Which statement made by the nurse demonstrates the best understanding of nonverbal communication?

Correct Answer: B

Rationale: **Rationale:** **Correct Answer (B):** This choice reflects a nuanced and professional understanding of nonverbal communication. The nurse actively assesses for congruence between verbal and nonverbal cues, which is critical in healthcare. Patients may say they are "fine" verbally while displaying nonverbal signs of distress (e.g., clenched fists, avoiding eye contact). By cross-validating these signals, the nurse ensures accurate interpretation and avoids misjudgment. This approach aligns with evidence-based practice, where holistic assessment improves patient care. It also acknowledges the complexity of communication, where nonverbal cues (e.g., tone, posture) often reveal unspoken emotions or needs. --- **Incorrect Answers:** **A:** While this statement acknowledges a discrepancy between verbal and nonverbal communication, it lacks the actionable insight demonstrated in **B**. Simply recognizing a difference is insufficient without further exploration. Nurses must actively investigate incongruence to understand underlying issues (e.g., pain, anxiety). The statement also risks oversimplification—nonverbal and verbal communication aren’t "often" different but may be in specific contexts. Without the nurse’s proactive validation, this observation alone doesn’t improve patient care. **C:** This choice reflects a common pitfall: overinterpreting a single nonverbal cue. Slumped posture could indicate fatigue, pain, or even relaxation—not just anger or depression. Nonverbal communication is context-dependent, and assumptions without further assessment can lead to misdiagnosis or inappropriate interventions. Effective nursing requires gathering additional data (e.g., asking open-ended questions) rather than jumping to conclusions based on isolated behaviors. **D:** This statement undervalues the role of nonverbal communication, which is often more revealing than verbal language. Studies show that nonverbal cues (facial expressions, gestures) convey up to 93% of emotional meaning. In healthcare, patients may struggle to articulate distress verbally, making nonverbal signals vital. Dismissing nonverbal communication as "harder to understand" neglects its importance in building trust and identifying unmet needs. Competent nurses prioritize both forms of communication equally. --- **Key Takeaways:** - **B** stands out because it emphasizes *active validation*, a skill that bridges the gap between observation and clinical judgment. - **A** is passive, **C** is presumptive, and **D** misrepresents the complexity of communication. - Effective nursing integrates verbal and nonverbal cues to form a complete picture of the patient’s state, ensuring accurate and empathetic care.

Correct Answer: A

Rationale: Healthcare professionals should be most alert to the possibility of communication errors resulting in harm to the patient during change of shift reports. This is a critical time when information is transferred between healthcare providers, and any errors in communication during this handover can lead to adverse outcomes for the patient.

Correct Answer: D

Rationale: Asking 'why' questions is not considered a therapeutic technique in patient-centered communication as it can make patients feel defensive or judged. 'Why' questions may imply criticism or put the patient on the spot, potentially hindering open and honest communication. Instead, focusing on open-ended questions that encourage patients to express their feelings and thoughts without feeling judged or interrogated is more conducive to therapeutic communication.

Correct Answer: A

Rationale: Carolina's best response is **A: *"That sounds exciting, would you be willing to visit and show me the app?"*** because it demonstrates openness, curiosity, and a patient-centered approach. By validating the patient’s interest in the app, Carolina fosters trust and keeps communication lines open. This response allows her to assess the app’s credibility, discuss its integration with their ongoing therapy, and ensure the patient isn’t abandoning evidence-based care prematurely. It also avoids defensiveness, which could alienate the patient. A collaborative approach encourages the patient to remain engaged while allowing Carolina to provide professional guidance on whether the app complements or conflicts with their treatment plan. **B: *"At this time, there is no real evidence that the app can replace our therapy."*** is problematic because it dismisses the patient’s autonomy and enthusiasm without exploration. While it may be true that many apps lack rigorous evidence, outright rejection can make the patient defensive. A better approach would involve discussing research together, evaluating the app's merits, and addressing gaps in its effectiveness rather than issuing a blanket dismissal. This response risks shutting down dialogue and may push the patient further away from professional support. **C: *"I am not sure that is a good idea right now, we are so close to progress."*** assumes that the therapist's perspective on progress outweighs the patient’s agency. While the concern is valid—abruptly stopping therapy can disrupt gains—this phrasing centers Carolina’s agenda rather than the patient’s needs. It could come across as manipulative ("we’re *so close*") rather than collaborative. A more effective approach would be acknowledging the patient’s autonomy while discussing potential risks of discontinuing sessions. **D: *"Why would you think that is a better option than meeting with me?"*** is the least constructive, as it frames the question confrontationally. This puts the patient in a position to justify their choice defensively, which could damage rapport. It implies that Carolina’s ego is more important than understanding the patient’s perspective. Even if the app is inadequate, this response fails to guide the patient toward an informed decision, instead breeding resentment or withdrawal. In summary, **A** succeeds because it balances professional guidance with respect for the patient’s choices, fostering a partnership rather than authority-based compliance. The incorrect options either dismiss, manipulate, or challenge the patient in ways that undermine therapeutic trust. Effective responses in such scenarios prioritize curiosity, collaboration, and patient empowerment while ensuring clinical oversight.

Correct Answer: A

Rationale: Choice A, 'Hitting me when you are angry is unacceptable,' demonstrates a well-structured attempt at limit setting because it clearly defines the unacceptable behavior without ambiguity. This statement sets a clear boundary and clearly communicates the consequence for the behavior. In contrast, choices B, C, and D are less effective in setting limits as they are either vague expectations or commands without specific consequences for crossing the limit.