn may lead him or her to change behavior and choose a healthier lifestyle. Integrated Processes: Communication and Documentation Content Area: Mental Health: Therapeutic Communication Cognitive Level: Knowledge Client Need: Psychosocial Integrity: Therapeutic Communication Chapter 2: Basics of Communication; Types of Communication PTS: 1 9. ANS: REF: Chapter 2: Basics of Communication; Types of Communication aphasia Page: 18 Feedback: A person with aphasia has no speech from damage to a portion of the brain. The three types of aphasia include the following: expressive—difficulty in verbal expression; receptive—difficulty with interpretation of written or verbal communication; and global—combination of receptive and expressive. Integrated Processes: Communication and Documentation Content Area: Mental Health: Therapeutic Communication Cognitive Level: Knowledge Client Need: Psychosocial Integrity: Therapeutic Communication Chapter 2: Basics of Communication; Challenges to Communication; Table 2-1, Types of Aphasia PTS: 1 REF: Chapter 2: Basics of Communication; Challenges to Communication; Table 2-1 Types of Aphasia MULTIPLE RESPONSE 10. ANS: 1, 2, 3 Page: 21 Integrated Processes: Communication and Documentation Content Area: Mental Health: Therapeutic Communication Cognitive Level: Application Client Need: Psychosocial Integrity: Therapeutic Communication Chapter 2: Basics of Communication; Techniques of Therapeutic/Helping Communication 1. Feedback Correct. Clarifying terms is a therapeutic technique. Nurses must be sure that Copyright © 2019 F. A. Davis Company 2. 3. 4. 5. the terms they choose are correct and mean the same thing to all parties involved in the interaction. If the nurse does not clarify simple words, she or he could incorrectly infer the patient’s level of ability or cooperation. Correct. Remaining silent is a therapeutic technique. First, it allows the nurse and the patient a short time to collect their thoughts; second, it shows patience and acceptance on the part of the nurse. Correct. Asking open-ended questions is a therapeutic technique. Open-ended communication allows the patient to become more involved in his or her plan of care. Incorrect. Offering false reassurance is a nontherapeutic technique. These are phrases nurses may use to sound supportive. In social communication, these expressions sound friendly, but in a therapeutic relationship, they invalidate the patient’s concerns. Incorrect. Discouraging expression of feelings that are unacceptable is a nontherapeutic technique. The goal of therapeutic communication is for patients to express positive and negative feelings. PTS: 1 REF: Chapter 2: Basics of Communication; Techniques of Therapeutic/Helping Communication 11. ANS: 2, 3, 4 Page: 14 Integrated Processes: Communication and Documentation Content Area: Mental Health: Therapeutic Communication Cognitive Level: Knowledge Client Need: Psychosocial Integrity: Therapeutic Communication Chapter 2: Basics of Communication; Communication Theory 1. 2. 3. 4. 5. Feedback Incorrect. Impairment is not a component of communication. Correct. Message is a component of communication. Message is what the sender delivers (sends) to the receiver. Correct. Sender is a component of communication. Sender is the person who transmits (sends) the message. Correct. Receiver is a component of communication. Receiver is the person who accepts (receives) the message. Incorrect. Therapeutic is not a component of communication. PTS: 1 12. ANS: 1, 2, 3, 4 REF: Chapter 2: Basics of Communication; Communication Theory Page: 16 Integrated Processes: Communication and Documentation Content Area: Mental Health: Therapeutic Communication Cognitive Level: Application Client Need: Psychosocial Integrity: Therapeutic Communication Chapter 2: Basics of Communication; Therapeutic Communication Copyright © 2019 F. A. Davis Company 1. 2. 3. 4. 5. 6. Feedback Correct. Communication is an active, two-way process between patient and nurse. It is not passive. Correct. Communication is a complex activity requiring a sender, message, and receiver, as well as cultural influences. Correct. Communication is the exchange of information. Correct. Communication involves verbal and nonverbal. Incorrect. Communication is a two-way process between patient and nurse. Incorrect. Communication is not advising; in fact, the nurse’s role is to listen and support, not advise. PTS: 1 13. ANS: 2, 3, 4, 6 REF: Chapter 2: Basics of Communication; Therapeutic Communication Page: 19 Integrated Processes: Communication and Documentation Content Area: Mental Health: Communication Cognitive Level: Evaluation Client Need: Psychosocial Integrity: Therapeutic Communication Chapter 2: Basics of Communication; Therapeutic Communication 1. 2. 3. 4. 5. 6. Feedback Incorrect. False reassurance/social clichés, not advising, tell the patient his or her concerns are not valid. Correct. Advising sets up, in the patient’s mind, some sort of value system that puts the nurse’s value as the “right” one. Correct. Giving advice can sound very judgmental. Correct. Advising sets the stage for expectations that the patient may not be able to meet. Incorrect. Open-ended questions discourage yes or no answers, not advising. Correct. Advising is a nontherapeutic technique that blocks communication. PTS: 1 14. ANS: 1, 2, 5, 6 REF: Chapter 2: Basics of Communication; Therapeutic Communication Page: 24 Integrated Processes: Communication and Documentation Content Area: Mental Health: Therapeutic Communication Cognitive Level: Comprehension Client Need: Psychosocial Integrity: Therapeutic Communication Chapter 2: Basics of Communication; Challenges to Communication 1. Feedback Correct. A patient who is blind requires adaptive communication techniques. Sightless people cannot see a wave of the hand or when someone leaves or enters a room; these events must be verbalized. Patient teaching for a person with a visual impairment may involve physically moving or touching him or her and verbally explaining in much more detail than usual, like using a clock Copyright © 2019 F. A. Davis Company 2. 3. 4. 5. 6. face to describe food positions on a plate. Correct. A patient who has aphasia requires adaptive communication techniques depending on the type of aphasia present. Incorrect. A patient who with schizophrenia does not require adaptive techniques. Patients with challenges to sight, sound, and speech require adaptive techniques. Incorrect. A patient who is elderly does not require adaptive techniques. Correct. A patient with dysphasia requires adaptive communication techniques. Patients with dysphasia have great difficulty with speech. Correct. A patient who has language differences from the staff requires adaptive communication techniques. Adaptive techniques to ensure understanding is needed. PTS: 1 15. ANS: 2, 5, 6 REF: Chapter 2: Basics of Communication; Challenges to Communication Page: 15 Integrated Processes: Communication and Documentation Content Area: Mental Health: Therapeutic Communication Cognitive Level: Application Client Need: Psychosocial Integrity: Therapeutic Communication Chapter 2: Basics of Communication; Types of Communication; Aggressive Communication Versus Assertive Communication 1. 2. 3. 4. 5. 6. Feedback Incorrect. Statements that begin with the word “you” are aggressive statements, not assertive. Correct. Statements that deal with thoughts and feelings are assertive statements. Saying “I think” or “I feel” helps to keep people in control of their emotions, while allowing honest, open expression of the feelings they have as a result of someone else’s behavior. Incorrect. Aggressive statements, not assertive, place blame. Incorrect. Aggressive statements, not assertive, put the responsibility for the interaction on the other person. Correct. Assertive behavior and communication are techniques of personal empowerment. Correct. Assertive behavior is self-responsible, expressing the speaker’s thoughts and feelings honestly. PTS: 1 REF: Chapter 2: Basics of Communication; Types of Communication; Aggressive Communication Versus Assertive Communication Copyright © 2019 F. A. Davis Company