NUR 111 - Final Exam - All Modules Questions with Complete Solutions Pre-interactive phase of a nurse-patient relationship - Correct Answer Begins before the nurse's first contact w/the patient. The nurse's role is self-exploration and gathering data about the patient.Introductory or orientation phase of a nurse-patient relationship - Correct Answer When the nurse & client first meet. The nurse seeks to find out why the client sought help. The tasks during this phase are to establish trust, understanding, acceptance, open communication and formulate a contract with the patient.The working phase of a nurse-patient relationship - Correct Answer Where most of the therapeutic work is carried out. The nurse & patient explore stressors and promote the development of insight in the patient by linking perceptions, thoughts, feelings and actions.Termination phase of a nurse-patient relationship - Correct Answer The most difficult, a summarizing process, discuss termination and allow time for patient adjustment to independence. Also a time to exchange feelings and memories and to mutually evaluate the patients progress and goal attainment.Communication skills needed by a nurse during the working phase of a nurse-patient relationship - Correct Answer Empathetic listening and responding, respect, genuineness, concreteness (holding the patient accountable), reflecting, paraphrasing, clarifying and confronting.Elements of the communication process - Correct Answer Communication involves the sender, aka the source encoder. Encoding involves the selection of signs or symbols to transmit the message, such as which language to use or how to arrange the words. The message is the second component and is conveyed via a channel (i.e. talking face to face or writing a message). The third component is the receiver who must listen or observe. The receiver is also the decoder and must perceive what message the sender intended. The fourth component is the response or feedback which allows the sender to correct or reword a message Verbal communication - Correct Answer Uses the spoken or written word and includes noticing things such as pace of speech, intonation (tone of voice), simplicity, clarity (saying precisely what is meant) and brevity (using the fewest words possible), timing & relevance, adaptability, credibility and humor. 1 / 4
Non-verbal communication - Correct Answer Uses other forms such as gestures, facial expression and touch known as body language which is less controlled than verbal behavior because it reinforces or contradicts what is said. Body language requires a systematic assessment of the overall physical appearance, posture, gait (how the patient walks/moves), facial expressions and gestures. Patients with autism have a hard time decoding non-verbal behavior. Patients w/communication problems rely on non-verbal communication such as sign language or reading lips for deaf/hoh, finger taps, eye blinks or object boards for expressive aphasia.Factors that influence the communication process - Correct Answer Development, gender, values & perceptions, personal space, territoriality, roles and relationships, environment, congruence and attitudes. Development - age of the client. Gender - males vs. females communicate in very different ways. Territoriality - patients claiming items in the hospital room as their own. Roles and relationships - nursing student & instructor, client & primary care provider or parent & child. Environment - must be comfortable, temperature extremes or excessive noise can be barriers. Congruence - when the verbal & nonverbal aspects of the communication match.Communicating w/children - Correct Answer For young children, they need plenty of time to be able to verbalize their thoughts. Adults should ask simple questions, provide simple answers and use one-step directions due to the child's short attention span. Avoid sudden or rapid advances, threatening gestures or prolonged eye contact. Communicate through transitional objects such as a stuffed animal. Speak in a quiet, unhurried, confident tone. For school age children, talk to the child at eye level and try to include the child in the conversation if the parents or caretakers are present. Be honest and offer a choice only when one exists.Communicating w/adolescents - Correct Answer Allow time to build rapport. Be honest and offer a choice only when one exists. Use active listening skills and be non-judgmental or non-reactive if the adolescent makes disturbing comments.Communicating w/elderly patients - Correct Answer Ensure the client is using assistive devices like glasses or hearing aids and that they are in working order. Use communication aids such as communication boards, or pictures, when possible. Speak in short, simple sentences and focus on one subject at a time. Always face the client because coming up behind someone can be frightening. Include family & friends in conversation. Reminisce with the client to maintain memory connections, enhance self-identity & self-esteem. When verbal & non-verbal communication is incongruent, believe the non- verbal. Find out what is important and has meaning to the client and try to maintain these things as much as possible.Primary group - Correct Answer Small & intimate. Personal, spontaneous, sentimental, cooperative and inclusive. Communicate primarily face to face. Support each other in times of stress. 2 / 4
Secondary groups - Correct Answer Larger and less personal, less sentimental. Once group goal has been achieved the group usually disbands. Members don't have to know each other. Communication is not always face to face. Member expectations administered through impersonal controls & external restraints (i.e. NUR 111 class) Formal groups - Correct Answer Rigidity of purpose, rules & authority comes from above, managers are symbol of authority, power (i.e. corporations) Semi-formal groups - Correct Answer Prestige, status often accrued from membership (i.e. country clubs) Informal groups - Correct Answer Not bound by rules & regulations, ideal testing ground for leadership techniques Functions of groups - Correct Answer • Socialization • Support • Task completion • Camaraderie • Information • Normative function - Boy Scouts, Church groups • Empowerment - support group or education group, AA or NA • Governance - Political Features of an effective group - Correct Answer • Goal accomplishment • Maintaining cohesion • Develop & modify structure to improve effectiveness Physical conditions that influence groups - Correct Answer • Privacy • Comfort of room and seating • Ability of everyone to have eye contact 3 / 4
• Environmental noise level • Temperature • Lighting Group dynamics - Correct Answer 1. Commitment
- Decision making ability, effective decisions are made when group listens to members ideas, members
- Member behavior & their different roles, information givers/seekers, opinion givers, coordinator,
- Cohesiveness - the attachment that members feel for each other & the group
- Power - to encourage cooperation & collaboration in accomplishing a task
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satisfied with their participation, problem solving is facilitated, group atmosphere is positive, time is well used, using expertise of members, members committed to decisions and responsible for implementation of decisions
initiator-contributor, energizer and evaluator
Roles of group members - Correct Answer • Information givers/seekers • Opinion givers • Coordinators • Initiator - contributor • Energizer • Evaluator Can also be maladaptive roles such as monopolize, recognition seeker, playboy/girl, help seeker, aggressor, groupthink, scapegoat, or blocker.The 5 stages of Tuckman's group development - Correct Answer 1) Forming 2) Storming 3) Norming 4) Performing 5) Adjourning If you lose a member of a group, you regress to a lesser stage