The nurse recognizes the patient who demonstrates communication congruency when the patient
wrings her hands and paces around the room while denying that she is upset.
states she is comfortable while she frowns, and her teeth are clenched.
is tearful and slow in speech when talking about her husband's death.
smiles and laughs while speaking of feeling lonely and depressed.
The Correct Answer is C
A. wrings her hands and paces around the room while denying that she is upset.
This example reflects incongruence. The patient's body language (pacing, wringing hands) suggests anxiety or distress, which does not match her verbal denial of being upset.
B. states she is comfortable while she frowns, and her teeth are clenched.
This example also reflects incongruence. Her facial expression and clenched teeth contradict her statement of comfort, indicating her communication is not aligned.
C. is tearful and slow in speech when talking about her husband's death.
This example reflects congruence. The patient’s verbal expression and nonverbal cues are aligned, indicating that her communication is consistent with her emotions.
D. smiles and laughs while speaking of feeling lonely and depressed.
This example reflects incongruence. Smiling and laughing contradict the verbal expression of loneliness and depression, indicating a mismatch in her communication.
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Correct Answer is D
Explanation
A. Avoid the use of eye contact to allow the patient to express herself without feeling stared at or demeaned.
Avoiding eye contact can make the patient feel ignored or unheard and is generally not effective in active listening.
B. Ask probing questions to direct the conversation and obtain the information needed as efficiently as possible.
Active listening involves allowing the patient to lead the conversation rather than directing it with probing questions.
C. Anticipate what the speaker is trying to say and help the patient express herself when she has difficulty with finishing a sentence.
While well-intentioned, finishing sentences can prevent the patient from expressing thoughts fully.
D. Use nonverbal cues such as leaning forward, focusing on the speaker's face, and slightly nodding to indicate that the message has been heard.
Correct Answer is D
Explanation
A. “Taking fluids poorly, but more than yesterday."
This assessment is vague (“taking fluids poorly”), lacks measurable details, and does not meet the clarity standard required in documentation.
B. "Apparently comfortable all night. Offers no complaints of pain."
“Apparently comfortable” is an assumption rather than an observable, objective statement, which could be legally questionable.
C. "Patient says she is still slightly nauseated, would like to try some toast and tea."
While this is clear, “slightly nauseated” could be more specific, and this does not objectively quantify the patient’s condition.
D. "4 cm reddened area over sacrum. Skin intact, warm, and dry."
This statement is concise, uses precise measurements, and includes objective data, meeting legal documentation guidelines.