Ch. 20: Communication
1. During rounds, a charge nurse hears the patient care technician yelling loudly to a patient
regarding a transfer from the bed to chair. When entering the room, what is the nurse’s best
response?
a. “You need to speak to the patient quietly. You are disturbing the patient.”
b. “Let me help you with your transfer technique.”
c. “When you are finished, be sure to apologize for your rough demeanor.”
d. “When your patient is safe and comfortable, meet me at the desk.” (pt safety first and discuss
matters privately = therapeutic communication)
2. A public health nurse is leaving the home of a young mother who has a special needs baby. The
neighbor states, “How is she doing, since the baby’s father is no help?” What is the nurse’s best
response to the neighbor?
a. “New mothers need support.” (general statement, not judgemental)
b. “The lack of a father is difficult.”
c. “How are you today?”
d. “It is a very sad situation.”
3. A 3-year-old child is being admitted to a medical division for vomiting, diarrhea, and
dehydration. During the admission interview, the nurse should implement which
communication techniques to elicit the most information from the parents?
a. The use of reflective questions
b. The use of closed questions
c. The use of assertive questions
d. The use of clarifying questions (can avoid misconceptions -> inappropriate nursing
diagnosis)
4. A nurse enters a patient’s room and examines the patient’s IV fluids and cardiac monitor. The
patient states, “Well, I haven’t seen you before. Who are you?” What is the nurse’s best
response?
a. “I’m just the IV therapist checking your IV.”
b. “I’ve been transferred to this division and will be caring for you.”
c. “I’m sorry, my name is John Smith and I am your nurse.”
d. “My name is John Smith, I am your nurse and I’ll be caring for you until 11 p.m.”
5. A nurse enters the room of a patient with cancer. The patient is crying and states, “I feel so
alone.” Which statement is the most therapeutic?
,a. The nurse stands at the patient’s bedside and states, “I understand how you feel. My mother
said the same thing when she was ill.”
b. The nurse places a hand on the patient’s arm and states, “You feel so alone.”
c. The nurse stands in the patient’s room and asks, “Why do you feel so alone? Your wife has
been here every day.”
d. The nurse holds the patient’s hand and asks, “What makes you feel so alone?” (open-ended)
6. A nurse caring for a patient who is hospitalized following a double mastectomy is preparing a
discharge plan for the patient. Which action should be the focus of this termination phase of
the helping relationship?
a. Determining the progress made in achieving established goals
b. Clarifying when the patient should take medications
c. Reporting the progress made in teaching to the staff
d. Including all family members in the teaching session
7. A nursing student is nervous and concerned about the work she is about to do at the clinical
facility. To allay anxiety and be successful in her provision of care, it is most important for her
to:
a. Determine the established goals of the institution
b. Be sure her verbal and nonverbal communication is congruent
c. Engage in self-talk to plan her day and decrease her fear
d. Speak with her fellow colleagues about how they feel
8. A nurse in the rehabilitation division states to her head nurse, Mr. Tyler, “I need the day off
and you didn’t give it to me!” The head nurse replies, “Well, I wasn’t aware you needed the day
off, and it isn’t possible since staffing is so inadequate.” Instead of this exchange, what
communication by the nurse would have been more effective?
a. “Mr. Tyler, I placed a request to have August 8th off, but I’m working and I have a doctor’s
appointment.”
b. “Mr. Tyler, I would like to discuss my schedule with you. I requested the 8th of August off for
a doctor’s appointment. Could I make an appointment?” (nonthreatening and shows respect)
c. “Mr. Tyler, I will need to call in on the 8th of August because I have a doctor’s appointment.”
d. “Mr. Tyler, since you didn’t give me the 8th of August off, will I need to find someone to work
for me?”
9. During a nursing staff meeting, the nurses resolve a problem of delayed documentation by
agreeing unanimously that they will make sure all vital signs are reported and charted within
15 minutes following assessment. This is an example of which characteristics of effective
communication? Select all that apply.
,a. Group decision making
b. Group leadership
c. Group power
d. Group identity (all members agree that task is important)
e. Group patterns of interaction (honest communication and member support)
f. Group cohesiveness (trust, commitment, and cooperation bet. members)
10. A nurse sees a patient walking to the bathroom with a stooped gait, facial grimacing, and
gasping sounds. It is important that the nurse assess the patient for:
a. Pain
b. Anxiety
c. Depression
d. Fluid volume deficit
11. A nursing student is preparing to administer morning care to a patient. What is the most
important question that the nursing student should ask the patient about personal hygiene?
a. “Would you prefer a bath or a shower?”
b. “May I help you with a bed bath now or later this morning?”
c. “I will be giving you your bath. Do you use soap or shower gel?”
d. “I prefer a shower in the evening. When would you like your bath?”
12. A nurse is providing instruction to a patient regarding the procedure to change his colostomy
bag. During the teaching session, he asks, “What type of foods should I avoid to prevent gas?”
The patient’s question allows for what type of communication?
a. A closed-ended answer
b. Information clarification ( nurse clarifies info that is new to pt and requires further
explanation)
c. The nurse to give advice
d. Assertive behavior
13. When interacting with a patient, the nurse answers, “I am sure everything will be fine. You
have nothing to worry about.” This is an example of what type of inappropriate
communication technique?
a. Cliché (false assurance)
b. Giving advice
c. Being judgmental
d. Changing the subject
, 14. A 76-year-old patient states, “I have been experiencing complications of diabetes.” The nurse
needs to direct the patient to gain more information. What is the most appropriate comment
or question to elicit additional information?
a. “Do you take two injections of insulin to decrease the complications?”
b. “Most physicians recommend diet and exercise to regulate blood sugar.”
c. “Most complications of diabetes are related to neuropathy.”
d. “What specific complications have you experienced?”
15. During an interaction with a patient diagnosed with epilepsy, a nurse notes that the patient is
silent after she communicates the plan of care. What would be appropriate nurse responses in
this situation? Select all that apply.
a. Fill the silence with lighter conversation directed at the patient.
b. Use the time to perform the care that is needed uninterrupted.
c. Discuss the silence with the patient to ascertain its meaning.
d. Allow the patient time to think and explore inner thoughts.
e. Determine if the patient’s culture requires pauses between conversation.
f. Arrange for a counselor to help the patient cope with emotional issues.
(During periods of silence, the nurse should reflect on what has already been shared and observe the
patient without having to concentrate simultaneously on the spoken word)
SBAR: Situation, Background, Assessment, Recommendations
AIDET: Acknowledge, Introduce, Duration, Explanation. Thank You
Ch. 23: Asepsis
1. A nurse is following the principles of medical asepsis when performing patient care in a
hospital setting. Which nursing action performed by the nurse follows these recommended
guidelines?
a. The nurse carries the patients’ soiled bed linens close to the body to prevent spreading
microorganisms into the air.
b. The nurse places soiled bed linens and hospital gowns on the floor when making the bed.
c. The nurse moves the patient table away from the nurse’s body when wiping it off after a
meal.
d. The nurse cleans the most soiled items in the patient’s bathroom first and follows with the
cleaner items.
1. During rounds, a charge nurse hears the patient care technician yelling loudly to a patient
regarding a transfer from the bed to chair. When entering the room, what is the nurse’s best
response?
a. “You need to speak to the patient quietly. You are disturbing the patient.”
b. “Let me help you with your transfer technique.”
c. “When you are finished, be sure to apologize for your rough demeanor.”
d. “When your patient is safe and comfortable, meet me at the desk.” (pt safety first and discuss
matters privately = therapeutic communication)
2. A public health nurse is leaving the home of a young mother who has a special needs baby. The
neighbor states, “How is she doing, since the baby’s father is no help?” What is the nurse’s best
response to the neighbor?
a. “New mothers need support.” (general statement, not judgemental)
b. “The lack of a father is difficult.”
c. “How are you today?”
d. “It is a very sad situation.”
3. A 3-year-old child is being admitted to a medical division for vomiting, diarrhea, and
dehydration. During the admission interview, the nurse should implement which
communication techniques to elicit the most information from the parents?
a. The use of reflective questions
b. The use of closed questions
c. The use of assertive questions
d. The use of clarifying questions (can avoid misconceptions -> inappropriate nursing
diagnosis)
4. A nurse enters a patient’s room and examines the patient’s IV fluids and cardiac monitor. The
patient states, “Well, I haven’t seen you before. Who are you?” What is the nurse’s best
response?
a. “I’m just the IV therapist checking your IV.”
b. “I’ve been transferred to this division and will be caring for you.”
c. “I’m sorry, my name is John Smith and I am your nurse.”
d. “My name is John Smith, I am your nurse and I’ll be caring for you until 11 p.m.”
5. A nurse enters the room of a patient with cancer. The patient is crying and states, “I feel so
alone.” Which statement is the most therapeutic?
,a. The nurse stands at the patient’s bedside and states, “I understand how you feel. My mother
said the same thing when she was ill.”
b. The nurse places a hand on the patient’s arm and states, “You feel so alone.”
c. The nurse stands in the patient’s room and asks, “Why do you feel so alone? Your wife has
been here every day.”
d. The nurse holds the patient’s hand and asks, “What makes you feel so alone?” (open-ended)
6. A nurse caring for a patient who is hospitalized following a double mastectomy is preparing a
discharge plan for the patient. Which action should be the focus of this termination phase of
the helping relationship?
a. Determining the progress made in achieving established goals
b. Clarifying when the patient should take medications
c. Reporting the progress made in teaching to the staff
d. Including all family members in the teaching session
7. A nursing student is nervous and concerned about the work she is about to do at the clinical
facility. To allay anxiety and be successful in her provision of care, it is most important for her
to:
a. Determine the established goals of the institution
b. Be sure her verbal and nonverbal communication is congruent
c. Engage in self-talk to plan her day and decrease her fear
d. Speak with her fellow colleagues about how they feel
8. A nurse in the rehabilitation division states to her head nurse, Mr. Tyler, “I need the day off
and you didn’t give it to me!” The head nurse replies, “Well, I wasn’t aware you needed the day
off, and it isn’t possible since staffing is so inadequate.” Instead of this exchange, what
communication by the nurse would have been more effective?
a. “Mr. Tyler, I placed a request to have August 8th off, but I’m working and I have a doctor’s
appointment.”
b. “Mr. Tyler, I would like to discuss my schedule with you. I requested the 8th of August off for
a doctor’s appointment. Could I make an appointment?” (nonthreatening and shows respect)
c. “Mr. Tyler, I will need to call in on the 8th of August because I have a doctor’s appointment.”
d. “Mr. Tyler, since you didn’t give me the 8th of August off, will I need to find someone to work
for me?”
9. During a nursing staff meeting, the nurses resolve a problem of delayed documentation by
agreeing unanimously that they will make sure all vital signs are reported and charted within
15 minutes following assessment. This is an example of which characteristics of effective
communication? Select all that apply.
,a. Group decision making
b. Group leadership
c. Group power
d. Group identity (all members agree that task is important)
e. Group patterns of interaction (honest communication and member support)
f. Group cohesiveness (trust, commitment, and cooperation bet. members)
10. A nurse sees a patient walking to the bathroom with a stooped gait, facial grimacing, and
gasping sounds. It is important that the nurse assess the patient for:
a. Pain
b. Anxiety
c. Depression
d. Fluid volume deficit
11. A nursing student is preparing to administer morning care to a patient. What is the most
important question that the nursing student should ask the patient about personal hygiene?
a. “Would you prefer a bath or a shower?”
b. “May I help you with a bed bath now or later this morning?”
c. “I will be giving you your bath. Do you use soap or shower gel?”
d. “I prefer a shower in the evening. When would you like your bath?”
12. A nurse is providing instruction to a patient regarding the procedure to change his colostomy
bag. During the teaching session, he asks, “What type of foods should I avoid to prevent gas?”
The patient’s question allows for what type of communication?
a. A closed-ended answer
b. Information clarification ( nurse clarifies info that is new to pt and requires further
explanation)
c. The nurse to give advice
d. Assertive behavior
13. When interacting with a patient, the nurse answers, “I am sure everything will be fine. You
have nothing to worry about.” This is an example of what type of inappropriate
communication technique?
a. Cliché (false assurance)
b. Giving advice
c. Being judgmental
d. Changing the subject
, 14. A 76-year-old patient states, “I have been experiencing complications of diabetes.” The nurse
needs to direct the patient to gain more information. What is the most appropriate comment
or question to elicit additional information?
a. “Do you take two injections of insulin to decrease the complications?”
b. “Most physicians recommend diet and exercise to regulate blood sugar.”
c. “Most complications of diabetes are related to neuropathy.”
d. “What specific complications have you experienced?”
15. During an interaction with a patient diagnosed with epilepsy, a nurse notes that the patient is
silent after she communicates the plan of care. What would be appropriate nurse responses in
this situation? Select all that apply.
a. Fill the silence with lighter conversation directed at the patient.
b. Use the time to perform the care that is needed uninterrupted.
c. Discuss the silence with the patient to ascertain its meaning.
d. Allow the patient time to think and explore inner thoughts.
e. Determine if the patient’s culture requires pauses between conversation.
f. Arrange for a counselor to help the patient cope with emotional issues.
(During periods of silence, the nurse should reflect on what has already been shared and observe the
patient without having to concentrate simultaneously on the spoken word)
SBAR: Situation, Background, Assessment, Recommendations
AIDET: Acknowledge, Introduce, Duration, Explanation. Thank You
Ch. 23: Asepsis
1. A nurse is following the principles of medical asepsis when performing patient care in a
hospital setting. Which nursing action performed by the nurse follows these recommended
guidelines?
a. The nurse carries the patients’ soiled bed linens close to the body to prevent spreading
microorganisms into the air.
b. The nurse places soiled bed linens and hospital gowns on the floor when making the bed.
c. The nurse moves the patient table away from the nurse’s body when wiping it off after a
meal.
d. The nurse cleans the most soiled items in the patient’s bathroom first and follows with the
cleaner items.
