GALEN COLLEGE OF NURSING
Course Code: COM 2100
Instructor:
Date: 2026
FINAL EXAM – PRINCIPLES OF COMMUNICATION
1. A 78‑year‑old patient with hearing impairment reports confusion after a
medication change. Which communication strategy most improves
comprehension during medication teaching?
A. Speak faster to finish quickly
B. Use medical jargon to be precise
C. Face the patient, speak clearly at a moderate pace, use short
sentences, and provide written instructions in large font
D. Rely solely on family members to explain
Answer: C
Rationale: Facing the patient improves lip‑reading; clear, concise verbal
instructions plus readable written materials compensate for hearing loss and
support retention.
2. During a multidisciplinary handoff, which structured tool best reduces
information omission and improves patient safety?
A. Unstructured verbal report only
B. Email summary after shift
C. SBAR (Situation, Background, Assessment, Recommendation)
D. Relying on memory of outgoing nurse
Answer: C
Rationale: SBAR standardizes critical information transfer, reducing
omissions and improving clarity for clinical decision‑making.
3. A nurse notices a family member becoming agitated during end‑of‑life
1
,discussions. Which immediate communication technique is most appropriate
to de‑escalate?
A. Match their tone to show empathy
B. Ignore the agitation and continue
C. Use a calm voice, lower your tone, acknowledge feelings, and offer a
private space to talk
D. Provide detailed medical statistics to prove a point
Answer: C
Rationale: Calm, empathic responses and private setting reduce arousal
and facilitate constructive dialogue; matching agitation escalates conflict.
4. Which element of nonverbal communication most reliably conveys
empathy in a clinical encounter?
A. Rapid eye movement
B. Crossed arms
C. Open posture, appropriate eye contact, and nodding
D. Looking at the computer screen while the patient speaks
Answer: C
Rationale: Open posture and attentive nonverbal cues signal presence and
empathy; distracted behaviors undermine rapport.
5. A patient with limited English proficiency requires discharge teaching.
Which approach best ensures understanding?
A. Use family member as interpreter exclusively
B. Provide English pamphlets only
C. Use a certified medical interpreter and teach‑back method with
translated materials
D. Speak louder in English
Answer: C
Rationale: Certified interpreters ensure accurate translation and
confidentiality; teach‑back confirms comprehension; family interpreters risk
errors and privacy breaches.
6. Which communication style is most appropriate when advocating for a
patient’s safety with a physician who is dismissive?
A. Passive compliance
B. Aggressive confrontation
C. Assertive, evidence‑based communication using specific observations
and recommendations
D. Avoid raising concerns to prevent conflict
Answer: C
Rationale: Assertive, respectful, data‑driven communication preserves
professional relationships while prioritizing patient safety.
2
, 7. Which question type best elicits a patient’s perspective and promotes
therapeutic rapport?
A. Closed yes/no questions only
B. Leading questions that suggest Answers
C. Open‑ended questions that invite narrative (e.g., “Tell me how your pain
affects your daily life.”)
D. Rapid series of factual questions without pause
Answer: C
Rationale: Open‑ended questions encourage expression of concerns and
values, essential for patient‑centered care.
8. A nurse documents a patient encounter. Which documentation practice
most supports legal defensibility and continuity of care?
A. Vague phrases like “patient stable” without specifics
B. Delayed notes written from memory at end of shift
C. Timely, objective, specific entries including patient quotes, assessments,
interventions, and responses
D. Omitting adverse events to avoid blame
Answer: C
Rationale: Accurate, contemporaneous, objective documentation provides
a reliable clinical record and legal protection.
9. Which communication approach is most effective for motivating a patient
to change a health behavior (e.g., smoking cessation)?
A. Confrontational advice to quit immediately
B. Providing only pamphlets and no follow‑up
C. Motivational interviewing: express empathy, develop discrepancy, roll
with resistance, support self‑efficacy
D. Threatening consequences if they do not comply
Answer: C
Rationale: Motivational interviewing elicits intrinsic motivation and is
evidence‑based for behavior change.
10. In telehealth visits, which practice most preserves therapeutic presence
and communication quality?
A. Positioning the camera so the clinician is off‑screen
B. Multitasking during the visit
C. Maintain eye contact by looking at the camera, ensure good lighting,
minimize background noise, and use clear verbal cues
D. Relying solely on chat messages for complex discussions
Answer: C
Rationale: Visual and auditory quality and intentional nonverbal cues
3
Course Code: COM 2100
Instructor:
Date: 2026
FINAL EXAM – PRINCIPLES OF COMMUNICATION
1. A 78‑year‑old patient with hearing impairment reports confusion after a
medication change. Which communication strategy most improves
comprehension during medication teaching?
A. Speak faster to finish quickly
B. Use medical jargon to be precise
C. Face the patient, speak clearly at a moderate pace, use short
sentences, and provide written instructions in large font
D. Rely solely on family members to explain
Answer: C
Rationale: Facing the patient improves lip‑reading; clear, concise verbal
instructions plus readable written materials compensate for hearing loss and
support retention.
2. During a multidisciplinary handoff, which structured tool best reduces
information omission and improves patient safety?
A. Unstructured verbal report only
B. Email summary after shift
C. SBAR (Situation, Background, Assessment, Recommendation)
D. Relying on memory of outgoing nurse
Answer: C
Rationale: SBAR standardizes critical information transfer, reducing
omissions and improving clarity for clinical decision‑making.
3. A nurse notices a family member becoming agitated during end‑of‑life
1
,discussions. Which immediate communication technique is most appropriate
to de‑escalate?
A. Match their tone to show empathy
B. Ignore the agitation and continue
C. Use a calm voice, lower your tone, acknowledge feelings, and offer a
private space to talk
D. Provide detailed medical statistics to prove a point
Answer: C
Rationale: Calm, empathic responses and private setting reduce arousal
and facilitate constructive dialogue; matching agitation escalates conflict.
4. Which element of nonverbal communication most reliably conveys
empathy in a clinical encounter?
A. Rapid eye movement
B. Crossed arms
C. Open posture, appropriate eye contact, and nodding
D. Looking at the computer screen while the patient speaks
Answer: C
Rationale: Open posture and attentive nonverbal cues signal presence and
empathy; distracted behaviors undermine rapport.
5. A patient with limited English proficiency requires discharge teaching.
Which approach best ensures understanding?
A. Use family member as interpreter exclusively
B. Provide English pamphlets only
C. Use a certified medical interpreter and teach‑back method with
translated materials
D. Speak louder in English
Answer: C
Rationale: Certified interpreters ensure accurate translation and
confidentiality; teach‑back confirms comprehension; family interpreters risk
errors and privacy breaches.
6. Which communication style is most appropriate when advocating for a
patient’s safety with a physician who is dismissive?
A. Passive compliance
B. Aggressive confrontation
C. Assertive, evidence‑based communication using specific observations
and recommendations
D. Avoid raising concerns to prevent conflict
Answer: C
Rationale: Assertive, respectful, data‑driven communication preserves
professional relationships while prioritizing patient safety.
2
, 7. Which question type best elicits a patient’s perspective and promotes
therapeutic rapport?
A. Closed yes/no questions only
B. Leading questions that suggest Answers
C. Open‑ended questions that invite narrative (e.g., “Tell me how your pain
affects your daily life.”)
D. Rapid series of factual questions without pause
Answer: C
Rationale: Open‑ended questions encourage expression of concerns and
values, essential for patient‑centered care.
8. A nurse documents a patient encounter. Which documentation practice
most supports legal defensibility and continuity of care?
A. Vague phrases like “patient stable” without specifics
B. Delayed notes written from memory at end of shift
C. Timely, objective, specific entries including patient quotes, assessments,
interventions, and responses
D. Omitting adverse events to avoid blame
Answer: C
Rationale: Accurate, contemporaneous, objective documentation provides
a reliable clinical record and legal protection.
9. Which communication approach is most effective for motivating a patient
to change a health behavior (e.g., smoking cessation)?
A. Confrontational advice to quit immediately
B. Providing only pamphlets and no follow‑up
C. Motivational interviewing: express empathy, develop discrepancy, roll
with resistance, support self‑efficacy
D. Threatening consequences if they do not comply
Answer: C
Rationale: Motivational interviewing elicits intrinsic motivation and is
evidence‑based for behavior change.
10. In telehealth visits, which practice most preserves therapeutic presence
and communication quality?
A. Positioning the camera so the clinician is off‑screen
B. Multitasking during the visit
C. Maintain eye contact by looking at the camera, ensure good lighting,
minimize background noise, and use clear verbal cues
D. Relying solely on chat messages for complex discussions
Answer: C
Rationale: Visual and auditory quality and intentional nonverbal cues
3
