Deck 1: Communication for Nurses How to Prevent Harmful Events and Promote Patient Safety

Question 1

The patient needs an immediate referral to a cardiologist. Continuity of care and patient safety are enhanced by all of the following EXCEPT:

A)Sharing detailed information with the cardiologist
B)Withholding the reason for referral from the patient to decrease fear
C)Using a structured handoff procedure
D)Reconciliation of medications

Answer 1

Withholding the reason for referral from the patient to decrease fear

Question 2

System inputs within the nursing work system include all EXCEPT:

A) Organizational management
B)Human abilities
C)Work environment
D)External environment

Answer 2

Human abilities

Question 3

In Reason's accident causation theory, the unsafe acts committed by health-care providers are termed:

A)Latent conditions
B)Personal failures
C)Active failures
D)Error-provoking conditions

Answer 3

Active failures

Question 4

Unsafe acts include all EXCEPT:

A)Attention failures
B)Memory failures
C)Violations
D)Latent conditions

Question 5

More acutely ill patients; shorter hospital stays; frequent patient turnover; extended hours and overtime; stressful, interruption-driven environment; and large nursing workloads are considered _________ in Reason's accident causation theory.

A)Active failures
B)Latent conditions
C)System perspectives
D)Situational awareness

Question 6

A nurse is called to the telephone to receive an order from a physician for a patient who needs pain medication. After clearly establishing the identity of the patient and physician, the nurse should:

A) Write the drug on the order sheet, fax the order sheet to the pharmacy, obtain the drug, and promptly bring the drug to the bedside.
B)Ask the charge nurse to spell the drug's name if unsure how to spell it, and record the drug name, dose, method of administration, and frequency on the order sheet.
C)Repeat what the physician says, then write it down on the order sheet.
D)Write the order on the order sheet, read the order back to the physician, and verify the order is accurate.

Question 7

A night nurse is concerned about a newly admitted surgical patient and needs to call to awaken the surgeon. The nurse uses the SBAR to get the information together. He plans to introduce himself to the surgeon, identify the patient, and describe:

A)The Situation, Background, Assessment , Recommendations
B)The Systems, Background, Assessment, Requirements
C)The Social Background, Aliments, Rx
D)The Solutions, Background, Activities, Respiratory

Question 8

Communication and patient safety are connected in health care because:

A)Clinical decisions are made based on shared information
B)One person dies every 5 minutes due to medical errors
C)Sentinel events occur in hospitals
D)There is a lack of quality care and services provided to patients by health-care organizations

Question 9

Nurses use communication in each of the following role functions EXCEPT:

A)Transferring responsibility of care
B)Actively involving the patient in the plan of care
C)Ensuring accuracy in interpreting information
D)Prescribing medications to treat illness

Question 10

The transformational model of communication emphasizes:

A)Shared message creation
B)Creating effects and outcomes
C)Message transmission
D)Message exchange

Question 11

The elements of the transformational model of communication include all EXCEPT:

A)Patient-safe strategies
B)Risk factors
C)Linear message transmission
D)Context factors

Question 12

Communication occurs for the purpose of the expression of thoughts and feelings to:

A)Meet physical, social, practical, and identity needs
B)Clarify and verify the meaning of messages
C)Describe risk factors in a situation
D)Understand a situational context

Question 13

Identify all communication risk factors from the transformational model of communication:

A)Anxiety
B)Blindness
C)Hand-off
D)Tall-man lettering
E) CUS

Question 14

In the patient-safe strategy of perception checking, which response is most appropriate to promoting a positive transformational outcome?

A)"Why didn't you eat your lunch? What's the matter?"
B)"I noticed that you didn't eat lunch. Is the food not good, or are you not feeling well? Is something wrong?"
C)"Since you didn't eat, I will ask the dietitian to come and talk to you."
D)"We can't continue talking about your eating problem right now. It's time for your bath."

Question 15

Nurses can increase their ability to perceive themselves accurately by:

A)Self-disclosure within the nurse-patient relationship
B)Using the self-fulfilling prophecy
C)Getting in touch with the unknown self
D)Eliciting feedback from others

Question 16

Order the importance of characteristics of the person delivering a message that influences the meaning given to the message:
______The words spoken by the nurse
______The appearance and nonverbal behavior of the nurse
______The tone of voice of the nurse

Question 17

Select the statements that promote a positive communication climate between communicators:

A)Restating the problem
B)Giving a pep talk about the problem
C)Defending your position
D)Giving advice about the problem
E) Asking challenging "why" questions
F) Giving general leads such as "Please go on" and "Yes"

Question 18

The nurse confirms listening has occurred through all the following EXCEPT:

A)Giving advice
B)Paraphrasing
C)Questioning
D)Silence

Question 19

The nurse's knowledge about culture begins by:

A)Researching popular cultural groups
B)Understanding the nurse's own cultural values and beliefs
C)Sharing personal values and beliefs with patients
D)Integrating spirituality into nursing care of patients

Question 20

Patterns of speech in men are focused on all EXCEPT:

A)Hierarchy
B)Status
C)Intimacy
D)Independence

Question 21

Match the description to the terms given.
Universal responses to stress-matching (may be used more than once)

-Worried about offending anyone

A) Blamer
B) Placater
C) Computer
D) Distractor

Question 22

Match the description to the terms given.
Universal responses to stress-matching (may be used more than once)

-Ignores people who speak to them

A) Blamer
B) Placater
C) Computer
D) Distractor

Question 23

Match the description to the terms given.
Universal responses to stress-matching (may be used more than once)

-Hangs up the telephone on a person

A) Blamer
B) Placater
C) Computer
D) Distractor

Question 24

Match the description to the terms given.
Universal responses to stress-matching (may be used more than once)

-Speaks in monotones

A) Blamer
B) Placater
C) Computer
D) Distractor

Question 25

Match the description to the terms given.
Universal responses to stress-matching (may be used more than once)

-Will not discuss emotions

A) Blamer
B) Placater
C) Computer
D) Distractor

Question 26

Match the description to the terms given.
Universal responses to stress-matching (may be used more than once)

-Talks nervously, makes little sense, fails to focus on the problem

A) Blamer
B) Placater
C) Computer
D) Distractor

Question 27

A patient is being discharged to a nursing home. While preparing the discharge summary, the patient says: "I feel that nobody cares about me." The nurse could improve the communication climate by saying:

A)"You feel all alone."
B)"You are angry about this situation."
C)"You cannot stay here any longer."
D)"Your family doesn't have the skills to care of you."

Question 28

You teach a patient to think of a relaxing situation every time stress increases. This is called:

A)Progressive relaxation
B)Visual imagery
C)Assertiveness
D)Restorative care

Question 29

As a patient-safe response to an angry patient, the nurse should improve the communication climate by:

A)Focusing on something other than the patient's anger
B)Pointing out the angry behavior to the patient
C)Encouraging the patient to share feelings
D)Keeping the patient as active as possible

Question 30

Which of the following are examples of protective touch?

A)Hold patient's hand before surgery
B)Apply vest restraint
C)Give an a-frame hug
D)Shaking hands with patient
E) Give injection
F) Message patient's hands
G) Hold the patient's arm down while the lab technician draws blood

Question 31

In which of the following situations could the nurse use humor appropriately as a patient-safe strategy?

A)When a patient is in severe pain
B)When providing patient education
C)When maintaining a helping relationship
D)When a patient is very distraught and the nurse is providing care
E) When a patient is vomiting and the nurse is holding the emesis basin
F) When the nurse is inserting a urinary catheter into the patient

Question 32

Which of the following nurse responses would be appropriate for a patient who is crying?

A)"I can see you're upset."
B)"There's no need to cry."
C)"You must be strong."
D)Sit on the same level as the patient.
E) "Think of your family."
F) "Are those tears I see?"
G) "What's the matter?"
H) "It's time to get on with your life."
I) Hold the patient's hand.

Question 33

A male patient is crying, and the only word the nurse understands is "wife." What should the nurse say?

A)"I'm sure your wife is fine."
B)"Are you concerned about your wife?"
C)"What did your wife do to upset you?"
D)"Your wife will be visiting later today."

Question 34

The elderly patient who is dying starts to cry and says, "I was always concerned about myself first, and I hurt many people during my life." What is the underlying feeling being expressed by the patient?

A)Ambivalence
B)Sadness
C)Anger
D)Guilt

Question 35

You go to visit a family member after the death of their loved one. After the death of a loved one, which of these statements demonstrates high-level communication competency?

A)"I know just how you feel."
B)"Your grief will lessen with time."
C)"This has to be a hard time for you. Does it help you to talk?"
D)"It is better to put this painful experience out of your mind."

Question 36

When educating patients, it is inappropriate for the nurse to:

A)Treat all patients the same
B)Help patients find a way to word questions for their physicians
C)Ask patients what specifically they want to know
D)Teach patients about their disease and treatments in language they can understand

Question 37

Humor can be used to facilitate communication in which situation?

A)During patient education
B)During painful procedures
C)When the patient has high anxiety
D)When the patient is cognitively impaired

Question 38

Humor is an effective patient-safe strategy when used to:

A)Increase negative feelings
B)Laugh at the patient
C)Reframe reality
D)Avoid facing problems

Question 39

Hugs can be comforting forms of touch EXCEPT when:

A)Sharing joy or sorrow
B)The patient has a history of abuse
C)Offering emotional support
D)Saying goodbye to a patient

Question 40

Learning means that a change has occurred within the patient that is not accounted for by:

A)Psychomotor behavioral capabilities
B)Cognitive knowledge
C)Affective dispositions
D)Biological growth

Question 41

Health literacy programs encourage patients to ask three questions with every health-care interaction. These questions include all of the following EXCEPT:

A)How much will this cost?
B)What is my main problem?
C)What do I need to do?
D)Why is it important for me to do this?

Question 42

Self-disclosure within social relations is done for all the following reasons EXCEPT:

A)Self-clarification
B)Self-validation
C)Relationship termination
D)Unload and vent problems

Question 43

Communication with patients with dementia or Alzheimer's disease is difficult because they have:

A)Difficulty understanding what is said
B)Difficulty hearing what is said
C)Visual impairments
D)Olfactory impairments

Question 44

During the assessment step of the patient-safe communication process, the nurse:

A)Determines needs of the communicators
B)Observes effects of the message
C)Obtains validation feedback
D)Selects the best channel