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Galen College of Nursing: NSG 3180 Communication & Teamwork
Section 1: TeamSTEPPS & Standardized Frameworks
1. (Select All That Apply) The TeamSTEPPS framework utilizes specific communication
tools to enhance patient safety. Which of the following statements accurately describe
the "CUS" tool?
A) "C" stands for "I am Concerned."
B) "U" stands for "I am Uncomfortable."
C) "S" stands for "This is a Safety issue."
D) It is used to delegate tasks to unlicensed assistive personnel.
E) It is designed to "stop the line" and immediately alert team members to a critical
patient risk. Elaboration: The CUS acronym is an assertive communication tool used in
healthcare to clearly and immediately escalate an issue when a team member
identifies a critical safety breach.
2. A physician gives a rapid verbal order during a code. The nurse replies, "Epinephrine 1
mg IV push, is that correct?" The physician replies, "That is correct." This communication
loop is known as a:
A) Call-Out.
B) Two-Challenge Rule.
C) Check-Back.
D) Handoff. Elaboration: A Check-Back is a closed-loop communication strategy where
the receiver restates the information sent by the sender, and the sender verifies that
the information was received correctly.
3. (Priority Setting) A nurse notices a surgeon about to make an incision on the wrong
surgical site. The nurse verbally points this out, but the surgeon ignores the comment.
According to the Two-Challenge Rule, what is the nurse's next immediate action?
A) Document the error in the patient's chart.
B) Step out of the room to call the hospital ethics committee.
C) Voice the concern a second time assertively, and if still ignored, invoke a chain of
command to stop the line.
, D) Assume the surgeon knows best and assist with the procedure. Elaboration: The
Two-Challenge Rule empowers all team members to voice a safety concern at least
two times. If the safety issue is not addressed after the second challenge, the team
member must take a stronger course of action or utilize the chain of command.
4. (Negative Phrasing) A nursing team is utilizing the "Call-Out" strategy during a trauma
resuscitation. Which action by a team member represents an inappropriate use of this
tool?
A) Shouting, "Airway is clear!"
B) Announcing, "Blood pressure is dropping, 80/40!"
C) Quietly whispering a medication dose to the pharmacist so the patient does not
hear.
D) Calling out, "IV access established on the right arm!" Elaboration: A Call-Out is
specifically designed to be loud and clear to simultaneously inform all team members
of critical information during an emergency, maintaining situational awareness.
5. A "Shared Mental Model" in healthcare teamwork is best defined as:
A) All team members having the exact same level of education.
B) The perception of, understanding of, or knowledge about a situation or process that
is shared among team members.
C) A documented care plan that cannot be altered.
D) The physician holding all knowledge and distributing it as needed. Elaboration: A
shared mental model ensures everyone on the team is "on the same page" regarding
the patient's status, goals, and the team's operational plan.
6. (SATA) Which of the following are recognized barriers to effective interprofessional
communication and team performance?
A) Hierarchical culture and power distances.
B) Shift changes and handoffs.
C) Standardized SBAR utilization.
D) Heavy workload and fatigue.
E) Differences in disciplinary training and jargon. Elaboration: Power dynamics,
fatigue, transitions of care, and confusing jargon all create massive vulnerabilities
where critical information is lost or misunderstood.
, 7. A nurse leader is conducting a "Brief" at the start of a shift. The primary purpose of a
brief is to:
A) Review what went wrong during the previous shift.
B) Form the team, designate roles, establish climate, and set short-term goals.
C) Discuss individual staff performance evaluations.
D) Terminate the shift and send staff home. Elaboration: Briefs are short planning
sessions prior to the start of work to align the team. Debriefs occur after the work is
done to review performance.
8. During a busy shift, the charge nurse calls a "Huddle." This is distinct from a "Brief"
because a huddle is used to:
A) Form the team for the first time.
B) Re-establish situational awareness, reinforce plans, and adjust the plan if patient
conditions have changed.
C) Document end-of-shift notes.
D) Address severe lateral violence. Elaboration: A huddle is an ad hoc meeting called
mid-shift to adapt to unexpected changes or redistribute resources.
9. (Priority Setting) A patient is transferred from the ICU to the med-surg unit. During the
I-PASS handoff, the most critical piece of information the transferring nurse must
convey first is the:
A) Patient's dietary preferences.
B) Patient's Illness severity (e.g., "stable," "watcher," or "unstable").
C) List of family members who visited.
D) Routine morning lab values. Elaboration: In the I-PASS handoff framework, "I"
stands for Illness severity, ensuring the receiving nurse immediately understands the
acuity and stability of the patient.
10. A nurse successfully uses advocacy and assertion when communicating with a physician
by:
A) Avoiding eye contact to show respect.
B) Making statements that are firm, respectful, and focused entirely on the patient's
safety.
C) Demanding the physician follow the nurse's exact orders.
Galen College of Nursing: NSG 3180 Communication & Teamwork
Section 1: TeamSTEPPS & Standardized Frameworks
1. (Select All That Apply) The TeamSTEPPS framework utilizes specific communication
tools to enhance patient safety. Which of the following statements accurately describe
the "CUS" tool?
A) "C" stands for "I am Concerned."
B) "U" stands for "I am Uncomfortable."
C) "S" stands for "This is a Safety issue."
D) It is used to delegate tasks to unlicensed assistive personnel.
E) It is designed to "stop the line" and immediately alert team members to a critical
patient risk. Elaboration: The CUS acronym is an assertive communication tool used in
healthcare to clearly and immediately escalate an issue when a team member
identifies a critical safety breach.
2. A physician gives a rapid verbal order during a code. The nurse replies, "Epinephrine 1
mg IV push, is that correct?" The physician replies, "That is correct." This communication
loop is known as a:
A) Call-Out.
B) Two-Challenge Rule.
C) Check-Back.
D) Handoff. Elaboration: A Check-Back is a closed-loop communication strategy where
the receiver restates the information sent by the sender, and the sender verifies that
the information was received correctly.
3. (Priority Setting) A nurse notices a surgeon about to make an incision on the wrong
surgical site. The nurse verbally points this out, but the surgeon ignores the comment.
According to the Two-Challenge Rule, what is the nurse's next immediate action?
A) Document the error in the patient's chart.
B) Step out of the room to call the hospital ethics committee.
C) Voice the concern a second time assertively, and if still ignored, invoke a chain of
command to stop the line.
, D) Assume the surgeon knows best and assist with the procedure. Elaboration: The
Two-Challenge Rule empowers all team members to voice a safety concern at least
two times. If the safety issue is not addressed after the second challenge, the team
member must take a stronger course of action or utilize the chain of command.
4. (Negative Phrasing) A nursing team is utilizing the "Call-Out" strategy during a trauma
resuscitation. Which action by a team member represents an inappropriate use of this
tool?
A) Shouting, "Airway is clear!"
B) Announcing, "Blood pressure is dropping, 80/40!"
C) Quietly whispering a medication dose to the pharmacist so the patient does not
hear.
D) Calling out, "IV access established on the right arm!" Elaboration: A Call-Out is
specifically designed to be loud and clear to simultaneously inform all team members
of critical information during an emergency, maintaining situational awareness.
5. A "Shared Mental Model" in healthcare teamwork is best defined as:
A) All team members having the exact same level of education.
B) The perception of, understanding of, or knowledge about a situation or process that
is shared among team members.
C) A documented care plan that cannot be altered.
D) The physician holding all knowledge and distributing it as needed. Elaboration: A
shared mental model ensures everyone on the team is "on the same page" regarding
the patient's status, goals, and the team's operational plan.
6. (SATA) Which of the following are recognized barriers to effective interprofessional
communication and team performance?
A) Hierarchical culture and power distances.
B) Shift changes and handoffs.
C) Standardized SBAR utilization.
D) Heavy workload and fatigue.
E) Differences in disciplinary training and jargon. Elaboration: Power dynamics,
fatigue, transitions of care, and confusing jargon all create massive vulnerabilities
where critical information is lost or misunderstood.
, 7. A nurse leader is conducting a "Brief" at the start of a shift. The primary purpose of a
brief is to:
A) Review what went wrong during the previous shift.
B) Form the team, designate roles, establish climate, and set short-term goals.
C) Discuss individual staff performance evaluations.
D) Terminate the shift and send staff home. Elaboration: Briefs are short planning
sessions prior to the start of work to align the team. Debriefs occur after the work is
done to review performance.
8. During a busy shift, the charge nurse calls a "Huddle." This is distinct from a "Brief"
because a huddle is used to:
A) Form the team for the first time.
B) Re-establish situational awareness, reinforce plans, and adjust the plan if patient
conditions have changed.
C) Document end-of-shift notes.
D) Address severe lateral violence. Elaboration: A huddle is an ad hoc meeting called
mid-shift to adapt to unexpected changes or redistribute resources.
9. (Priority Setting) A patient is transferred from the ICU to the med-surg unit. During the
I-PASS handoff, the most critical piece of information the transferring nurse must
convey first is the:
A) Patient's dietary preferences.
B) Patient's Illness severity (e.g., "stable," "watcher," or "unstable").
C) List of family members who visited.
D) Routine morning lab values. Elaboration: In the I-PASS handoff framework, "I"
stands for Illness severity, ensuring the receiving nurse immediately understands the
acuity and stability of the patient.
10. A nurse successfully uses advocacy and assertion when communicating with a physician
by:
A) Avoiding eye contact to show respect.
B) Making statements that are firm, respectful, and focused entirely on the patient's
safety.
C) Demanding the physician follow the nurse's exact orders.
