Deck 2: Communication and Collaboration

Question 1

The registered nurse is orienting a new nurse to the unit.They are completing paperwork on a newly admitted patient.When the experienced nurse asks what the new nurse thinks the patient will need to learn for self-care at home, the new nurse expresses surprise.What statement by the registered nurse is most appropriate?

A) "You should always at least start thinking about discharge planning."
B) "We don't want to wait too long because unexpected things happen."
C) "The admitting nurse has to fill in all sections of this document."
D) "Best practice is to begin discharge planning on admission."

Answer 1

"Best practice is to begin discharge planning on admission."

Question 2

A patient who says that both parents died of heart disease early in life is waiting for diagnostic testing results.The patient is biting fingernails and pacing around the room.Which statement should the nurse use to clarify patient information?

A) "I can see that you are anxious about dying."
B) "Tell me more about your family's history."
C) "Do you have your parents' medical records?"
D) "I'm not sure that I understand what you mean."

Answer 2

"Tell me more about your family's history."

Question 3

The nurse is caring for a patient who refuses to participate in physical therapy (PT) and states, "I really don't like to exercise." Which response by the nurse is most likely to help engage the patient in PT?

A) "It makes the pain worse, doesn't it?"
B) "What don't you like about exercise?"
C) "You really should do these exercises."
D) "Do you like to do any other activities?"

Answer 3

"What don't you like about exercise?"

Question 4

A patient with a history of violence directed toward others becomes very excited and agitated during the nurse's interview.Which intervention does the nurse implement to foster therapeutic communication?

A) Call the security staff for assistance.
B) Ask the patient to use self-control.
C) Lean forward and touch the patient's arm.
D) Assume an open, nonthreatening posture.

Question 5

The nurse interviews a patient during admission.Which observation by the nurse identifies consistency between the patient's verbal and nonverbal communication?

A) Asserts she is eager to answer questions while reading a magazine.
B) States that he wants information while frequently changing the subject.
C) Asks the nurse to explain a surgical procedure while she listens intently.
D) Explains that he is relaxed while continuously shifting in his chair.

Question 6

A patient's mother died several days ago.The patient begins to cry and states, "The pain of her death is impossible to bear." Which statement by the nurse is the most effective response?

A) "I was depressed last year when my mother died, too."
B) "I know things seem bleak, but you are doing so well."
C) "I can see this is a very difficult time for you right now."
D) "Should I cancel your appointment with the cardiologist?"

Question 7

After receiving a diagnosis of a fatal disease, the patient expresses sadness and states "I don't know what to do next".Which action by the nurse best facilitates communication at this time?

A) Sit quietly with the patient and observe nonverbal communication.
B) Reassure the patient that his family will take care of him.
C) Refer the patient to a church for spiritual counseling.
D) Tell the patient that hospice care is available immediately.

Question 8

The patient tells the nurse, "I must be very sick because so many tests are being performed." Which statement does the nurse use to clarify the patient's message?

A) "I sense that you are very worried."
B) "Why do you mention this so frequently?"
C) "We should talk about this more."
D) "Are you saying you think you are seriously ill?"

Question 9

The nursing staff are using the SBAR communication technique during patient hand-off communication.The circumstances leading up to the current status would be explained by the nurses during which step of the technique?

A) Situation
B) Background
C) Assessment
D) Recommendations

Question 10

The nursing staff are working with a postoperative patient from another culture who does not understand or speak the English language well.Which approach by the nurse would be best?

A) Act out what the patient needs to do.
B) Obtain a medical interpreter.
C) Assess if the patient can read or write.
D) Talk slowly when instructions are given.

Question 11

The nurse is caring for a patient who states, "I don't feel well today." Which is the best response by the nurse?

A) Ask the patient to continue to describe the feeling.
B) Measure the blood pressure and temperature.
C) State that the patient's diagnostic testing had normal results.
D) Compare recent laboratory results with the prior results.

Question 12

The nurse is explaining a procedure to a 3-year-old patient.Which strategy would the nurse use for patient teaching?

A) Ask the patient to draw her feelings.
B) Show needles, syringes, and bandages.
C) Tell the patient about postoperative pain.
D) Use dolls and stories to explain surgery.

Question 13

The nurse is preparing to begin the patient hand-off procedure for five patients.Who should the nurse include in this process?

A) Only the licensed nurses
B) The nursing personnel caring for the patients
C) The entire interdisciplinary team
D) The nurses and health care provider

Question 14

The patient tells the nurse, "I want to die." Which is the best response by the nurse to facilitate therapeutic communication?

A) "Now why would you say a thing like that?"
B) "Tell me more about how you're feeling."
C) "We need to tell the provider how you feel."
D) "You have too much to live for to say that."

Question 15

A student is watching a nurse perform a medication reconciliation prior to transferring the patient to a skilled nursing facility.What explanation of this process to the student is best?

A) "It is required by the Joint Commission before discharge or transfer."
B) "It creates an accurate list of medications so errors do not occur later."
C) "It helps us recognize lapses in patients' ability to remember their medications."
D) "Receiving facilities won't accept patients without a reconciliation."

Question 16

The nurse brings the patient's medications into the room, and the patient shouts, "You don't care if I take these, so get out of my room!" Which response by the nurse is most appropriate?

A) "Who misinformed you about my feelings?"
B) "You seem very angry about the medications."
C) "We know each other; why are you saying this?"
D) "I cannot leave until you take these medications."

Question 17

The nurse admits a patient who is nonverbal and agitated.What can the nurse do to communicate effectively with the patient?

A) Use a communication aid.
B) Wait for family to arrive.
C) Call interpreter services.
D) Treat the patient for pain.

Question 18

The nurse is interviewing a newly admitted patient.Which statement by the nurse is most likely to result in effective patient communication?

A) "I'm not sure why you're here.Can you explain it to me?"
B) "Tell me about things and people that are important to you."
C) "Tell me more about your pain.Where does it start?"
D) "If you think it's important, I'll try to notify the provider."

Question 19

The patient shouts at the nurse, "No one answered my nurse call system all night!" Which response would the nurse use with this patient to restore therapeutic communication?

A) "Shouting is going to disturb other patients."
B) "I see how that would make you very angry."
C) "Are you sure the nurses were avoiding you?"
D) "The unit has many very sick patients right now."

Question 20

The nurse is working toward discharging a patient.Which of following demonstrates patient engagement during the discharge process?

A) Teaching the patient how to use his equipment
B) Having the patient establish daily goals
C) Reviewing the discharge instructions with the patient
D) Including the family in the discharge planning

Question 21

A nurse is reviewing medications and treatments one final time before the patient goes home.The patient becomes agitated and says "I just can't do this! I'm too upset to ever be able to learn this!" What action by the nurse is best?

A) Provide immediate remediation on the knowledge and skills.
B) Ask the patient if home health care might be acceptable.
C) Request the provider re-examine all the discharge orders.
D) Tell the patient you would like to understand what is most difficult.

Question 22

Which of the following pieces of information should be included in a hand-off to ensure patient safety? (Select all that apply.)

A) Code status
B) Recent changes in condition
C) Age
D) Family visitation
E) Use of oxygen

Question 23

A faculty member is explaining personal factors that influence communication.What factors does the faculty member include? (Select all that apply.)

A) Perceptions
B) Values
C) Emotions
D) Relationships
E) Pain