with the nurse, the patient is demonstrating
stoicism or exploring inner thoughts, the
patient may be fearful, etc.).
6.Sample answers:
a.“Tell me about the night you had.”
b.“Let’s try walking on that foot now.”
c. “What things prompted you to stop taking your
insulin?”
d.“Tell me what makes you afraid of taking the
test.”
e.“Your procedure has been performed
successfully every time here.”
f. Should not be said at all
7.Mrs. Clarke, age 42, underwent a mastectomy. She
has a husband and two children, ages 10 and 5.
When the nurse enters Mrs. Clarke’s room, she finds
her patient’s eyes are teary and there is a worried
expression on her face. When asked how she is feel-
ing, Mrs. Clarke replies “fine,” although her face is
rigid and her mouth is drawn in a firm line. She is
moving her foot back and forth under the covers.
On further investigation, the nurse finds out Mrs.
Clarke is worried about her children and her own
ability to be a healthy, functioning wife and mother
again. After prompting, Mrs. Clarke says, “I don’t
know if my husband will still love me like this.” She
sighs and falls silent, reflecting upon her recovery.
The nurse tries to make Mrs. Clarke comfortable
and puts her hand over Mrs. Clarke’s hand. She
establishes eye contactwith Mrs. Clarke and reas-
sures her that things have a way of working out
and suggests that she give her situation some time.
8.Sample answers:
a.Orientation phase:
1.By 8/6/12, Mr. Uhl will call Nurse Parish by
her name.
2.By 8/6/12, Mr. Uhl will describe his freedoms/
responsibilities within the institute.
b.Working phase:
1.By 8/10/12, Mr. Uhl will list various
classes/activities available to patients.
2.By 8/10/12, Mr. Uhl will express any
anxieties he may have in his new
environment to the nurse.
c. Termination phase:
1.By 8/25/12, Mr. Uhl will be introduced to
the new nurse in charge of his case by Nurse
Parish, who will continue to oversee the new
relationship until her departure.
2.By 8/27/12, Mr. Uhl will report feeling good
about his past care and look forward to his
new relationship.
9.Sample answers:
a.Warmth and friendliness: A nurse who greets a
patient with a pleasant smile
b.Openness: A nurse who provides an honest
explanation of a procedure
c. Empathy: A nurse who listens to a woman’s
lament over her miscarriage while helping her
bathed.Competence: A nurse who competently and
smoothly inserts a Hep-Lock into a patient’s vein
e.Consideration of patient variables: A nurse who
finds another nurse who speaks Spanish for her
Hispanic patient
10.Sample answers:
a.Empathic component: “Mr. Johnson, you’ve
always been so independent, it must be difficult
for you to accept the fact that you need medical
care.”
b.Description: “Mr. Johnson, you’ve been
diagnosed with prostate cancer. There are
several options for treatment.”
c. Expectation: “Mr. Johnson, your prognosis for
leading a normal life is good, but we need your
cooperation to make this treatment work.”
d.Consequence: “When you are discharged on
Tuesday, we’ll set you up with a schedule for
your radiation treatments and let you know
what you can expect. I’d like to work with you
to help you understand your illness and its
treatments better.”
11.Sample answers:
a.Failure to perceive the patient as a human
being: The nurse should focus on the whole
person, not simply the illness or dysfunction.
b.Failure to listen: Nurses should be open to
opportunities for communication by keeping
an open mind and focusing on the patient’s
needs instead of their own needs.
c. Use of inappropriate comments or questions: The
nurse should avoid certain types of comments
and questions (clichés, questions that probe for
information, leading questions, comments that
give advice, judgmental comments) that tend to
impede communication.
d.Changing the subject: The nurse should avoid
changing the subject; the patient may be ready
to discuss something and may be frustrated if
put off by a change in topic.
e.Giving false assurance: The nurse should not try
to convince the patient that things are going to
turn out well when knowing the chances are
not good. False assurance may give patients the
impression the nurse is not interested in their
problems.
REFLECTIVE PRACTICE USING CRITICAL
THINKING SKILLS
Sample Answers
1.What communication skills might the nurse use to
complete an assessment of Mrs. Russellinski?
The nurse should orient Mrs. Russellinski to his or
her presence before initiating conversation and
talk directly to her while facing her. Important
information should be communicated in a quiet
environment where there is little to distract Mrs.
Russellinski’s attention and conversation should
be kept simple and concrete. The nurse must be
patient and give Mrs. Russellinski time to respond.Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing:360 ANSWER KEY
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