NUR 2356 EXAM 1 – MDC 1 (2026) RASMUSSEN
COLLEGE | 260 PRACTICE QUESTIONS WITH
DETAILED RATIONALES
SECTION I: COMMUNICATION & FOUNDATIONAL CONCEPTS (Questions 1–25)
1. A nursing student is preparing to communicate with a postoperative patient
experiencing significant pain. The student asks the instructor, “What is the
primary purpose of therapeutic communication in this situation?” Which
response by the instructor is most accurate?
A. To exchange information and meaning between the nurse and patient to
promote understanding and healing
B. To persuade the patient to accept the recommended treatment plan without
question
C. To document the patient’s complaints accurately in the medical record for legal
purposes
D. To redirect the patient’s attention away from their pain using distraction
techniques
Correct Answer: A
Rationale: The primary purpose of communication is the exchange of
information and meaning between people. In therapeutic communication, verbal
and nonverbal messages must match for effectiveness, and the goal is to promote
understanding and a trusting nurse-patient relationship. Persuading the patient
(B) is non-therapeutic; documentation (C) is important but not the primary
purpose of communication; and distraction (D) is a specific intervention, not the
overarching purpose of communication itself.
2. A nurse is teaching a group of nursing students about the communication
process. The nurse explains that communication consists of four essential parts.
The student correctly identifies which of the following as the four parts of the
communication process?
,A. Sender, message, channel, and receiver
B. Speaker, listener, interpreter, and responder
C. Encoder, decoder, transmitter, and feedback loop
D. Initiator, content, medium, and recipient
Correct Answer: A
Rationale: The four parts of the communication process are sender,
message, channel, and receiver. The sender encodes the message, which is
transmitted through a channel to the receiver, who decodes it. This foundational
model is central to understanding both therapeutic and non-therapeutic
communication. While other frameworks describe similar concepts, the standard
four-part model uses these exact terms.
3. A nurse enters a patient’s room to perform a preoperative assessment. The
television is on loudly, the patient appears anxious, and family members are
having a conversation nearby. Which factor is most likely to act as “noise”
interfering with nurse-patient communication?
A. All of the listed factors (TV volume, anxiety, family conversation)
B. Only the television volume, since it is the only external distraction
C. Only the patient’s anxiety, because internal factors are the strongest barriers
D. None of these, because the patient is awake and able to respond
Correct Answer: A
Rationale: “Noise” in the communication process refers to any factor that
interferes with the accurate transmission and reception of a message. Noise can
be external (TV volume, family conversation, environmental distractions) or
internal (pain, anxiety, fatigue). In this scenario, all listed factors—the loud TV, the
patient’s anxiety, and the nearby family conversation—act as barriers to effective
communication. The curriculum emphasizes identifying and minimizing all forms
of noise to promote effective nurse-patient communication.
,4. A nurse is caring for a patient who expresses concern about an upcoming
surgery, stating, “I just know something terrible is going to happen.” Which
response by the nurse is an example of a non-therapeutic communication
technique that should be avoided?
A. “Don’t worry, everything will be fine. I’m sure you have nothing to worry
about.”
B. “You seem really worried. Can you tell me more about what’s on your mind?”
C. “It sounds like you’re feeling anxious about the surgery. Many patients feel that
way.”
D. “Let’s talk about what you’re expecting and how we can support you.”
Correct Answer: A
Rationale: Offering false reassurance (“Don’t worry, everything will be
fine”) is a non-therapeutic communication technique because it dismisses the
patient’s feelings and closes off further discussion. Therapeutic responses (B, C, D)
encourage the patient to express concerns, validate feelings, and open dialogue.
Non-therapeutic techniques include false reassurance, giving advice, changing the
subject, and minimizing feelings.
5. A nurse is caring for a patient who speaks a different language. The patient’s
daughter is available to translate. What is the most appropriate action for the
nurse to take to ensure accurate communication?
A. Use the daughter to translate to save time.
B. Ask a housekeeping staff member who speaks the language to interpret.
C. Request a professional medical interpreter from the facility.
D. Use hand gestures and written notes only.
Correct Answer: C
Rationale: Professional interpreters are the standard to avoid errors;
family members might filter information for cultural reasons or lack the medical
vocabulary to translate accurately. Using untrained staff or family members can
lead to miscommunication, missed symptoms, or incorrect understanding of
, instructions. Facility-provided interpreters ensure accuracy and confidentiality.
6. The nurse is documenting the care provided to a patient. Which entry best
reflects the principle of objective documentation?
A. “Patient seems in a lot of pain and looks uncomfortable.”
B. “Patient stated pain level is an 8 out of 10.”
C. “Patient is probably anxious about the surgery tomorrow.”
D. “Incision appears to be healing nicely.”
Correct Answer: B
Rationale: Objective documentation includes observable, measurable
data. Quoting the patient directly with a numeric pain scale is objective.
Subjective terms like “seems,” “probably,” or “nicely” are vague, open to
interpretation, and should not be used in documentation. Objective data can be
verified by others.
7. When teaching a patient about a new medication, the nurse uses the “teach-
back” method. Which statement by the nurse best utilizes this method?
A. “Do you understand what I just explained to you?”
B. “Please repeat back to me the main side effects you need to watch for.”
C. “I’m going to give you this pamphlet to read at home.”
D. “Make sure you take this pill every morning with food.”
Correct Answer: B
Rationale: The teach-back method requires the patient to demonstrate
understanding in their own words. Simply asking “Do you understand” (A) usually
results in a “yes” even if the patient is confused. Providing a pamphlet (C) does
not confirm comprehension. Giving a directive (D) is instruction, not assessment
of learning.
COLLEGE | 260 PRACTICE QUESTIONS WITH
DETAILED RATIONALES
SECTION I: COMMUNICATION & FOUNDATIONAL CONCEPTS (Questions 1–25)
1. A nursing student is preparing to communicate with a postoperative patient
experiencing significant pain. The student asks the instructor, “What is the
primary purpose of therapeutic communication in this situation?” Which
response by the instructor is most accurate?
A. To exchange information and meaning between the nurse and patient to
promote understanding and healing
B. To persuade the patient to accept the recommended treatment plan without
question
C. To document the patient’s complaints accurately in the medical record for legal
purposes
D. To redirect the patient’s attention away from their pain using distraction
techniques
Correct Answer: A
Rationale: The primary purpose of communication is the exchange of
information and meaning between people. In therapeutic communication, verbal
and nonverbal messages must match for effectiveness, and the goal is to promote
understanding and a trusting nurse-patient relationship. Persuading the patient
(B) is non-therapeutic; documentation (C) is important but not the primary
purpose of communication; and distraction (D) is a specific intervention, not the
overarching purpose of communication itself.
2. A nurse is teaching a group of nursing students about the communication
process. The nurse explains that communication consists of four essential parts.
The student correctly identifies which of the following as the four parts of the
communication process?
,A. Sender, message, channel, and receiver
B. Speaker, listener, interpreter, and responder
C. Encoder, decoder, transmitter, and feedback loop
D. Initiator, content, medium, and recipient
Correct Answer: A
Rationale: The four parts of the communication process are sender,
message, channel, and receiver. The sender encodes the message, which is
transmitted through a channel to the receiver, who decodes it. This foundational
model is central to understanding both therapeutic and non-therapeutic
communication. While other frameworks describe similar concepts, the standard
four-part model uses these exact terms.
3. A nurse enters a patient’s room to perform a preoperative assessment. The
television is on loudly, the patient appears anxious, and family members are
having a conversation nearby. Which factor is most likely to act as “noise”
interfering with nurse-patient communication?
A. All of the listed factors (TV volume, anxiety, family conversation)
B. Only the television volume, since it is the only external distraction
C. Only the patient’s anxiety, because internal factors are the strongest barriers
D. None of these, because the patient is awake and able to respond
Correct Answer: A
Rationale: “Noise” in the communication process refers to any factor that
interferes with the accurate transmission and reception of a message. Noise can
be external (TV volume, family conversation, environmental distractions) or
internal (pain, anxiety, fatigue). In this scenario, all listed factors—the loud TV, the
patient’s anxiety, and the nearby family conversation—act as barriers to effective
communication. The curriculum emphasizes identifying and minimizing all forms
of noise to promote effective nurse-patient communication.
,4. A nurse is caring for a patient who expresses concern about an upcoming
surgery, stating, “I just know something terrible is going to happen.” Which
response by the nurse is an example of a non-therapeutic communication
technique that should be avoided?
A. “Don’t worry, everything will be fine. I’m sure you have nothing to worry
about.”
B. “You seem really worried. Can you tell me more about what’s on your mind?”
C. “It sounds like you’re feeling anxious about the surgery. Many patients feel that
way.”
D. “Let’s talk about what you’re expecting and how we can support you.”
Correct Answer: A
Rationale: Offering false reassurance (“Don’t worry, everything will be
fine”) is a non-therapeutic communication technique because it dismisses the
patient’s feelings and closes off further discussion. Therapeutic responses (B, C, D)
encourage the patient to express concerns, validate feelings, and open dialogue.
Non-therapeutic techniques include false reassurance, giving advice, changing the
subject, and minimizing feelings.
5. A nurse is caring for a patient who speaks a different language. The patient’s
daughter is available to translate. What is the most appropriate action for the
nurse to take to ensure accurate communication?
A. Use the daughter to translate to save time.
B. Ask a housekeeping staff member who speaks the language to interpret.
C. Request a professional medical interpreter from the facility.
D. Use hand gestures and written notes only.
Correct Answer: C
Rationale: Professional interpreters are the standard to avoid errors;
family members might filter information for cultural reasons or lack the medical
vocabulary to translate accurately. Using untrained staff or family members can
lead to miscommunication, missed symptoms, or incorrect understanding of
, instructions. Facility-provided interpreters ensure accuracy and confidentiality.
6. The nurse is documenting the care provided to a patient. Which entry best
reflects the principle of objective documentation?
A. “Patient seems in a lot of pain and looks uncomfortable.”
B. “Patient stated pain level is an 8 out of 10.”
C. “Patient is probably anxious about the surgery tomorrow.”
D. “Incision appears to be healing nicely.”
Correct Answer: B
Rationale: Objective documentation includes observable, measurable
data. Quoting the patient directly with a numeric pain scale is objective.
Subjective terms like “seems,” “probably,” or “nicely” are vague, open to
interpretation, and should not be used in documentation. Objective data can be
verified by others.
7. When teaching a patient about a new medication, the nurse uses the “teach-
back” method. Which statement by the nurse best utilizes this method?
A. “Do you understand what I just explained to you?”
B. “Please repeat back to me the main side effects you need to watch for.”
C. “I’m going to give you this pamphlet to read at home.”
D. “Make sure you take this pill every morning with food.”
Correct Answer: B
Rationale: The teach-back method requires the patient to demonstrate
understanding in their own words. Simply asking “Do you understand” (A) usually
results in a “yes” even if the patient is confused. Providing a pamphlet (C) does
not confirm comprehension. Giving a directive (D) is instruction, not assessment
of learning.
