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Galen College of Nursing: NSG 3180 Communication & Teamwork
Section 1: Special Communication Needs & Sensory Deficits
1. A patient is recovering from a stroke and exhibits expressive aphasia. Which
communication strategy is most appropriate for the nurse to implement?
A) Speak louder so the patient can process the words more easily.
B) Ask complex, open-ended questions to stimulate brain activity.
C) Provide a picture board and ask simple "yes/no" questions.
D) Answer questions for the patient to prevent frustration. Elaboration: Expressive
aphasia impairs the physical ability to produce language, not the ability to hear or
understand. Simple questions and visual aids allow the patient to communicate their
needs without verbal frustration.
2. A nurse is caring for an older adult with severe sensorineural hearing loss. Which action
best facilitates effective communication?
A) Speaking directly into the patient's ear at a high volume.
B) Facing the patient directly in a well-lit room and speaking in a normal, distinct tone.
C) Over-exaggerating lip movements to assist with lip-reading.
D) Using high-pitched tones, as they are easier to hear. Elaboration: High-pitched
sounds are the first to be lost in age-related hearing loss. Facing the patient allows
them to read nonverbal cues and lips naturally without the distortion caused by
shouting.
3. When entering the room of a patient who is completely blind, the nurse's first action
must be to:
A) Touch the patient's shoulder to alert them of presence.
B) Turn on all the overhead lights.
C) Verbally announce their name and purpose for entering the room.
D) Wait for the patient to ask who is there. Elaboration: Touching a visually impaired
patient without verbal warning causes severe startle responses and anxiety.
Announcing oneself establishes a safe environment.
,4. A patient with advanced dementia repeatedly asks to go home to cook dinner for her
children, who are now adults. Using Validation Therapy, the nurse should respond by
saying:
A) "Your children are grown and you live in this facility now."
B) "You cannot go home right now, it is time for medication."
C) "You must really love cooking for your family. Tell me about your favorite meal to
make for them."
D) "Let's go watch television in the day room instead." Elaboration: Validation therapy
avoids correcting the patient's reality, which causes agitation. Instead, it validates the
emotion behind the statement (love for family) and gently redirects the conversation.
5. A patient is intubated in the ICU and is fully awake but unable to speak. The nurse notes
the patient looks panicked. The best immediate intervention is to:
A) Administer a sedative to calm the patient down.
B) Explain that they cannot talk right now and must remain calm.
C) Provide an alphabet board or pen and paper, and ask them to point to what is
bothering them.
D) Rely on family members to interpret the patient's anxiety. Elaboration: Being
mechanically ventilated is terrifying because the patient loses their primary means of
communication. Providing alternative tools restores a sense of control and allows for
accurate assessment.
6. A nurse is attempting to educate a patient who is experiencing acute, severe pain (9/10).
The nurse understands that:
A) Pain enhances memory retention due to adrenaline release.
B) Severe pain acts as a physiological noise barrier, making learning impossible until
the pain is managed.
C) The education should be delivered rapidly before the pain worsens.
D) Written materials should be used instead of verbal communication. Elaboration:
According to Maslow's hierarchy, basic physiological comfort must be met before
higher-level cognitive processing (learning) can occur.
7. A patient with Wernicke’s (receptive) aphasia is attempting to communicate. The nurse
expects the patient to present with:
A) An inability to speak any words.
, B) Fluent, articulated speech that makes absolutely no logical sense in context.
C) Frustration because they know what they want to say but cannot say it.
D) A complete lack of nonverbal facial expressions. Elaboration: Wernicke's aphasia
affects comprehension. Patients speak smoothly, but the words are jumbled or
unrelated ("word salad") because they do not understand the conversation.
8. Which strategy is most effective when communicating with a patient who has cognitive
impairment or a traumatic brain injury?
A) Ask multi-part questions to assess cognitive processing speed.
B) Provide all discharge instructions at once.
C) Use short, simple sentences and allow extra time for the patient to process the
information and respond.
D) Direct all communication to the patient's caregiver. Elaboration: Cognitive
impairment slows processing time. Multi-step commands overwhelm the patient,
leading to confusion and non-compliance.
9. A non-English speaking patient requires a complex procedure. The nurse uses a certified
telephone interpreter. During the conversation, the nurse should maintain eye contact
with:
A) The telephone or interpreting device.
B) The patient's family member.
C) The patient.
D) The floor, to focus on listening. Elaboration: Eye contact establishes trust and allows
the nurse to assess the patient's nonverbal reactions to the translated information.
10. A nurse is caring for a patient who is comatose. Which principle must guide the nurse's
communication?
A) Communication is unnecessary since the patient cannot hear.
B) Hearing is the last sense to be lost; the nurse should explain all care and provide
verbal reassurance.
C) Only family members should speak to the patient.
D) Communication should be restricted to loud, painful stimuli. Elaboration: Even if a
patient cannot respond, auditory processing may remain intact. Explaining procedures
preserves patient dignity and prevents startle reflexes.
Galen College of Nursing: NSG 3180 Communication & Teamwork
Section 1: Special Communication Needs & Sensory Deficits
1. A patient is recovering from a stroke and exhibits expressive aphasia. Which
communication strategy is most appropriate for the nurse to implement?
A) Speak louder so the patient can process the words more easily.
B) Ask complex, open-ended questions to stimulate brain activity.
C) Provide a picture board and ask simple "yes/no" questions.
D) Answer questions for the patient to prevent frustration. Elaboration: Expressive
aphasia impairs the physical ability to produce language, not the ability to hear or
understand. Simple questions and visual aids allow the patient to communicate their
needs without verbal frustration.
2. A nurse is caring for an older adult with severe sensorineural hearing loss. Which action
best facilitates effective communication?
A) Speaking directly into the patient's ear at a high volume.
B) Facing the patient directly in a well-lit room and speaking in a normal, distinct tone.
C) Over-exaggerating lip movements to assist with lip-reading.
D) Using high-pitched tones, as they are easier to hear. Elaboration: High-pitched
sounds are the first to be lost in age-related hearing loss. Facing the patient allows
them to read nonverbal cues and lips naturally without the distortion caused by
shouting.
3. When entering the room of a patient who is completely blind, the nurse's first action
must be to:
A) Touch the patient's shoulder to alert them of presence.
B) Turn on all the overhead lights.
C) Verbally announce their name and purpose for entering the room.
D) Wait for the patient to ask who is there. Elaboration: Touching a visually impaired
patient without verbal warning causes severe startle responses and anxiety.
Announcing oneself establishes a safe environment.
,4. A patient with advanced dementia repeatedly asks to go home to cook dinner for her
children, who are now adults. Using Validation Therapy, the nurse should respond by
saying:
A) "Your children are grown and you live in this facility now."
B) "You cannot go home right now, it is time for medication."
C) "You must really love cooking for your family. Tell me about your favorite meal to
make for them."
D) "Let's go watch television in the day room instead." Elaboration: Validation therapy
avoids correcting the patient's reality, which causes agitation. Instead, it validates the
emotion behind the statement (love for family) and gently redirects the conversation.
5. A patient is intubated in the ICU and is fully awake but unable to speak. The nurse notes
the patient looks panicked. The best immediate intervention is to:
A) Administer a sedative to calm the patient down.
B) Explain that they cannot talk right now and must remain calm.
C) Provide an alphabet board or pen and paper, and ask them to point to what is
bothering them.
D) Rely on family members to interpret the patient's anxiety. Elaboration: Being
mechanically ventilated is terrifying because the patient loses their primary means of
communication. Providing alternative tools restores a sense of control and allows for
accurate assessment.
6. A nurse is attempting to educate a patient who is experiencing acute, severe pain (9/10).
The nurse understands that:
A) Pain enhances memory retention due to adrenaline release.
B) Severe pain acts as a physiological noise barrier, making learning impossible until
the pain is managed.
C) The education should be delivered rapidly before the pain worsens.
D) Written materials should be used instead of verbal communication. Elaboration:
According to Maslow's hierarchy, basic physiological comfort must be met before
higher-level cognitive processing (learning) can occur.
7. A patient with Wernicke’s (receptive) aphasia is attempting to communicate. The nurse
expects the patient to present with:
A) An inability to speak any words.
, B) Fluent, articulated speech that makes absolutely no logical sense in context.
C) Frustration because they know what they want to say but cannot say it.
D) A complete lack of nonverbal facial expressions. Elaboration: Wernicke's aphasia
affects comprehension. Patients speak smoothly, but the words are jumbled or
unrelated ("word salad") because they do not understand the conversation.
8. Which strategy is most effective when communicating with a patient who has cognitive
impairment or a traumatic brain injury?
A) Ask multi-part questions to assess cognitive processing speed.
B) Provide all discharge instructions at once.
C) Use short, simple sentences and allow extra time for the patient to process the
information and respond.
D) Direct all communication to the patient's caregiver. Elaboration: Cognitive
impairment slows processing time. Multi-step commands overwhelm the patient,
leading to confusion and non-compliance.
9. A non-English speaking patient requires a complex procedure. The nurse uses a certified
telephone interpreter. During the conversation, the nurse should maintain eye contact
with:
A) The telephone or interpreting device.
B) The patient's family member.
C) The patient.
D) The floor, to focus on listening. Elaboration: Eye contact establishes trust and allows
the nurse to assess the patient's nonverbal reactions to the translated information.
10. A nurse is caring for a patient who is comatose. Which principle must guide the nurse's
communication?
A) Communication is unnecessary since the patient cannot hear.
B) Hearing is the last sense to be lost; the nurse should explain all care and provide
verbal reassurance.
C) Only family members should speak to the patient.
D) Communication should be restricted to loud, painful stimuli. Elaboration: Even if a
patient cannot respond, auditory processing may remain intact. Explaining procedures
preserves patient dignity and prevents startle reflexes.
