Therapeutic Communication

Question 1

Sender or encoder

Answer 1

Initiator of message

Question 2

Encoding

Answer 2

Selecting words, gestures, tone of voice

Question 3

Message

Answer 3

Actual information that is sent, verbal or nonverbal, content matter, substance

Question 4

Channel

Answer 4

Medium used to send the message:

face-to-face, written pamphlets, telephone or text messages, Internet

Question 5

Receiver or decoder

Answer 5

Person to whom the messages sent, uses a variety of senses to decode the message

Question 6

Feedback

Answer 6

Interpreting and reacting to the message, evidence that the intended message has been received

Question 7

Attending

Answer 7

Involve facing the other person squarely, adopting an open pasture, leaning forward, maintaining eye contact

Question 8

Clarifying

Answer 8

Method of eliciting clear or more specific information.

Requesting more specific information

Question 9

4 phases of the therapeutic helping relationship

Answer 9

Pre-interaction/ preparatory
introductory,
working,
termination

Question 10

Introductory phase consists of three stages:

Answer 10

Opening the relationship,
clarifying the problem,
establish a structure and form of the contact

Question 11

Working phase of therapeutic relationship

2 stages:

Answer 11

1-Exploration and understanding of thoughts and feelings

2-Facilitating the clients decision making and supporting appropriate action

Question 12

Preintroduction phase / preparatory phase

Answer 12

Nurse has basic demographic and illness data on patient but has not met them
Nurse sets up room to ensure privacy and comfort

Question 13

Termination phase of a therapeutic relationship

Answer 13

Concludes ideally when the client is having a positive attitude and feelings capable of functioning independently in the future

Question 14

Three domains of learning as identified by Bloom in 1956

Answer 14

Cognitive domain is involved in thinking

Affective domain is involved with emotional responsiveness

Psychomotor domain addresses motor skills

Question 15

Basic principles of learning three principles To be considered

Answer 15

The clients motivation to learn,

the clients readiness to learn,

and the learning environment

Question 16

Basic principles of teaching-

Steps in planning a specific education or learning class

Answer 16

establish priorities- by either client’s ranking or by Maslows needs

schedule and plan

Write educational objectives,

Guide content with objectives

Select appropriate teaching methods

Evaluation

Question 17

Learning Objectives are best when they contain outcomes.

What are 4 parts of and objective?

Answer 17

1- patient behavior- what will the client do?
2- observable behavior- “draw up right amount of insulin using proper technique”
3-modifier- if necessary.
4- time period- “by the end of this session”

Question 18

General adaptation syndrome GAS or stress syndrome

Answer 18

Occurs with the release of certain hormones and subsequent changes in the structure and chemical composition of the body.
G.I. tract, the adrenal gland, and lymphatic structures.

Question 19

Local adaptation syndrome LAS

Answer 19

The body can react locally as in one organ or part of the body reacts alone. Can be inflammation

Question 20

Three stages of GAS and LAS

Answer 20

Alarm Reaction
resistance
exhaustion

Question 21

Alarm reaction

Answer 21

Initial reaction of the body and alerts the body’s defenses divided into two parts:
Shock phase
Countershock phase

Question 22

Alarm reaction -chemical reaction in body

Answer 22

Stressors stimulate sympathetic nervous system which stimulates the hypothalamus.
Hypothalamus releases Corticotropin releasing hormone which stimulates the anterior pituitary gland to release adrenocorticotropic hormone.
Adrenal medulla releases epinephrine and norepinephrine

Question 23

Alarm reaction- body responses to epinephrine (5)

Answer 23

1- increased myocardial contractility. Increase cardiac output and blood flow to active muscles
2- bronchial dilation-allows increased oxygen intake
3- increase cellular metabolism
4- Increased blood clotting
5- Increased fat mobilization to provide energy into synthesize other compounds

Question 24

Principal effect of norepinephrine

Answer 24

Decreased blood to the kidneys and increased secretion of renin.

Question 25

Stage of resistance (stage 2 of GAS)

Answer 25

Body’s adaptation takes place

Body attempts to cope with stressor and limit it to the smallest area of body to deal with it

Question 26

Stage of exhaustion

3rd stage of GAS

Answer 26

Adaptation cant be maintained

Question 27

NANDA -I approved nsg dx that address therapeutic communication: (4)

Answer 27

1- readiness for enhanced communication
2-impaired verbal communication,
3- impaired social interaction,
4-ineffective health maintenance

Question 28

Identify NANDA - I approved nursing diagnoses that address stress and anxiety (6)

Answer 28

1- Anxiety, 
2-ineffective coping, 
3-ineffective denial, 
4-defensive coping, 
5-compromised family coping, 
6-decisional conflict

Question 29

Identify NANDA-I approved Nursing diagnoses that address teaching and learning (3)

Answer 29

1-Readiness for enhanced coping,

2-ineffective health maintenance, 3-readiness for enhanced Health management

Question 30

Which phase of nursing interview (therapeutic relationship) does the nurse gather all info for the subjective database?

Answer 30

Working phase

Question 31

Which phase of nursing interview does the nurse prepare the patient and environment for interview?

Answer 31

Preparatory phase

Question 32

Which phase of nursing interview sets tone for the rest of the interview?

Answer 32

Introductory phase

Question 33

Which phase of patient interview does the nurse read past and current records?

Answer 33

Preparatory

Question 34

Which phase of patient interview does the nurse gather all info needed to form the subjective database?

Answer 34

Working phase

Question 35

Which phase of patient interview does the nurse assess the patient’s comfort and ability to participate in interview?

Answer 35

Introductory phase

Question 36

Identifies patient weaknesses and strengths, potential and actual health problems, and health risks.

Answer 36

Nursing history

Question 37

Meaning of “adaptability” as used in communication.

Answer 37

Adjusting tone and speech to match facial expression.

Question 38

Zones of proximity and their distances. (Proxemics)

Answer 38

Intimate- body contact. Used for procedures.

Personal- 1.5-4 feet. Used to converse with patient

Social- 4-12 feet

Public-12-15 feet.requires loud voice.

Question 39

What is a process recording?

Answer 39

Word for word accounting of conversation.

Appropriate for evaluating effectiveness of a teaching session.

Question 40

Bandura’s theory

Answer 40

Imitation

Bandura claims that most learning comes from observation and instruction.

Question 41

Lewin’s theory of cognitivism

What is it and what are the four types of changes involved?

Answer 41

Theory of learning

1-Cognitive structure
2-Sense of belonging to the group
3-Motivation
4-voluntary muscle control

Question 42

What is the most negative factor affecting a nurse his credibility?

Answer 42

Communication breakdown

Question 43

The best communicator is the nurse who:

Answer 43

Thinks critically

Question 44

Difference between types of communication: 
intrapersonal 
interpersonal 
transpersonal 
nonverbal

Answer 44

intrapersonal :self instructions, mental rehearsal

interpersonal: face to face with someone else
transpersonal: occurs within spiritual practice (prayer)
nonverbal: all five senses, but not spoken or written