60. Your patient had spine surgery 2 days ago and is sched- uled for discharge tomorrow. He has been taking nar- cotic pain relievers every 4 hours around the clock. You note that the patient has not had a bowel movement since surgery. You know that the narcotics can be con- stipating and you think it would be best if the problem is handled prior to the patient leaving for home. There is no order on the chart for a laxative. From the follow- ing possible actions, choose which you think represents the most focused and necessary thing(s) for you to do as you prepare to call the doctor for a verbal order for a laxative. a. Gather information about the patient's usual bowel habits; ask if he feels constipated and if he has used laxatives in the past. b. Ask the patient what laxative has worked for him in the past. c. Ask the patient to try to have a bowel movement. d. Get the chart and have a pen ready. Indicate whether the following statements are True (T) or False (F). 61. 62. 63. 64. Downward communication is communication with people you supervise. When you communicate effectively and profes- sionally, you are role modeling, too. As a team leader, you have a responsibility to tell the people you supervise about your facility's policies and procedures. When assigning tasks to a team, you should explain how one task relates to another even if two different people are doing the tasks separately. This is called "job rationale." 65. _ The shift-to-shift report is so important that The Joint Commission has made it a patient safety goal. 66. It is not important for the shift report to be stan- dardized in a facility, but it is important that the nurses coming on duty have plenty of time to ask questions. 67. 68. Chapter 6 Communication and Relationships 51 Giving reports to the oncoming shift is considered confidential. Select a sequence to present each patient's report so you will be less likely to forget something. Choose the correct answer(s). In some questions, more than one answer is correct. Select all that apply. 69. The basis of the nurse-patient relationship is a. admiration. b. integrity. c. trust. d. caring. 70. You are interviewing a new patient who is being admitted to the psychiatric unit. Your technique in this interview will largely be a. nondirective, with many open-ended questions. b. directive, with many closed-ended questions. c. directive, with many open-ended questions. d. nondirective, with many closed-ended questions. 71. Communicating with the hearing impaired can be a challenge. Which of the following techniques has been identified as helpful? a. Facing the person and getting his or her attention before starting to communicate. alwa 2 b. Speaking clearly with markedly increased volume. c. Speaking to the patient, not the interpreter, if there is one present. d. Eliminating background noise or other distractions. 72. You are assigned to care for a female patient with severe vision impairment. How can you best communicate with her? a. Identify yourself when you enter the room. b. Announce when you will be performing direct patient care before you touch the patient. c. Avoid raising the volume of your voice. d. Avoid using body language since she cannot see do so. e. Before leaving the room, ask if she needs anythi and tell her that you are leaving.