Chapter 02: Communication and Collaboration

Question 1

The nurse interviews a patient during admission. Which observation by the nurse identifies
consistency between the patient’s verbal and nonverbal communication?
a. Asserts she is eager to answer questions while reading a magazine.
b. States that he wants information while frequently changing the subject.
c. Asks the nurse to explain a surgical procedure while she listens intently.
d. Explains that he is relaxed while continuously shifting in his chair.

Answer 1

c. Asks the nurse to explain a surgical procedure while she listens intently.

Question 2

The nurse is interviewing a newly admitted patient. Which statement by the nurse is most
likely to result in effective patient communication?
a. “I’m not sure why you’re here. Can you explain it to me?”
b. “Tell me about things and people that are important to you.”
c. “Tell me more about your pain. Where does it start?”
d. “If you think it’s important, I’ll try to notify the provider.”

Answer 2

c. “Tell me more about your pain. Where does it start?”

Question 3

After receiving a diagnosis of a fatal disease, the patient expresses sadness and states “I don’t
know what to do next”. Which action by the nurse best facilitates communication at this time?
a. Sit quietly with the patient and observe nonverbal communication.
b. Reassure the patient that his family will take care of him.
c. Refer the patient to a church for spiritual counseling.

d. Tell the patient that hospice care is available immediately.

Answer 3

a. Sit quietly with the patient and observe nonverbal communication

Question 4

The nurse is preparing to begin the patient hand-off procedure for five patients. Who should
the nurse include in this process?
a. Only the licensed nurses
b. The nursing personnel caring for the patients
c. The entire interdisciplinary team
d. The nurses and health care provider

Answer 4

b. The nursing personnel caring for the patients

Question 5

The nurse brings the patient’s medications into the room, and the patient shouts, “You don’t
care if I take these, so get out of my room!” Which response by the nurse is most appropriate?
a. “Who misinformed you about my feelings?”
b. “You seem very angry about the medications.”
c. “We know each other; why are you saying this?”
d. “I cannot leave until you take these medications.”

Answer 5

b. “You seem very angry about the medications.”

Question 6

The patient shouts at the nurse, “No one answered my nurse call system all night!” Which
response would the nurse use with this patient to restore therapeutic communication?

a. “Shouting is going to disturb other patients.”
b. “I see how that would make you very angry.”
c. “Are you sure the nurses were avoiding you?”
d. “The unit has many very sick patients right now.”

Answer 6

b. “I see how that would make you very angry.”

Question 7

A patient with a history of violence directed toward others becomes very excited and agitated
during the nurse’s interview. Which intervention does the nurse implement to foster
therapeutic communication?
a. Call the security staff for assistance.
b. Ask the patient to use self-control.
c. Lean forward and touch the patient’s arm.
d. Assume an open, nonthreatening posture.

Answer 7

d. Assume an open, nonthreatening posture.

Question 8

The nurse admits a patient who is nonverbal and agitated. What can the nurse do to
communicate effectively with the patient?
a. Use a communication aid.
b. Wait for family to arrive.
c. Call interpreter services.
d. Treat the patient for pain.

Answer 8

a. Use a communication aid.

Question 9

A patient’s mother died several days ago. The patient begins to cry and states, “The pain of
her death is impossible to bear.” Which statement by the nurse is the most effective response?
a. “I was depressed last year when my mother died, too.”
b. “I know things seem bleak, but you are doing so well.”
c. “I can see this is a very difficult time for you right now.”
d. “Should I cancel your appointment with the cardiologist?”

Answer 9

c. “I can see this is a very difficult time for you right now.”

Question 10

A patient who says that both parents died of heart disease early in life is waiting for diagnostic
testing results. The patient is biting fingernails and pacing around the room. Which statement
should the nurse use to clarify patient information?
a. “I can see that you are anxious about dying.”
b. “Tell me more about your family’s history.”
c. “Do you have your parents’ medical records?”
d. “I’m not sure that I understand what you mean.”

Answer 10

b. “Tell me more about your family’s history.”

Question 11

The patient tells the nurse, “I must be very sick because so many tests are being performed.”
Which statement does the nurse use to clarify the patient’s message?
a. “I sense that you are very worried.”
b. “Why do you mention this so frequently?”
c. “We should talk about this more.”
d. “Are you saying you think you are seriously ill?”

Answer 11

d. “Are you saying you think you are seriously ill?”

Question 12

The patient tells the nurse, “I want to die.” Which is the best response by the nurse to facilitate
therapeutic communication?
a. “Now why would you say a thing like that?”
b. “Tell me more about how you’re feeling.”
c. “We need to tell the provider how you feel.”
d. “You have too much to live for to say that.”

Answer 12

b. “Tell me more about how you’re feeling.”

Question 13

The nurse is explaining a procedure to a 3-year-old patient. Which strategy would the nurse
use for patient teaching?
a. Ask the patient to draw her feelings.
b. Show needles, syringes, and bandages.
c. Tell the patient about postoperative pain.
d. Use dolls and stories to explain surgery.

Answer 13

d. Use dolls and stories to explain surgery

Question 14

The nurse is caring for a patient who states, “I don’t feel well today.” Which is the best
response by the nurse?
a. Ask the patient to continue to describe the feeling.
b. Measure the blood pressure and temperature.
c. State that the patient’s diagnostic testing had normal results.
d. Compare recent laboratory results with the prior results.

Answer 14

a. Ask the patient to continue to describe the feeling.

Question 15

The nurse is caring for a patient who refuses to participate in physical therapy (PT) and states,
“I really don’t like to exercise.” Which response by the nurse is most likely to help engage the
patient in PT?
a. “It makes the pain worse, doesn’t it?”
b. “What don’t you like about exercise?”
c. “You really should do these exercises.”
d. “Do you like to do any other activities?”

Answer 15

b. “What don’t you like about exercise?”

Question 16

The nursing staff are using the SBAR communication technique during patient hand-off
communication. The circumstances leading up to the current status would be explained by the
nurses during which step of the technique?
a. Situation
b. Background
c. Assessment
d. Recommendations

Answer 16

b. Background

Question 17

The nursing staff are working with a postoperative patient from another culture who does not
understand or speak the English language well. Which approach by the nurse would be best?
a. Act out what the patient needs to do.
b. Obtain a medical interpreter.
c. Assess if the patient can read or write.
d. Talk slowly when instructions are given.

Answer 17

b. Obtain a medical interpreter.

Question 18

The nurse is working toward discharging a patient. Which of following demonstrates patient
engagement during the discharge process?
a. Teaching the patient how to use his equipment
b. Having the patient establish daily goals
c. Reviewing the discharge instructions with the patient
d. Including the family in the discharge planning

Answer 18

b. Having the patient establish daily goals

Question 19

The registered nurse is orienting a new nurse to the unit. They are completing paperwork on a newly admitted patient. When the experienced nurse asks what the new nurse thinks the
patient will need to learn for self-care at home, the new nurse expresses surprise. What
statement by the registered nurse is most appropriate?
a. “You should always at least start thinking about discharge planning.”
b. “We don’t want to wait too long because unexpected things happen.”
c. “The admitting nurse has to fill in all sections of this document.”
d. “Best practice is to begin discharge planning on admission.”

Answer 19

d. “Best practice is to begin discharge planning on admission.”

Question 20

A student is watching a nurse perform a medication reconciliation prior to transferring the
patient to a skilled nursing facility. What explanation of this process to the student is best?
a. “It is required by the Joint Commission before discharge or transfer.”
b. “It creates an accurate list of medications so errors do not occur later.”
c. “It helps us recognize lapses in patients’ ability to remember their medications.”
d. “Receiving facilities won’t accept patients without a reconciliation.”

Answer 20

b. “It creates an accurate list of medications so errors do not occur later.”

Question 21

A nurse is reviewing medications and treatments one final time before the patient goes home.
The patient becomes agitated and says “I just can’t do this! I’m too upset to ever be able to
learn this!” What action by the nurse is best?
a. Provide immediate remediation on the knowledge and skills.
b. Ask the patient if home health care might be acceptable.
c. Request the provider re-examine all the discharge orders.
d. Tell the patient you would like to understand what is most difficult.

Answer 21

d. Tell the patient you would like to understand what is most difficult.

Question 22

During a home care visit, the patient experiences an angry outburst and hits the nurse on the
thigh and yells at her. The patient continues to be threatening. What are the most appropriate
initial actions by the nurse? (Select all that apply.)
a. Increase the personal space between the nurse and patient.
b. Call law enforcement to take the patient to the hospital.
c. Restrain the patient’s hands to the chair.
d. Be empathetic to the patient’s feelings and concerns.
e. Call the nursing agency to ask for advice in working with this patient.
f. Use a calm, quiet voice when talking with the patient.

Answer 22

a. Increase the personal space between the nurse and patient.
d. Be empathetic to the patient’s feelings and concerns.
f. Use a calm, quiet voice when talking with the patient.

Question 23

Which of the following pieces of information should be included in a hand-off to ensure
patient safety? (Select all that apply.)
a. Code status
b. Recent changes in condition
c. Age
d. Family visitation
e. Use of oxygen

Answer 23

a. Code status
b. Recent changes in condition

e. Use of oxygen

Question 24

A faculty member is explaining personal factors that influence communication. What factors
does the faculty member include? (Select all that apply.)
a. Perceptions
b. Values
c. Emotions
d. Relationship
e. Pain

Answer 24

a. Perceptions
b. Values
c. Emotions
d. Relationship