N104: Essentials of Nursing Care - Health Safety

N104 Study Guide

Chapter 3 1. C - Interrupting the patient may be required in extreme circumstances, but it is not considered a therapeutic communication technique. 2. D - In this example, the nurse is the sender, and any environmental issues (e.g., a noisy room) might be an external influence and the verbal or written nature of the interaction would be the medium. The instructions being given are the message. 3. B - If it is obvious the patient is not paying attention, it is critical for the nurse to resolve any issues that might be preventing the patient from hearing the instructions. An effective way to do this is to reflect what the nurse is seeing (“You seem distracted”) and to provide an outlet for the patient to explain what is distracting her (“Tell me what you’re thinking about”). Once the distraction is removed, the patient should be able to concentrate on the teaching. The other options do not address the behavior and will typically not result in adequate learning. 4. D - All of these options are examples of effective teaching techniques. 5. C - Reflection is the technique of repeating all or part of a message back to the patient, and can be used to reflect a patient’s non-verbal behaviors. 6. B - When talking about any diagnosis, the statement that everything will be fine will either be perceived as disingenuous or will perhaps give the patient faulty information. Giving the patient permission to talk about the diagnosis or his feelings will open lines of communication, reassuring the patient that he will get the best of care, which provides an honest and true response. 7. D - Return demonstrations in which the patient shows that she can physically perform a skill or task shows learning in the psychomotor domain. 8. A - Children learn best in very short, play-filled sessions. The young or school age child may not be able to readwell enough to understand written instructions. Teaching should generally progress from the simplest concept to the most complex. However, the parents should also be taught the new skill and the nurse should typically aim all the teaching at the child. 9. D - During the introductory phase, introductions are made with clarification of the problems and roles in the relationship. This positive interaction must lead to the development of a trusting relationship. Evaluation of goals will typically not occur until the termination phase of the therapeutic relationship after the work has been done during the working phase. 10. C - Previous negative experiences with the same diagnosis may result in increased anxiety or a belief that the same outcome is inevitable in this case. Increased anxiety or negative emotions typically will have a negative effect on the patient’s ability to learn new information or skills.

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