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ATI
ATI PN
PN FUNDAMENTALS PROCTORED
FUNDAMENTALS PROCTORED EXAM
EXAM
(Detail Solutions)
1. A nurse is taking a history on a patient who cannot speak English. Which action
will the nurse take?
a. Obtain an interpreter.
b. Refer to a speech therapist.
c. Let a close family member talk.
d. Find a mental health nurse specialist.
ANS: A
Interpreters are often necessary for patients who speak a foreign language. Using a
family member can lead to legal issues, speech therapists help patients with
aphasia, and mental health nurse specialists help angry or highly anxious patients
to communicate more effectively.
2. A nurse is using SOLER to facilitate active listening. Which technique should the
nurse use for R?
a. Relax
b. Respect
c. Reminisce
d. Reassure
ANS: A
In SOLER, the R stands for relax. It is important to communicate a sense of being
relaxed and comfortable with the patient. Active listening enhances trust because
the nurse communicates acceptance and respect for the patient, but it is not the R
in SOLER. Reminisce is a therapeutic communication technique, especially when
used with the elderly. Reassuring can be therapeutic if the nurse reassures patients
that there are many kinds of hope and that meaning and personal growth can come
from illness experiences. However, false reassurance can block communication.
3. An older-adult patient is wearing a hearing aid. Which technique should
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the nurse use to facilitate communication?
a. Chew gum.
b. Turn off the television.
c. Speak clearly and loudly.
d. Use at least 14-point print.
ANS: B
Turning off the television will facilitate communication. Patients who are hearing
impaired benefit when the following techniques are used: check for hearing aids
and glasses, reduce environmental noise, get the patient’s attention before speaking,
do not chew gum, and speak at normal volume—do not shout. Using at least 14-
point print is for sight/visually impaired, not hearing impaired.
4. When making rounds, the nurse finds a patient who is not able to sleep because
of surgery in the morning. Which therapeutic response is most appropriate?
a. “You will be okay. Your surgeon will talk to you in the morning.”
b. “Why can’t you sleep? You have the best surgeon in the hospital.”
c. “Don’t worry. The surgeon ordered a
sleeping pill to help you sleep.” “It must be
difficult not to know what the surgeon will
find. What can
d. I do to help?”
ANS: D
“It must be difficult not to know what the surgeon will find. What can I do to help?”
is using therapeutic communication techniques of empathy and asking relevant
questions. False reassurances (“You will be okay” and “Don’t worry”) tend to block
communication. Patients frequently interpret “why” questions as accusations or
think the nurse knows the reason and is simply testing them.
5. Which situation will cause the nurse to intervene and follow up on the nursing
assistive personnel’s (NAP) behavior?
The nursing assistive personnel is calling the older-adult patient
a. “honey.”
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The nursing assistive personnel is facing the older-adult patient when
b. talking.
The nursing assistive personnel cleans the older-adult patient’s glasses
c. gently.
The nursing assistive personnel allows time for the older-adult patient
d. to respond.
ANS: A
The nurse needs to intervene to correct the use of “honey.” Avoid terms of
endearment such as “honey,” “dear,” “grandma,” or “sweetheart.” Communicate
with older adults on an adult level, and avoid patronizing or speaking in a
condescending manner. Facing an older-adult patient, making sure the older adult
has clean glasses, and allowing time to respond facilitate communication with
older-adult patients and should be encouraged, not stopped.
6. A confused older-adult patient is wearing thick glasses and a hearing
aid. Which intervention is the priorityto facilitate communication?
a. Focus on tasks to be completed.
b. Allow time for the patient to respond.
c. Limit conversations with the patient.
d. Use gestures and other nonverbal cues.
ANS: B
Allowing time for patients to respond will facilitate communication, especially
for a confused, older patient. Focusing on tasks to be completed and limiting
conversations do not facilitate communication; in fact, they block
communication. Using gestures and other nonverbal cues is not effective for
visually impaired (thick glasses) patients or for patients who are confused.
7. The staff is having a hard time getting an older-adult patient to communicate.
Which technique should the nurse suggest the staff use?
a. Try changing topics often.
b. Allow the patient to reminisce.
c. Ask the patient for explanations.
d. Involve only the patient in conversations.
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ANS: B
Encouraging older adults to share life stories and reminisce about the past has a
therapeutic effect and increases their sense of well-being. Avoid sudden shifts
from subject to subject. It is helpful to include the patient’s family and friends and
to become familiar with the patient’s favorite topics for conversation. Asking for
explanations is a nontherapeutic technique.
8. A nurse is implementing nursing care measures for patients’ special
communication needs. Which patient will need the most nursing care measures?
a. The patient who is oriented, pain free, and blind
b. The patient who is alert, hungry, and has strong self-esteem
c. The patient who is cooperative, depressed, and hard of hearing
d. The patient who is dyspneic, anxious, and has a tracheostomy
ANS: D
Facial trauma, laryngeal cancer, or endotracheal intubation often prevents
movement of air past vocal cords or mobility of the tongue, resulting in inability to
articulate words. An extremely breathless person needs to use oxygen to breathe
rather than speak. Persons with high anxiety are sometimes unable to perceive
environmental stimuli or hear explanations. People who are alert, have strong self-
esteem, and are cooperative and pain free do not cause communication concerns.
Although hunger, blindness, and difficulty hearing can cause communication
concerns, dyspnea, tracheostomy, and anxiety all contribute to communication
concerns.
9. A patient is aphasic, and the nurse notices that the patient’s hands shake
intermittently. Which nursing action is most appropriate to facilitate
communication?
a. Use a picture board.
b. Use pen and paper.
c. Use an interpreter.
d. Use a hearing aid.
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ATI
ATI PN
PN FUNDAMENTALS PROCTORED
FUNDAMENTALS PROCTORED EXAM
EXAM
(Detail Solutions)
1. A nurse is taking a history on a patient who cannot speak English. Which action
will the nurse take?
a. Obtain an interpreter.
b. Refer to a speech therapist.
c. Let a close family member talk.
d. Find a mental health nurse specialist.
ANS: A
Interpreters are often necessary for patients who speak a foreign language. Using a
family member can lead to legal issues, speech therapists help patients with
aphasia, and mental health nurse specialists help angry or highly anxious patients
to communicate more effectively.
2. A nurse is using SOLER to facilitate active listening. Which technique should the
nurse use for R?
a. Relax
b. Respect
c. Reminisce
d. Reassure
ANS: A
In SOLER, the R stands for relax. It is important to communicate a sense of being
relaxed and comfortable with the patient. Active listening enhances trust because
the nurse communicates acceptance and respect for the patient, but it is not the R
in SOLER. Reminisce is a therapeutic communication technique, especially when
used with the elderly. Reassuring can be therapeutic if the nurse reassures patients
that there are many kinds of hope and that meaning and personal growth can come
from illness experiences. However, false reassurance can block communication.
3. An older-adult patient is wearing a hearing aid. Which technique should
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the nurse use to facilitate communication?
a. Chew gum.
b. Turn off the television.
c. Speak clearly and loudly.
d. Use at least 14-point print.
ANS: B
Turning off the television will facilitate communication. Patients who are hearing
impaired benefit when the following techniques are used: check for hearing aids
and glasses, reduce environmental noise, get the patient’s attention before speaking,
do not chew gum, and speak at normal volume—do not shout. Using at least 14-
point print is for sight/visually impaired, not hearing impaired.
4. When making rounds, the nurse finds a patient who is not able to sleep because
of surgery in the morning. Which therapeutic response is most appropriate?
a. “You will be okay. Your surgeon will talk to you in the morning.”
b. “Why can’t you sleep? You have the best surgeon in the hospital.”
c. “Don’t worry. The surgeon ordered a
sleeping pill to help you sleep.” “It must be
difficult not to know what the surgeon will
find. What can
d. I do to help?”
ANS: D
“It must be difficult not to know what the surgeon will find. What can I do to help?”
is using therapeutic communication techniques of empathy and asking relevant
questions. False reassurances (“You will be okay” and “Don’t worry”) tend to block
communication. Patients frequently interpret “why” questions as accusations or
think the nurse knows the reason and is simply testing them.
5. Which situation will cause the nurse to intervene and follow up on the nursing
assistive personnel’s (NAP) behavior?
The nursing assistive personnel is calling the older-adult patient
a. “honey.”
31
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The nursing assistive personnel is facing the older-adult patient when
b. talking.
The nursing assistive personnel cleans the older-adult patient’s glasses
c. gently.
The nursing assistive personnel allows time for the older-adult patient
d. to respond.
ANS: A
The nurse needs to intervene to correct the use of “honey.” Avoid terms of
endearment such as “honey,” “dear,” “grandma,” or “sweetheart.” Communicate
with older adults on an adult level, and avoid patronizing or speaking in a
condescending manner. Facing an older-adult patient, making sure the older adult
has clean glasses, and allowing time to respond facilitate communication with
older-adult patients and should be encouraged, not stopped.
6. A confused older-adult patient is wearing thick glasses and a hearing
aid. Which intervention is the priorityto facilitate communication?
a. Focus on tasks to be completed.
b. Allow time for the patient to respond.
c. Limit conversations with the patient.
d. Use gestures and other nonverbal cues.
ANS: B
Allowing time for patients to respond will facilitate communication, especially
for a confused, older patient. Focusing on tasks to be completed and limiting
conversations do not facilitate communication; in fact, they block
communication. Using gestures and other nonverbal cues is not effective for
visually impaired (thick glasses) patients or for patients who are confused.
7. The staff is having a hard time getting an older-adult patient to communicate.
Which technique should the nurse suggest the staff use?
a. Try changing topics often.
b. Allow the patient to reminisce.
c. Ask the patient for explanations.
d. Involve only the patient in conversations.
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ANS: B
Encouraging older adults to share life stories and reminisce about the past has a
therapeutic effect and increases their sense of well-being. Avoid sudden shifts
from subject to subject. It is helpful to include the patient’s family and friends and
to become familiar with the patient’s favorite topics for conversation. Asking for
explanations is a nontherapeutic technique.
8. A nurse is implementing nursing care measures for patients’ special
communication needs. Which patient will need the most nursing care measures?
a. The patient who is oriented, pain free, and blind
b. The patient who is alert, hungry, and has strong self-esteem
c. The patient who is cooperative, depressed, and hard of hearing
d. The patient who is dyspneic, anxious, and has a tracheostomy
ANS: D
Facial trauma, laryngeal cancer, or endotracheal intubation often prevents
movement of air past vocal cords or mobility of the tongue, resulting in inability to
articulate words. An extremely breathless person needs to use oxygen to breathe
rather than speak. Persons with high anxiety are sometimes unable to perceive
environmental stimuli or hear explanations. People who are alert, have strong self-
esteem, and are cooperative and pain free do not cause communication concerns.
Although hunger, blindness, and difficulty hearing can cause communication
concerns, dyspnea, tracheostomy, and anxiety all contribute to communication
concerns.
9. A patient is aphasic, and the nurse notices that the patient’s hands shake
intermittently. Which nursing action is most appropriate to facilitate
communication?
a. Use a picture board.
b. Use pen and paper.
c. Use an interpreter.
d. Use a hearing aid.
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