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Chapter 08: Communication and the Nurse-Patient Relationship
Williams: deWit's Fundamental Concepts and Skills for Nursing, 5th Edition
MULTIPLE CHOICE
1. The nurse can best ensure that communication is understood by:

a. speaking slowly and clearly in the patient’s native language.
b. asking the family members whether the patient understands.
c. obtaining feedback from the patient that indicates accurate comprehension.
d. checking for signs of hearing loss or aphasia before communicating.
ANS: C
The best way to determine understanding is to ask the patient. Factors such as anxiety,
hearing acuity, language, aphasia, or lack of familiarity with medical jargon or routines can
all contribute to misunderstanding.
DIF: Cognitive Level: Comprehension REF: p. 103 OBJ: Theory #1

TOP: Feedback KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
2. The nurse recognizes a verbal response when the patient:

a. nods her head when asked whether she wants juice.
b. writes the answer to a question asked by the nurse.
c. begins sobbing uncontrollably when asked about her daughter.
d. is moaning and restless and appears to be in pain.
ANS: B
Verbal communication involves words, either written or spoken. Nodding, sobbing, and
moaning are nonverbal communication.

TOP: Verbal Communication Feedback KEY: Nursing Process Step: Assessment
3. The nurse recognizes the patient who demonstrates communication congruency when the
patient:
a. smiles and laughs while speaking of feeling lonely and depressed.
b. wrings her hands and paces around the room while denying that she is upset.
c. is tearful and slow in speech when talking about her husband’s death.
d. states she is comfortable while she frowns and her teeth are clenched.
ANS: C
Congruent communication is the agreement of verbal and nonverbal messages.

TOP: Congruence KEY: Nursing Process Step: Assessment
4. A Hispanic patient approaches the Asian nurse and, standing very close, touches the nurse’s
shoulder during their conversation. The nurse begins to step back to 18 to 24 inches, while
smiling and nodding to the patient. This situation is most likely an example of:
a. the nurse’s need to maintain a professional role rather than a social role.
b. a patient’s attempt to keep the nurse’s attention.
c. a nurse’s need to establish a more appropriate location for conversation.
d. a difference in culturally learned personal space of the nurse and the patient.
ANS: D
Personal space between people is a culturally learned behavior; Asians, North American
natives, and Northern European people generally prefer more personal space than people of
Hispanic, Southern European, or Middle Eastern cultures.

TOP: Cultural Differences KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
5. A nurse says to a patient, “I am going to take your TPR, and then I’ll check to see whether
you can have a PRN analgesic.” In considering factors that affect communication, the nurse
has:
a. used terminology to clearly inform the patient of what she is doing.
b. given information that is unnecessary for the patient to know.
c. used medical jargon, which might not be understood by the patient.
d. taken into consideration the patient’s need to know what is happening.
ANS: C
Medical jargon such as abbreviations or medical terminology is often misunderstood, even
by well educated people.

TOP: Blocks to Communication KEY: Nursing Process Step: Implementation
6. A nurse using active listening techniques would:

a. use nonverbal cues such as leaning forward, focusing on the speaker’s face, and
slightly nodding to indicate that the message has been heard.
b. avoid the use of eye contact to allow the patient to express herself without feeling
stared at or demeaned.
c. anticipate what the speaker is trying to say and help the patient express herself
when she has difficulty with finishing a sentence.
d. ask probing questions to direct the conversation and obtain the information needed
as efficiently as possible.
ANS: A
Eye contact is a culturally learned behavior and in some cases may not be appropriate.
Probing questions or finishing the patient’s sentence is not part of active listening and is
detrimental to an interview.

TOP: Active Listening KEY: Nursing Process Step: Implementation
7. When the patient says, “I don’t want to go home,” the nurse’s best therapeutic verbal
response would be:
a. “I’m sure everything will be fine once you get home.”
b. “You don’t want to go home?”
c. “Doesn’t your family want you to come home?”
d. “I felt like that when I had surgery last year.”
ANS: B
The use of reflecting encourages the patient to expand on his or her feelings or thoughts.
DIF: Cognitive Level: Application REF: p. 105|Table 8-1

OBJ: Theory #3 TOP: Communication Techniques
KEY: Nursing Process Step: Implementation
8. To begin talking with a newly admitted patient about pain management, the nurse would
most appropriately state:
a. “You look pretty comfortable. Are you having any pain?”
b. “Tell me about the pain you’ve been having.”
c. “Is this pain the same as the pain you had yesterday?”
d. “Don’t worry; this pain won’t last forever.”
ANS: B
An open-ended question allows the patient to express his or her feelings or needs.

9. When a patient begins crying during a conversation with the nurse about the patient’s
upcoming surgery for possible malignancy, the nurse’s most therapeutic response would be:
a. “Your surgeon is excellent, and I know he’ll do a great job.”
b. “Oh, dear, your gown is way too big, let me get you another one.”
c. “Don’t cry; think about something else and you’ll feel better.”
d. “Here is a tissue. I’d like to sit here for a while if you want to talk.”
ANS: D
Offering self, or presence, and accepting a patient’s need to cry is supportive.

OBJ: Theory #3 TOP: Therapeutic Techniques
10. To enhance the establishment of rapport with a patient, the nurse should:
a. identify himself by name and title each time he introduces himself.
b. share his own personal experiences so that the patient gets to know him as a friend.
c. act in a trustworthy and reliable manner; respect the individuality of the patient.
d. share information with the patient about other patients and why they are
hospitalized.
ANS: C
Trust and reliability, as well as conveying respect for the individual, all promote rapport.
Identifying oneself is important but in itself does not promote rapport. Sharing personal
experiences or divulging the confidential nature of other patients’ conditions is not
appropriate in the nurse-patient relationship.
DIF: Cognitive Level: Comprehension REF: p. 111

OBJ: Clinical Practice #2 TOP: Rapport
11. The nurse explains that the therapeutic nurse-patient relationship differs from the social
relationship because:
a. a social relationship does not have goals or needs to be met.
b. the nurse-patient relationship ends when the patient is discharged.
c. the focus is mainly on the nurse in the nurse-patient relationship.
d. a social relationship does not require trust or sharing of life experiences.
ANS: B
The nurse-patient relationship is limited to the patient’s stay in the facility and is focused on
the patient. A social relationship may have goals or needs and does require trust and sharing
of life experiences.

TOP: Relationships KEY: Nursing Process Step: Implementation
12. The nurse has selected an outcome for the patient to eat all of the food on the breakfast tray
each day. Assessing that the patient has eaten all of the breakfast, the nurse would give
positive feedback by saying:
a. “Wow! That breakfast must have been pretty good.”
b. “I like pancakes too. Everyone on the hall seemed to enjoy them.”
c. “I hope you can keep all that breakfast down.”
d. “Hurray! You finished your whole meal! What would you like for tomorrow?”
ANS: D
Giving positive feedback increases the likelihood of the desired behavior to be repeated.
Commenting on the tastiness of the food or the fact that others liked it is not responding
directly to the patient’s having eaten the whole meal.
DIF: Cognitive Level: Application REF: p. 102 OBJ: Theory #9

TOP: Positive Feedback KEY: Nursing Process Step: Implementation
13. A 67-year-old woman had major abdominal surgery yesterday. She has IV lines, a urinary
catheter, and an abdominal wound dressing, and she is receiving PRN pain medication. The
end of shift report that best conveys the patient status is:
a. “Doing great, was up in the chair most of the day. No complaints of pain or
discomfort. Voiding adequately.”
b. “Abdominal surgery yesterday, dressing is dry and intact, her IVs are on time and
she’s had pain meds twice. Vital signs stable.”
c. “Abdominal dressing dry, IVs—800 mL left in #6; NS running at 125 mL/hr; urine
output 800 mL this shift; had morphine 15 mg for pain at 8:00 AM and at 1:30
PM. She’s comfortable now. Vital signs are stable, no fever.”
d. “Unchanged since this morning. She wanted to know how soon she can have
something to eat, so maybe you could check with her doctor this evening. Her
husband has been visiting all day and will let you know if she needs anything.”
ANS: C
This brief clear report addresses the major concerns of the abdominal dressing, the status of
the IV fluids, vital signs, and analgesia needs.
DIF: Cognitive Level: Application REF: p. 115|Box 8-2

OBJ: Clinical Practice #4 TOP: Shift Report
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
14. An aspect of computer use in patient care in which the LPN may need to be proficient
includes:
a. input of data such as requests for radiographs or laboratory services.
b. programming the computer to record data from primary care provider and other
health care workers.
c. educating patients how to use hospital computers to access information such as
discharge instructions or information relative to specific medications.
d. scheduling admissions, discharges, and nurse staffing to keep the unit at the best
occupancy and utilization.
ANS: A
Facilities use computers for data entry relative to requesting radiograph, laboratory services,
physical assessment and medication administration. Programming such computers is not a
nursing task and patients need to have individualized information about discharge and
medications.
DIF: Cognitive Level: Knowledge REF: p. 117 OBJ: Theory #8

TOP: Computer Use KEY: Nursing Process Step: Implementation
MSC: NCLEX: N/A
15. A patient with a nursing diagnosis of Sensory perception, disturbed auditory, would most
appropriately require the nurse to:
a. obtain a sign language interpreter when a family member is unavailable.
b. speak slowly and distinctly, but not shout.
c. provide bright lighting without glare and orient frequently.
d. reorient frequently to time, place, staff, and events.
ANS: B
A patient with disturbed auditory perception cannot hear well (or at all); therefore, speaking
slowly and distinctly without shouting increases patient comprehension.
DIF: Cognitive Level: Application REF: p. 111

OBJ: Clinical Practice #3
TOP: Hearing Impaired Patient Communication
16. When an office nurse asks the patient to repeat information that he has just given to the
patient over the telephone, the nurse is:
a. testing the patient’s intelligence and memory.
b. acting in a cautious way to avoid charges of negligence.
c. verifying that the patient understands the information.
d. saving the extra time it would take to mail the information.
ANS: C
Obtaining feedback from a patient to ascertain that the patient understands instructions is an
important part of the communication process, especially over the phone, when the nurse
does not have nonverbal cues.

TOP: Telephonic Communication KEY: Nursing Process Step: Implementation
17. A 36-year-old woman who is in traction for a fractured femur that she received in an auto
accident is found crying quietly. The nurse can best address this situation by saying:
a. “What’s the matter? Why are you crying? Are you in pain?”
b. “Stop crying and tell me what your problem is.”
c. “This could have been much worse. You’re lucky no one was killed.”
d. “You are upset. Can you tell me what’s wrong?”
ANS: D
The nurse offers a general lead as to what is causing the distress. The other options are
judgmental or clichéd or offer no opportunity for the patient to express feelings.

OBJ: Theory #3 TOP: Reflecting Observations
18. When the nurse is giving direction to a nursing assistant who is being delegated part of the
patient care, the nurse’s most effective direction would be:
a. “Do the morning care first on the patients in 205 and 206 who can’t get out of
bed.”
b. “You take care of all the patients in 205 and 206. Let me know how you’re doing
and whether you need any help.”
c. “Give the patient in 204A a shower after breakfast, and call me to check her feet
before you get her dressed.”
d. “Take the vital signs on all the patients in the lounge and tell me whether there are
problems.”
ANS: C
The clarity and brevity of the direction makes the delegated task clear and leaves the
responsibility of assessment to the nurse.

TOP: Delegation KEY: Nursing Process Step: Planning
19. When the patient says, “I get so anxious just lying here in this hospital bed. I have a million
things I should be doing at home,” the most empathetic response would be:
a. “I’d feel the same way you do. I know just what you’re going through.”
b. “It sounds like you’re having a tough time dealing with this situation.”
c. “It’s always darkest before the dawn. Hang in there; it will get better.”
d. “You sound pretty sorry for yourself. Why don’t you look at the positives?”
ANS: B
Empathy recognizes a patient’s situation and encourages expression of feelings.

TOP: Empathy KEY: Nursing Process Step: Implementation
20. A patient asks the nurse, “What would you do if you had cancer and had to choose between
surgery and chemotherapy?” The reply that can best help the patient is:
a. “If I were you, I would choose surgery and then consider chemo afterward.”
b. “What solutions have you considered?”
c. “I would talk it over with my friends first.”
d. “I don’t know. I’m glad it isn’t my decision.”
ANS: B
Nurses can help by reminding patients of alternatives open to them and should refrain from
giving advice but can encourage the patient to consider options. The nurse may be glad not
to face a decision a patient must, but it is not helpful to the patient to say this.

OBJ: Theory #3 TOP: Offering Alternatives
21. The nurse chooses to use touch in the nurse-patient relationship because touch:
a. can convey caring and support when words are difficult.
b. should be avoided because of problems of cultural misinterpretation.
c. is appropriate only in special circumstances, such as with young children.
d. is a nursing intervention of choice in almost all situations.
ANS: A
Touch is a powerful and supportive nonverbal communication in many situations. It is
appropriate for all ages, but not in some situations. Careful assessment of the patient’s
situation and cultural values should determine its use, but it should not be avoided because
of stereotypes.

TOP: Caring Touch KEY: Nursing Process Step: Implementation
22. When the nurse makes the statement, “We can come back to that later—right now I need to
know about when your symptoms started,” the nurse is:
a. letting the patient know that topic of conversation was inappropriate.
b. setting limits on the expression of feelings.
c. refocusing the patient to the issue at hand when the conversation has wandered.
d. closing off the conversation by quickly getting to the point of the interview.
ANS: C
Refocusing is often necessary to accomplish data collection. It does not block
communication and is not used to close a conversation or stop an inappropriate topic.

TOP: Refocusing Communication KEY: Nursing Process Step: Implementation
23. A patient who has had a stroke is unable to speak clearly and has right sided hemiplegia.
The nurse will design the approach to the assessment interview by:
a. asking questions and explaining procedures to the patient’s daughter.
b. speaking slowly and giving the patient time to respond.
c. telling the patient he will get all necessary information from the daughter.
d. prompting the answers and finishing the sentences for the patient.
ANS: B
Speaking slowly recognizes that the patient may process (if able) information more slowly.
DIF: Cognitive Level: Application REF: p. 105|Box 8-1

OBJ: Clinical Practice #3 TOP: Impaired Communication
24. When a nurse is conducting an assessment interview, the most efficient technique would be:
a. explaining the purpose of the interview.
b. excluding relatives and friends from the interaction.
c. telling the patient what data are already available.
d. asking closed questions to obtain essential information.
ANS: D
Closed questions have a definite place when the nurse wants to obtain specific essential
data. Closed questions force the patient to stick to the topic.

OBJ: Clinical Practice #1 TOP: Interview
25. While interviewing a Native American man for the admission history, the nurse should
expect to:
a. wait patiently through long pauses in the conversation.
b. maintain eye contact with the patient.
c. give the patient permission to speak.
d. have another family member speak for the patient.
ANS: A
Native Americans use long pauses in their conversation to better consider their answer and
consider the question. The culturally sensitive nurse would wait quietly through the pauses.
DIF: Cognitive Level: Comprehension REF: p. 105 OBJ: Clinical #1

TOP: Cultural Considerations KEY: Nursing Process Step: Planning
26. The nurse is aware that the purpose of therapeutic communication is to:
a. gather as much information as possible about the patient’s problem.
b. direct the patient to communicate about his deepest concerns.
c. focus on the patient and the patient needs to facilitate interaction.
d. gain specific medical information and history of illness.
ANS: C
Therapeutic communication is a conversation that is focused on the patient and promotes
understanding between the sender and the receiver.

TOP: Therapeutic Communication KEY: Nursing Process Step: Planning
27. The practical nursing student who is engaged in a therapeutic communication with a patient
will have the most difficulty with the technique of:
a. closed questions.
b. restating.
c. using general leads.
d. silence.
ANS: D
The use of silence is the hardest for most students to develop because it makes them
uncomfortable, so they tend to end it prematurely.

TOP: Silence KEY: Nursing Process Step: Implementation
28. To convey the intervention of active listening, the nurse would:

a. maintain eye contact by staring at the patient.
b. prompt the patient when the patient stops talking for a moment.
c. make a conscious effort to block out other sounds in the immediate environment.
d. write down remarks on a clipboard to facilitate later topics of conversation.
ANS: C
An active listener maintains eye contact without staring, gives the patient full attention, and
makes a conscious effort to block out other sounds and distractions.

TOP: Active Listening KEY: Nursing Process Step: Implementation
29. When the nurse enters the room, the patient is laughing out loud at something on TV. The
patient stops and apologizes for the laughter, saying, “I guess I ought not be laughing at all
since I am stuck here with two broken legs.” The nurse can use evidence-based information
when she responds:
a. “Laughter is nearly always a cover up for anxiety when facing a long
rehabilitation.”
b. “Long periods of laughter decrease the amount of oxygen available to your body
for healing.”
c. “Laughter in a hospital is often distracting and depressing to other patients
nearby.”
d. “Laughter truly is the best medicine as it has a positive effect on the immune
system.”
ANS: D
Hasen and Hasen (2009) found that laughter and appropriate use of humor decreased stress
and anxiety and had a positive effect on the immune system.
DIF: Cognitive Level: Application REF: p. 104 OBJ: Clinical #2

TOP: Use of Laughter KEY: Nursing Process Step: Implementation
30. When interacting with an older adult patient, the nurse would enhance communication by:
a. speaking slowly in order to allow the patient to process the message.
b. addressing him by his first name to encourage a therapeutic relationship.
c. standing in the doorway rather than entering the room to give the older adult
patient more privacy.
d. speaking in simple sentences, as if to a child.
ANS: A
When interacting with an older adult, the nurse should try not to speak too quickly or expect
an immediate answer because the older adult may take more time to process the message.
Do not use baby talk or speak to them as if they were children.

TOP: Communication KEY: Nursing Process Step: Implementation
31. When the nurse observes a resident in a long-term facility pounding his fists on his legs and
grinding his teeth, the nurse will validate her perception of the patient’s nonverbal
expression of anger by:
a. documenting that the patient was agitated and appeared angry.
b. asking the male nursing assistant if it is his perception that the patient appears
angry.
c. accessing the nursing care plan to ascertain if there is a nursing diagnosis relative
to anger.
d. sitting down near the patient and saying, “You seem upset…can I help?”
ANS: D
All perceptions based on the observation of nonverbal behavior should be validated by
consulting the patient.

TOP: Validating Perceptions
KEY: Nursing Process Step: Assessing Implementation
32. When a patient states, “I don’t feel like walking today,” the nurse’s most therapeutic verbal
response would be:
a. “You have to walk today.”
b. “You don’t want to walk today?”
c. “I don’t feel like walking today either.”
d. “Why don’t you want to walk today?”
ANS: B
Reflection is a way to restate the message. The idea is simply reflected back to the speaker
in a statement to encourage continued dialogue on the topic.

33. When a patient states, “My son hasn’t been to see me in months,” the nurse’s best verbal
response is:
a. “Don’t worry; I’m sure your son will visit.”
b. “Your son hasn’t been around much lately?”
c. “My son doesn’t come to visit me either.”
d. “How terrible that he doesn’t visit you.”
ANS: B
Restating in different words what the patient said encourages further communication on that
topic.

34. An example of a nurse communicating with a patient using open-ended questions would be:
a. “Is your pain less today than it was yesterday?”
b. “Did you sleep all night without waking?”
c. “How many bowel movements have you had today?”
d. “What was your daughter’s reaction to your desire for hospice?”
ANS: D
An open-ended question is broad, indicating only the topic, and it requires an answer of
more than a word or two. Use of an open-ended question or statement allows the patient to
elaborate on a subject or to choose aspects of the subject to be discussed. Open-ended
questions or statements are helpful to open up the conversation or to proceed to a new topic.
They usually cannot be answered with one word or just “yes” or “no.”
DIF: Cognitive Level: Comprehension REF: p. 105|Table 8-1

35. The nurse tells a patient, “For the last 2 days we have talked about whether to notify your
daughter of your upcoming surgery in 2 days. You have indicated you do not want to be a
burden to her, but you also would like to have her here. You may have to decide rather
quickly because of the time constraint.” The nurse is using the technique of:
a. focusing.
b. reflection.
c. restatement.
d. summarizing.
ANS: D
Summarizing presents the problem and possible solutions with the attendant difficulties.
This technique “unclutters” the problem and presents it back to the patient for his or her
choice of a solution.

TOP: Communication Techniques KEY: Nursing Process Step: Implementation
36. The nurse is caring for a patient who states, “I tossed and turned last night.” The nurse
responds to the patient, “You feel like you were awake all night?” This is an example of:
a. open-ended question.
b. restatement.
c. reflection.
d. offering self.
ANS: B
Restatement is a therapeutic communication technique in which the nurse restates in
different words what the patient said. This encourages further communication on that topic.

TOP: Restatement KEY: Nursing Process Step: Implementation
37. The nurse is caring for a patient who has just had a mastectomy (breast removal). The
patient expresses concern that her husband will no longer find her attractive because of her
mastectomy. The nurse appropriately responds:
a. “You’re concerned your husband will find you unattractive because of your
mastectomy?”
b. “You’re a beautiful woman; of course your husband will find you attractive after
your mastectomy.”
c. “Don’t worry; when I had my mastectomy, my husband still found me very
attractive.”
d. “You should leave your husband immediately if he thinks you’re unattractive after
a mastectomy.”
ANS: A
This is an example of restatement, which allows the patient to know her message was
understood and encourages the patient to continue about her concerns on the topic.

TOP: Restatement/Reflection KEY: Nursing Process Step: Implementation
38. A patient states, “I’m so worried that I might have cancer.” The nurse responds, “It is time
for you to eat breakfast.” The nurse’s response is an example of:
a. using clichés.
b. judgmental response.
c. changing the subject.
d. giving false reassurance.
ANS: C
Changing the subject is a block to effective communication in which the patient is deprived
of the chance to verbalize concerns.

OBJ: Theory #3 TOP: Changing the Subject
39. The nurse is aware that the use of false reassurance is harmful to the nurse-patient
relationship, because this communication block:
a. discounts the patient’s stated concerns.
b. shows a judgmental attitude on the part of the nurse.
c. summarizes the patient’s concerns and closes communication.
d. confuses the patient by giving information.
ANS: A
Giving false reassurance is a block to effective communication in which the patient’s
feelings are negated and in which the patient may be given false hope, which, if things turn
out differently, can destroy trust in the nurse.
OBJ: Theory #3 TOP: False Reassurance
40. A home health patient with a bleeding ulcer informs the nurse that she ate a bowl of chili
with jalapenos. An inappropriate communication block with a judgmental tone by the nurse
would be:
a. “Well, you have had this problem long enough to know what will happen—you
certainly can’t blame me!”
b. “I don’t think that was a smart thing for you to do considering your ulcer.”
c. “Well, you better watch your stool for evidence of blood so you can notify your
primary care provider.”
d. “Oh, poo! A bowl of chili every now and then won’t make a lot of difference to
your ulcer.”
ANS: B
Judgmental response is a block to effective communication in which the nurse is judging the
patient’s action. It implies that the patient must take on the nurse’s values and is demeaning
to the patient.
DIF: Cognitive Level: Analysis REF: p. 109|Table 8-3

OBJ: Theory #3 TOP: Judgmental Response
41. A patient tells the nurse that she dislikes the food that is served in the hospital. The nurse
responds, “Our cooks work very hard; the food that is served is very good.” The nurse’s
response is an example of the communication block of:
a. judgmental response.
b. giving advice.
c. defensive response.
d. using clichés.
ANS: C
Defensive response is a block to effective communication in which the nurse responds by
defending the hospital food. This prevents the patient from feeling that she is free to express
her feelings.

OBJ: Theory #3 TOP: Defensive Response
42. A nurse caring for a patient who fell off the roof while he was intoxicated asks the patient,
“Why in the world were you on the roof when you had been drinking?” The nurse’s
statement is an example of which type of communication?
a. Changing the subject
b. Defensive response
c. Inattentive listening
d. Asking probing questions
ANS: D
Asking probing questions is a block to effective communication in which the nurse pries
into the patient’s motives and therefore invades privacy.

OBJ: Theory #3 TOP: Probing KEY: Nursing Process Step: Implementation
43. The nurse caring for a patient who is concerned about her 10-pound weight loss relative to
her chemotherapy tells the patient, “Lucky you! Every cloud has a silver lining.” The
nurse’s statement is an example of which type of communication block?
a. Defensive response
b. Asking probing questions
c. Using clichés
d. Changing the subject
ANS: C
Using clichés is a block to effective communication in which the patient’s individual
situation is negated, and the patient is stereotyped. This type of response sounds flippant and
prevents the building of trust between the patient and the nurse.

TOP: Clichés KEY: Nursing Process Step: Implementation
44. The nurse is caring for a patient with a diagnosis of lung cancer. The nurse states, “If I were
you, I would have radiation therapy.” The nurse’s statement is an example of which type of
communication block?
a. Inattentive listening
b. Giving advice
c. Using clichés
d. Defensive response
ANS: B
Giving advice is a block to effective communication and tends to be controlling and
diminishes patients’ responsibility for taking charge of their own health.

TOP: Giving Advice KEY: Nursing Process Step: Implementation
45. The nurse is caring for a patient who is concerned about living alone. The best response by
the nurse is:
a. “Where have you considered living?”
b. “Why don’t you live with your family?”
c. “I think you should live with your family.”
d. “If you were my mom, I’d have you live with me.”
ANS: A
Rephrasing will help the patient explore various alternatives. The nurse should not use
phrases such as “Why don’t you ...” “When that happened to me, I did ...” or “I think you
should ...” Rephrasing, for example, “Have you thought of your options?” or “You might
want to think about ...” or “Have you considered ...?” will help the patient explore various
alternatives.

TOP: Offering Alternatives KEY: Nursing Process Step: Implementation
46. The characteristic that is representative of the nurse-patient relationship is that this
relationship:
a. focuses on the nurse’s ability to build rapport.
b. continues after discharge.
c. does not include humor.
d. focuses on the assessed patient health problems.
ANS: D
The nurse-patient relationship focuses on the patient, has goals, and is defined by specific
boundaries. The relationship takes place in the health care setting, and boundaries are
defined by the patient’s problems, the help needed, and the nurse’s professional role. When
the patient is discharged, the relationship ends.

TOP: Nurse-Patient Relationship KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
47. When communicating with an aphasic patient, the nurse appropriately:

a. speaks quickly and shouts so the patient can hear.
b. assumes the patient can understand what is heard.
c. speaks to the patient’s caregiver about the patient.
d. assumes the patient cannot understand what is heard.
ANS: B
When communicating with an aphasic patient, the nurse assumes the patient can understand
what is heard even though speech is jargon or the person is mute, unless deafness has been
diagnosed. The nurse should talk to the patient, and not talk to someone else in the room
about the patient. The nurse should speak slowly and distinctly and should not shout.
DIF: Cognitive Level: Comprehension REF: p. 113|Box 8-1

48. When communicating with a hearing impaired patient, the nurse appropriately:
a. shouts repeatedly at the patient.
b. speaks directly into the patient’s ear.
c. uses long, complex sentences.
d. uses short, simple sentences.
ANS: D
When communicating with a hearing impaired patient, the nurse appropriately uses short,
simple sentences. The nurse should not shout because this can distort speech and does not
make the message any clearer. The nurse should never speak directly into the person’s ear.
This can distort the message and hide all visual cues.
DIF: Cognitive Level: Comprehension REF: p. 113|Box 8-1

49. When communicating with a preschooler, the nurse should:

a. use abstract explanations.
b. use unfamiliar language.
c. use long, complex sentences.
d. consider the developmental level, using familiar words.
ANS: D
When interacting with a toddler or a preschooler, the nurse should focus on the child’s needs
and concerns. The nurse should also use simple, short sentences and concrete explanations
with familiar words.

OBJ: Clinical Practice #3 TOP: Communication with Children
50. When communicating with an adolescent, the nurse should be very sensitive to avoid:
a. asking embarrassing questions.
b. offering advice.
c. interrupting frequently.
d. using active listening.
ANS: C
An adolescent needs time to talk. The nurse should use active listening, avoid interrupting,
and show acceptance. The nurse should try not to give advice.

OBJ: Clinical Practice #3 TOP: Communication
51. The primary care provider informs the student nurse that he would like to give a telephone
order. The best response by the student is:
a. document the telephone order on the primary care provider’s orders.
b. ask another student to listen as a witness to the telephone order.
c. tape record the primary care provider giving the order to the student nurse.
d. ask the registered nurse to take the telephone order.
ANS: D
The student nurse should have an instructor or another registered nurse standing by to take
the new orders from the primary care provider because students cannot legally take
telephone orders.

TOP: Telephone Orders KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
52. A nurse is delegating to a nursing assistant. The most appropriate form of this type of
communication would be:
a. “Let me know if Mr. Jones’ temperature is high.”
b. “I need to know if Mr. Jones’ blood pressure is elevated.”
c. “Come and get me if Mr. Jones has a high heart rate.”
d. “If Mr. Jones’ heart rate is greater than 100, let me know.”
ANS: D
It is important to communicate well in order to assign tasks and delegate to others
effectively. The nurse should give clear, concise messages that include the desired results.

TOP: Delegation KEY: Nursing Process Step: Implementation
53. In order to safeguard patient information when using a computer, the nurse should:
a. only use the computer located in the nurse’s station.
b. wait until the end of the shift and document all information at one time.
c. use personal code words and abbreviations to disguise information.
d. change the computer password frequently.
ANS: D
Computerized patient information requires extra vigilance by the nurse to safeguard
confidentiality. Changing personal passwords frequently helps safeguard information. When
using the computer at a health care facility, the nurse must remember not to leave a
computer screen open when he or she is finished. The nurse should always log out so that
someone else cannot access information using his or her password and must not share his or
her password with others. Computers in the nurse’s station are not as convenient as those at
the bedside or in the hall. Personal codes and abbreviations are not useful.

TOP: Patient Information Safety KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
MULTIPLE RESPONSE
1. The nurse is alert to avoid using blocks to effective communication that include: (Select all
that apply.)
a. changing the subject.
b. using nonjudgmental remarks.
c. giving advice.
d. asking probing questions.
e. offering hope.
f. using clichés.
ANS: A, C, D, F
Such behavior as changing the subject, giving advice, asking probing questions that probe
into a patient’s motive, and using clichés all block communication. Offering hope and
giving remarks that are nonjudgmental are appropriate forms of communication.

TOP: Effective Communication KEY: Nursing Process Step: Implementation
2. During the initial interview of a patient, the nurse should: (Select all that apply.)
a. assess the language capabilities of the patient.
b. use open-ended questions.
c. limit the interview to approximately 30 minutes.
d. assess comprehension abilities of the patient.
e. make the patient as comfortable as possible.
f. obtain the patient’s medical history from the primary care provider.
ANS: A, C, D, E
During the initial assessment, the patient should be comfortable and the nurse should ask
closed questions to elicit specific information. The interview should last approximately 30
minutes, and the nurse needs to evaluate the language and comprehension skills of the
patient to ensure effective communication.

OBJ: Clinical Practice #1 TOP: Interview Skills
3. When using the telephone to communicate with a primary care provider about a patient, the
student nurse should have ready: (Select all that apply.)
a. current information relative to patient’s condition change.
b. assessment of vital signs.
c. information on urinary output.
d. patient’s social security number or hospital identification number.
e. medications received.
ANS: A, B, C, E
As a rule, the primary care provider does not need to have the social security number or the
hospital identification number, but does need information on the patient’s condition, vital
signs, urinary output, and medications received.

TOP: Telephone Communication with a primary care provider
4. The nurse will appropriately and deliberately use the closed question technique when the
patient is: (Select all that apply.)
a. being asked for specific information.
b. extremely anxious and unfocused.
c. having difficulty expressing feelings.
d. confused.
e. angry and ranting about his lack of medical care.
ANS: A, B, D
Closed questions are useful for gaining specific information such as age, address, and listing
of allergies. Closed questions help the anxious, confused, and unfocused patient to respond.
Patients who are having difficulty expressing feelings are not aided by closed questions.
Angry patients need to be helped by silence or general leads.

TOP: Closed Questions KEY: Nursing Process Step: Intervention
5. Behaviors that indicate to the patient that the nurse is inattentive to the patient’s concerns
are such activities as: (Select all that apply.)
a. turning back to straighten the bedside table while the patient is talking.
b. tapping feet or fingers.
c. sitting down in a chair near the bed with arms crossed.
d. leaving a hand on the door to go out.
e. nodding and asking for elaboration.
ANS: A, B, C, D
Turning from the patient, tapping the feet or fingers, sitting with arms crossed, and leaving
the patient all indicate to the patient that his or her concerns are not important and the
information is boring to the nurse. Nodding and asking for elaboration indicate that the
nurse is attentive and focused on his or her concerns.
DIF: Cognitive Level: Analysis REF: p. 110 OBJ: Theory #3

TOP: Inattentive Listening KEY: Nursing Process Step: Implementation
COMPLETION
1. Pain is often conveyed through nonverbal communication. Two other common, nonverbally
expressed emotions are _________________ and ______________.
ANS:
anxiety; fear
Anxiety and fear can be expressed nonverbally by behaviors such as restlessness and
picking at the bed covers.

TOP: Nonverbal Communication KEY: Nursing Process Step: Assessment
Test Bank for deWits Fundamental Concepts and Skills for Nursing 5th Edition by Williams
2. To elicit more information from a patient, the nurse should ask questions that require more
than a one-word answer. This type of question is called _______.
ANS:
open ended
open-ended
Open-ended questions provide more information than can be gathered from closed
questions.

TOP: Open Ended Questions KEY: Nursing Process Step: Implementation
3. The communication technique of __________ gives the caregiver the opportunity to ask and
respond to questions.
ANS:
ISBAR R
ISBAR R format allows the opportunity to ask and respond to questions concerning patient
care during the end of shift report. The initials stand for introduction, situation, background,
assessment, recommendation, and readback.

TOP: ISBAR R KEY: Nursing Process Step: Implementation
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The Project Gutenberg eBook of Motion
pictures, January-June 1974 : Catalog of
copyright entries, third series, volume 28,
parts 12-13, number 1
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and most other parts of the world at no cost and with almost no
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Title: Motion pictures, January-June 1974 : Catalog of copyright

entries, third series, volume 28, parts 12-13, number 1
Author: Library of Congress. Copyright Office
Release date: November 6, 2023 [eBook #72054]
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*** START OF THE PROJECT GUTENBERG EBOOK MOTION

PICTURES, JANUARY-JUNE 1974 : CATALOG OF COPYRIGHT
ENTRIES, THIRD SERIES, VOLUME 28, PARTS 12-13, NUMBER 1
***
Transcriber’s Note:
New original cover art included with this eBook is
granted to the public domain.
Catalog of Copyright Entries
Third Series
ISSN 0090–8371
Catalog of Copyright Entries: Third Series
Volume 28, Parts 12–13, Number 1

Motion Pictures
January-June
1974
COPYRIGHT OFFICE · THE LIBRARY OF CONGRESS

WASHINGTON: 1974
Library of Congress card no. 6–35347.
This number identifies the Library of Congress printed card for
the complete series of the Catalog of Copyright Entries.
ISSN 0090–8371 Key title: Catalog of copyright entries. Third
series. Parts 12–13. Motion pictures.
For sale by the Superintendent of Documents, U.S. Government
Printing Office, Washington, D.C. 20402. Price of this part is given
on page vi.
Preface
The CATALOG OF COPYRIGHT ENTRIES is published by

authority of sections 210 and 211 of Title 17 of the United States
Code. Section 210 provides in part: “The current catalog of copyright
entries and the index volumes herein provided for shall be admitted
in any court as prima facie evidence of the facts stated therein as
regards any copyright registration.”
Orders, payable in advance, for all parts of the Catalog of
Copyright Entries should be sent to the Superintendent of
Documents, U.S. Government Printing Office, Washington, D.C.
20402. Orders may be placed for individual issues, as subscriptions
for one or more parts, or for the complete Catalog, for periods of
one, two, or three years. All orders should state clearly the title and
the inclusive dates of the part wanted; checks or money orders
should be made payable to the Superintendent of Documents.
The Copyright Office welcomes inquiries, suggestions, and
comments on the content and organization of the Catalog. Such
communications should be addressed to the Chief of the Cataloging
Division, Copyright Office, Library of Congress, Washington D.C.
20559.
The record of each copyright registration listed in the Catalog
includes a description of the work copyrighted and data relating to
the copyright claim (the name of the copyright claimant as given in
the application for registration, the copyright date, the copyright
registration number, etc.). For each registration listed, except for
renewals, there has been deposited a copy or copies of the work in
accordance with the provisions contained in sections 12, 13, 14, or
215 of Title 17 of the United States Code.
Each part listed in the following table records registrations in the
class or classes indicated by the alphabetical symbols. The second
and third letters, if any, that follow the initial letter are added by the
Copyright Office for the purpose of statistical analysis. Their
significance is as follows:
F Published foreign works. In the case of books and periodicals, it

designates works manufactured outside the United States
(except those registered for ad interim copyright). In all other
classes to which it applies, it designates works first published
outside the United States, the authors of which are neither
citizens nor domiciliaries of the United States. (AF, EF)
I Books and periodicals registered for ad interim copyright. (AI, BI)
O Published works of foreign origin registered under the waiver-of-
fee provision (section 215 of Title 17 of the United States Code).
(BIO, GFO)
P Domestic published works in classes for which registration is
possible for either published or unpublished works. (EP, JP)
U Unpublished works in classes for which registration is possible for
either published or unpublished works. (DU, EU)
Price per
semiannual
issue
Part Books and Pamphlets, Including Serials and
1 Contributions to Periodicals $10.00
A Books
BB Contributions to periodicals
R Renewal registrations
Part Periodicals (Annual issue)

2 6.00
B Periodicals
Parts Dramas and Works Prepared for Oral Delivery

3–4 3.00
C Lectures and other works prepared for oral delivery
D Dramatic or dramatico-musical works
Part Music
5 10.00
E Musical compositions
Part Maps and Atlases

6 3.00
F Maps
Parts Works of Art, Reproductions of Works of Art, Scientific

7– and Technical Drawings, Photographic Works, Prints
11A and Pictorial Illustrations $3.00
G Works of art and models or designs for works of art
H Reproductions of works of art
I Drawings or sculptural works of a scientific or technical
character
J Photographs
K Prints and pictorial illustrations
Part Commercial Prints and Labels (Annual issue)

11B 5.00
KK Commercial prints and labels
Parts Motion Pictures

12–
13 3.00
L Motion-picture photoplays
M Motion pictures other than photoplays
Part Sound recordings

14 5.00
N Sound recordings
Subscription price: Complete Catalog for the year $75.00;

$18.75 additional for foreign mailing. Orders, accompanied by
remittances, should be addressed to the Superintendent of
Documents, U.S. Government Printing Office, Washington,
D.C. 20402.
Table of Contents
Page
Index 1
Current Registrations 35
Renewal Registrations 81
Introduction
Parts 12–13 list all registrations made in classes L and M for the
period covered by this issue. An index of names and titles associated
with the work is followed by the main entries, listed in order by
registration number. Filing of the index is letter by letter, except in
the case of inverted names which are filed up to the comma or
parenthesis, after which letter by letter filing is resumed.
The main entries include, when applicable, the following
information derived from the work and application.
1) Title, followed by subtitle and/or descriptive statements. The

authorship of the work is included in this statement, with
the nature of authorship (if available).
2) Edition statement.
3) Country of publication for works registered as foreign or as ad
interim works.
4) Label name and number for registered sound recordings.
5) Physical description of the deposit.
6) Series statement.
7) Additional titles associated with the registered work such as
variant titles, alternative titles, translated titles, etc.
8) Notes; information is given here which serves to supplement
the data that is given elsewhere in the entry in order to
describe a work more accurately or identify it more
explicitly.
9) Statement that the registered work is published in or as part of
another work, or is bound with another independent work.
10) Names of authors given in the application which do not appear
elsewhere in the entry.
11) Statement of those materials contained in the registered work
on which copyright is not claimed, when so stated in the
application.
12) Information contained in the application which relates to the
registration of an earlier version of the work.
13) Brief statement of the new matter on which copyright is
claimed when so stated in the application.
14) Copyright symbol © or Ⓟ.
15) A statement of limitation of claim if the application or notice
on the work explicitly limits the claim.
16) Name of the copyright claimant.
17) Date of publication for published works; for unpublished
works the date on which the last of all items required to
complete registration
was received in the Copyright Office.
18) Registration number.
For published works, whenever it is necessary to indicate a
variation between the information given in the application and in the
copy of the work with respect to the claimant’s name or the date of
publication, the data from the application is given first, followed by
the phrase “in notice” and the data given in the work; e.g., © John
Doe; 11Jan74 (in notice: 1973).
For renewal registrations the original date of publication and
registration number precede the name of the claimant of the renewal
registration. Following the name of the renewal claimant is a
statement in parentheses, usually abbreviated, giving the basis of the
renewal claim as supplied by the application; e.g., “John Doe (A)”
indicates that John Doe has made renewal claim as author.
Works deposited in connection with current copyright
registrations may be selected for inclusion in the collections of the
Library of Congress. Library of Congress printed cards are available
for many of the published works so selected. Orders for such cards or
inquiries concerning them should be addressed to the Card Division,
Building No. 159, Navy Yard Annex, Washington, D.C. 20541.
Registrations January-June 1974
Class L— Domestic published motion-picture photoplays 704

Foreign published motion-picture photoplays 34
Unpublished motion-picture photoplays 11
Class M— Domestic published motion pictures other than photoplays 777
Unpublished motion pictures other than photoplays 155
Total 1,681
Renewals: Classes L and M 532
These figures represent the number of registrations for motion

pictures for January-June 1974, but do not necessarily represent the
exact number of entries in this issue of the Catalog of Copyright
Entries. Registration figures for other classes of material may be
found in the respective parts.
Abbreviations and Symbols
The following list includes abbreviations and symbols used in this

catalog with specific copyright or bibliographic meanings.
(A) author(s)
a.a.d.o. accepted alternative designation of
a.k.a. also known as
acc. accompaniment
Adm.c.t.a. Administrator(s) cum testamento annexo
Adm.d.b.n.c.t.a. Administrator(s) de bonis non cum testamento
annexo
appl. application
approx. approximate, approximately
arr. arranged, arrangement, arranged by
Aufl. Auflage
augm. augmented
Ausg. Ausgabe
b&w black and white
Bd. Band (German)
bearb. bearbeitet
© copyright symbol
(C) child or children of the deceased author
ca. circa
chap. chapter(s)
col. colored
comp. compiler
d.b.a. doing business as
(E) executor(s) of the author
ed. edition, editor
enl. enlarged
fr. frames
ft. feet
hrsg. herausgegeben
illus. illustration(s)
m music, music by
min. minutes
mm. millimeters
(NK) next of kin of the deceased author
NM new matter
no. number(s)
nouv. nouveau, nouvelle
op. opus
p. page(s)
(PCB) proprietor of copyright in a work copyrighted by
a corporate body otherwise than as assignee or
licensee of the individual author
(PCW) proprietor of copyright in a composite work
(PPW) proprietor of copyright in a posthumous work
(PWH) proprietor of copyright in a work made for hire
prev. previous, previously

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1. The nurse can best ensure that communication is understood by:

DIF: Cognitive Level: Comprehension REF: p. 103 OBJ: Theory #1

2. The nurse recognizes a verbal response when the patient:

DIF: Cognitive Level: Comprehension REF: p. 101 OBJ: Theory #1

DIF: Cognitive Level: Comprehension REF: p. 101 OBJ: Theory #1

DIF: Cognitive Level: Comprehension REF: p. 103 OBJ: Theory #2

DIF: Cognitive Level: Comprehension REF: p. 103 OBJ: Theory #3

6. A nurse using active listening techniques would:

DIF: Cognitive Level: Comprehension REF: p. 104 OBJ: Theory #3

DIF: Cognitive Level: Application REF: p. 105|Table 8-1

DIF: Cognitive Level: Application REF: p. 105|Table 8-1

DIF: Cognitive Level: Application REF: p. 105|Table 8-1

DIF: Cognitive Level: Comprehension REF: p. 111

DIF: Cognitive Level: Comprehension REF: p. 111 OBJ: Theory #4

DIF: Cognitive Level: Application REF: p. 102 OBJ: Theory #9

DIF: Cognitive Level: Application REF: p. 115|Box 8-2

DIF: Cognitive Level: Knowledge REF: p. 117 OBJ: Theory #8

DIF: Cognitive Level: Application REF: p. 111

DIF: Cognitive Level: Comprehension REF: p. 103 OBJ: Theory #3

DIF: Cognitive Level: Application REF: p. 105|Table 8-1

DIF: Cognitive Level: Application REF: p. 115 OBJ: Theory #7

DIF: Cognitive Level: Application REF: p. 111 OBJ: Theory #3

DIF: Cognitive Level: Application REF: p. 105|Table 8-1

DIF: Cognitive Level: Comprehension REF: p. 106 OBJ: Theory #4

DIF: Cognitive Level: Comprehension REF: p. 103 OBJ: Theory #3

DIF: Cognitive Level: Application REF: p. 105|Box 8-1

DIF: Cognitive Level: Comprehension REF: p. 106

DIF: Cognitive Level: Comprehension REF: p. 105 OBJ: Clinical #1

DIF: Cognitive Level: Comprehension REF: p. 105 OBJ: Theory #4

DIF: Cognitive Level: Comprehension REF: p. 105 OBJ: Theory #31

28. To convey the intervention of active listening, the nurse would:

DIF: Cognitive Level: Comprehension REF: p. 104 OBJ: Theory #3

DIF: Cognitive Level: Application REF: p. 104 OBJ: Clinical #2

DIF: Cognitive Level: Comprehension REF: p. 104 OBJ: Theory #2

DIF: Cognitive Level: Application REF: p. 102 OBJ: Theory #9

DIF: Cognitive Level: Application REF: p. 105|Table 8-1

DIF: Cognitive Level: Application REF: p. 105|Table 8-1

DIF: Cognitive Level: Comprehension REF: p. 105|Table 8-1

DIF: Cognitive Level: Comprehension REF: p. 105 OBJ: Theory #3

DIF: Cognitive Level: Comprehension REF: p. 105 OBJ: Theory #3

DIF: Cognitive Level: Application REF: p. 105 OBJ: Theory #3

DIF: Cognitive Level: Comprehension REF: p. 109|Table 8-3

DIF: Cognitive Level: Analysis REF: p. 109|Table 8-3

DIF: Cognitive Level: Comprehension REF: p. 109|Table 8-3

DIF: Cognitive Level: Comprehension REF: p. 109|Table 8-3

DIF: Cognitive Level: Comprehension REF: p. 109 OBJ: Theory #3

DIF: Cognitive Level: Comprehension REF: p. 109 OBJ: Theory #3

DIF: Cognitive Level: Application REF: p. 104 OBJ: Theory #3

DIF: Cognitive Level: Knowledge REF: p. 111 OBJ: Theory #4

47. When communicating with an aphasic patient, the nurse appropriately:

DIF: Cognitive Level: Comprehension REF: p. 113|Box 8-1

DIF: Cognitive Level: Comprehension REF: p. 113|Box 8-1

49. When communicating with a preschooler, the nurse should:

DIF: Cognitive Level: Comprehension REF: p. 114

DIF: Cognitive Level: Comprehension REF: p. 114

DIF: Cognitive Level: Application REF: p. 115 OBJ: Theory #6

DIF: Cognitive Level: Comprehension REF: p. 104 OBJ: Theory #7

DIF: Cognitive Level: Comprehension REF: p. 117 OBJ: Theory #8