- In which circumstance would it be MOST appropriate to incorporate the phrase’ patient problem statement’ into the verbal communication?
A. The nurse tells the health care provider
(HCP) about a change in the patient’s respiratory status.
B. The nursing student and the nursing in-
structure discuss the patient’s care plan.
C. The home health nurse reviews the goals of rehabilitation with the patient and family.
D. The off-going nurse gives hand-off report about several patients to the oncoming nurse.
B. The nursing student and the nursing in-
structure discuss the patient’s care plan.
- What type of eye contact would be best to use if the nurse is trying to involve the patient in a discussion about sexuality without being threatening or intimidating?
A. Lean slightly forward and maintain extended eye contact.
B. Look downward if the patient uses slang terms related to sex.
C. Maintain eye contact for 2 to 6 seconds during the discussion.
D. Observe the patient and mimic the patient’s eye contact.
C. Maintain eye contact for 2 to 6 seconds during the discussion.
- A nursing student goes to an instructor’s office to discuss an uncomfortable interaction that occurred with a patient during the last clinical experience. Which behaviors suggest that the instructor is failing to give the student full attention? Select all that apply.
A. Instructor welcomes the student and offers 40 minutes for discussion.
B. Instructor smiles and waves at others who walk past the office.
C. Instructor offers advice before the student explains the details of the incident.
D. Instructor appears relaxed and asks open-ended questions.
E. Instructor frequently handles her cell phone.
F. Instructor shuffles and rearranges papers on the desk.
B. Instructor smiles and waves at others who walk past the office.
C. Instructor offers advice before the student explains the details of the incident.
E. Instructor frequently handles her cell phone.
F. Instructor shuffles and rearranges papers on the desk.
- The nurse is trying to interview a patient who is very hard of hearing. What strategy would the nurse try first?
A. Talk to the patient’s spouse.
B. Shout loudly into the patient’s good ear.
C. Use simple language and avoid medical terminology.
D. Use normal volume and lower tone of voice.
D. Use normal volume and lower tone of voice.
- The patient says, “I trust you, so I am going to tell you a secret. I am going to end it all by going for a long swim in the ocean.” What would the nurse do first?
A. Tell the patient that intent to harm self must be reported to the health care team.
B. Ask the patient to elaborate on the meaning of “end it all” and “long swim.”
C. Thank the patient for the trust and promise to keep the information confidential.
D. Stay with patient and wait for him to express his thoughts and feelings.
B. Ask the patient to elaborate on the meaning of “end it all” and “long swim.”
- The night nurse is giving report during shift change. A visitor passing by is an unintended receiver of the nurse’s communication. What is the best method to prevent this type of occurrence?
A. Ask visitors to leave the unit during shift change.
B. Give report in a private room with the door closed.
C. Eliminate negative connotations during report.
D. Make written notes that are passed only to staff members.
B. Give report in a private room with the door closed.
- The nurse is attempting to elicit the patient’s state of mind about an upcoming surgery.
Which approach is likely to be most effective?
A. “Are you afraid of having the procedure?”
B. “Let me give you information about the procedure.”
C. “Look at this series of pictures about the procedure.”
D. “What do you understand about the procedure?”
D. “What do you understand about the procedure?”
- A patient is grimacing while trying to change his position in bed. He tells the nurse that he is feeling great and is ready to get up and go home. Which response best indicates that the nurse recognizes that the patient’s communication is incongruent?
A. “Going home is the goal, but let me help you get up and you can walk around for a while.”
B. “Let me help you sit up and then you can get dressed and pack up your belongings.”
C. “Would you like a dose of pain medication before you go home?”
D. “That sounds great! I’ll call your HCP and inform her that you are ready to go home.”
A. “Going home is the goal, but let me help you get up and you can walk around for a while.”
- The nurse is about to begin teaching a small group of adolescents about healthy eating habits. Which nonverbal behavior best indicates potential interest in listening to the nurse?
A. Talking on a cell phone and smiling at the
nurse
B. Staring at the blackboard with a bored expression
C. Using the Internet to search for topics of interest
D. Removing a notebook and pen from a backpack
D. Removing a notebook and pen from a backpack
- The patient tells the nurse, “I’m supposed to check my blood sugar at least three times each day, but I can’t always find the test sticks and they’re very expensive.” Which response by the nurse is the best example of effective clarification?
A. “When did you last check your blood sugar?”
B. “I’ll speak with the nurse practitioner about your situation.”
C. “I see that you know how important it is to check your blood sugar.”
D. “Let me make sure I understand what your concern is with the blood sugar testing.”
D. “Let me make sure I understand what your concern is with the blood sugar testing.”
- The patient states, “I’m worried and don’t know what to expect after my biopsy.” Which question best encourages the patient to explain the problem to the nurse?
A. “Would you like to talk to your surgeon before the procedure?”
B. “Are you feeling anxious about the results of your biopsy?”
C. “What are you worried about?”
D. “How can I make you feel better?
C. “What are you worried about?”
- The nurse is trying to take a patient’s history, but the patient makes frequent references to her aunt’s health, a neighbor’s illness, and events that happened many years ago to him or others. Which therapeutic communication technique is the nurse most likely to use with this patient?
A. Clarifying
B. Paraphrasing
C. Restating
D. Closed questioning
D. Closed questioning
- When communicating with a patient who has expressive aphasia, which communication strategy is the nurse most likely to use?
A. Encourage the patient to speak as much as possible.
B. Use eye blinks, one for “yes” and two for
“no.”
C. Ask family members for information.
D. Speak loudly and slowly with good enunciation.
B. Use eye blinks, one for “yes” and two for
“no.”
- The patient has a cultural background that is unfamiliar to the nurse. What would the nurse do when communicating with the patient?
Select all that apply.
A. Use formal names until preference is assessed.
B. Realize that interpretation of social time versus clock time can differ.
C. Be aware that touch varies according to gender and relationship.
D. Assume that smiling and handshake are universal greetings.
E. Use tone of voice that is soft and deferential.
F. Understand that eye contact has different meaning among cultures.
A. Use formal names until preference is assessed.
B. Realize that interpretation of social time versus clock time can differ.
C. Be aware that touch varies according to gender and relationship.
F. Understand that eye contact has different meaning among cultures.
- When communicating with an older adult, what would the nurse do?
A. Speak loudly and at a very slow pace.
B. Allow time for processing information.
C. Provide a dark, quiet environment.
D. Discourage anecdotal or tangential replies.
B. Allow time for processing information.
- Which nurse behavior / response best indicates to the patient that the nurse is actively listening to what he or she is trying to say?
A. Says “Uh-huh”
B. Smiles and nods at patient
C. Says “So in other words, you are…”
D. Looks at patient and leans forward
C. Says “So in other words, you are…”
During the discharge teaching, the patient states, “I don’t know how I will be able to care for myself after I leave the hospital.” What is the most therapeutic response?
A. “You don’t know how you will take care of yourself when you leave the hospital?”
B. “It sounds like you have some concerns.
What do you think is going to happen?”
C. “Would you like me to review the instructions so the information is clear?”
D. “Could you get someone to stay with you until you are feeling better?”
B. “It sounds like you have some concerns.
What do you think is going to happen?”
- The nurse is working with a patient from a different culture. Which action by the nurse is most likely to cause offense if patient’s sense of intimate space differs from the nurse’s?
A. Assists the patient to transfer from bed to chair
B. Sits in a chair and speaks with the patient
C. Speaks to the family in the presence of the patient
D. Hangs the patient’s clothes in the closet
A. Assists the patient to transfer from bed to chair
- The nurse is completing the patient’s history.
Which question encourages the patient to provide a specific answer with relevant detail?
A. “What type of surgeries have you had in the past?”
B. “What kinds of problems do you have?”
C. “Are you having any pain?”
D. “How do you feel about your current health status?”
A. “What type of surgeries have you had in the past?”
- The patient tells the nurse that the unlicensed assistive personnel (UAP) is always making jokes. What is the best response?
A. “Laughter is the best medicine.”
B. “What do you think about the UAP’s jokes?”
C. “Yes, the UAP really is a funny person.”
D. “Would you tell me a joke?”
B. “What do you think about the UAP’s jokes?”
- The nurse is explaining a change in a patient’s condition to an HCP. The HCP rudely and sarcastically replies, “Well, what do you want me to do about that?” What is the best response?
A. “Well, mostly I just wanted you to know about the situation.”
B. “That’s really your decision. I’m merely reporting the patient’s condition.”
C. “Please come and examine the patient, because the condition has changed.”
D. “Sorry to bother you. I’ll just keep monitoring the patient’s condition.”
C. “Please come and examine the patient, because the condition has changed.”
- The patient has just died. The wife and daughter are holding each other and crying at the bedside, while the little boy is standing apart staring out the window. Which communication approach would be the best to support everyone in the family?
A. Talk to the little boy about what he is feeling and what he sees out the window.
B. Stand beside the wife and daughter and direct the little boy to join the group.
C. Use therapeutic touch with the wife and daughter and allow the little boy to have his space.
D. Stand beside the little boy and keep an open body position toward the mother and daughter.
D. Stand beside the little boy and keep an open body position toward the mother and daughter.
- The nurse is present when the obstetrician informs a 17-year-old that she is pregnant. The adolescent shrugs, appears bored, and says, “That’s no big deal to me.” The nurse, who has been trying to get pregnant for several years, feels angry and hostile toward the patient. What would the nurse do first?
A. Care for the patient and talk about the situation later with a friend.
B. Perform a self-assessment of ability to convey acceptance.
C. Be honest with the patient and express concern about her attitude.
D. Ask another nurse to take over care of the patient.
B. Perform a self-assessment of ability to convey acceptance.
- An experienced UAP gives excellent care and is well-liked by all of the residents in the long-term care facility. She calls the female residents “Sweetie” and the male residents “Honey-bunch.” The nurse is newly graduated but recognizes that the UAP is using “elderspeak.” What would the nurse do?
A. Let a good thing continue because everyone seems happy and the care is good.
B. Gain more experience and mimic the UAP’s behavior and communication style.
C. Report to the RN in charge about concerns for the UAP’s disrespect of residents.
D. Praise the UAP for giving excellent care and role-model use of “Mr.,” “Mrs.,” or “Ms.”
D. Praise the UAP for giving excellent care and role-model use of “Mr.,” “Mrs.,” or “Ms.”
