Deck 9: Communication and Collaboration in Nursing

Question 1

A nurse comments in private about a patient: "That lady with six kids is pregnant again! It makes me sick to see these people on welfare taking away from our tax dollars. I don't know how she can continue to do this." The best response by a nurse peer is to

A) ignore the biased statements.
B) accept the comments as self-disclosure.
C) offer neutral responses.
D) convey acceptance of the patient.

Answer 1

convey acceptance of the patient.

Question 2

During report, a nurse complains about a 3-year-old boy, saying "He sure knows when to pour on the tears. There's nothing wrong until he sees you; then the tears start, but they stop as soon as you leave or his mother comes. He's just spoiled because they have a nanny at home who waits on him hand and foot." This is an example of

A) lack of understanding of child development.
B) frustration that the mother is not present.
C) assessment of the child's behavior.
D) stereotyping because the child has a nanny.

Answer 2

stereotyping because the child has a nanny.

Question 3

One of the most important outcomes of the orientation phase of the nurse-patient relationship is the development of mutual

A) communication.
B) understanding.
C) acceptance.
D) trust.

Answer 3

trust.

Question 4

The nurse says to a newly diagnosed diabetic patient, "I will be working with you during your 3-day stay to help you practice insulin injections and to review your new diet. I'm wondering if we could find a time of day to begin the teaching sessions that is good for us." This conversation would occur in which phase of the nurse-patient relationship?

A) Acquaintance phase
B) Orientation phase
C) Working phase
D) Termination phase

Question 5

A newly diagnosed diabetic patient states "I have very definite likes and dislikes when it comes to food. Am I going to have to eat only certain foods, or will I have some choice?" The nurse responds, "Why don't you give me a list of your likes and dislikes? I will consult with the dietitian about how to include your preferences and still come up with a good diet for you." What phase of the nurse-patient relationship is this?

A) Relationship phase
B) Orientation phase
C) Working phase
D) Termination phase

Question 6

Using Hagerty and Patusky's theory of human relatedness (2003), the nurse-patient relationship has been reconceptualized by approaching

A) each patient contact as one step in a lengthy relationship-building process.
B) patients with a sense of the patient's autonomy, choice, and participation.
C) the relationship as one in which the nurse has the power.
D) the nurse-patient contact as an opportunity to streamline caregiving.

Question 7

Which is true of verbal and nonverbal communication?

A) Verbal messages are more important than nonverbal cues.
B) Individuals can exercise more control over nonverbal communication.
C) Verbal and nonverbal communication always match.
D) The nonverbal communication may be a more reliable message.

Question 8

A patient is being discharged from the hospital. Which statement by the nurse is appropriate for the termination phase of the nurse-patient relationship?

A) "You must be happy to be going home. Here are the written diet and medication instructions."
B) "It has been wonderful getting to know you. The best of luck when you get home."
C) "During the past 3 days, you have learned how to inject insulin and how to make appropriate food choices. Remember that you have the unit telephone number if you have any questions."
D) "You have done well learning a lot of new material and should be able to do well at home."

Question 9

Which of the following is an effective way to maintain safe professional boundaries?

A) Never accepting small gifts from patients
B) Finding ways to satisfy your needs through personal relationships outside of nursing
C) Avoiding caring for patients who ask personal questions about you
D) Sharing your personal stories so that patients will feel understood and trusting

Question 10

The nurse and patient may experience sadness during the termination phase. How can the nurse help the patient be successful in the termination phase of the nurse-patient relationship?

A) Providing personal contact information so the patient can contact the nurse if needed
B) Visiting the patient at home during off-duty time to help the transition to self-care
C) Emphasizing the achievements the patient has made, including the ability for self-care
D) Exchanging goodbye gifts as a sign that the relationship is terminated

Question 11

Which of the following could be considered congruent communication?

A) The nurse manager states, "Come by my office anytime." Then she keeps her door closed and does not answer phone calls.
B) As a co-worker hurries down the hall, he asks, "Is there anything you need help with?"
C) As she drops a stack of charts loudly on the desk, a co-worker states, "This is going to be a wonderful day."
D) The nurse manager sits with you in the nurse's lounge and asks, "Is there anything you would like to talk about?"

Question 12

Which of the following best describes Peplau's theory on therapeutic use of self?

A) Putting patients' needs ahead of your own
B) Providing excellent clinical skills to improve patients' health status
C) Using excellent interpersonal skills to help patients improve their health status
D) Self-protection through avoidance of a relationship with the patient

Question 13

Therapeutic use of self involves

A) forming a relationship based on the nurse's knowledge, attitudes, and skills to communicate effectively.
B) providing a safe environment based on the use of environmental manipulation and verbal limit setting.
C) evaluation of nurse-patient interactions and the creation of social alliances.
D) determining whether it is necessary to listen to the patient and provide feedback.

Question 14

Which of the following is most important in order for a new staff nurse to communicate therapeutically with patients?

A) Focusing interactions on educating patients about their treatments
B) Becoming aware of own feelings about illness and death
C) Sharing information about the intimate details of one's own life
D) Presenting himself or herself as a knowledgeable and experienced clinician

Question 15

A patient demonstrates obvious regression in ability to perform self-care during the working phase. Which response by the nurse is most appropriate?

A) Frustration because the patient does not appear to be motivated to achieve goals
B) Persistence in demonstrating the importance of achieving goals
C) Patience and understanding because regression is a defense mechanism
D) Ignoring it because the nurse realizes the patient is exhibiting childlike behavior

Question 16

Which of the following best illustrates nonjudgmental acceptance by the nurse?

A) Using professional influence to change a patient's morality to be more in keeping with societal norms
B) Changing your assignment if you discover that you have negative feelings toward your patient's lifestyle
C) Demonstrating caring behavior in spite of negative feelings
D) Avoiding all negative feelings about the patient

Question 17

What is the most important information the nurse should share with the patient during the orientation phase?

A) Name, credentials, extent of responsibility
B) Plan for the day, times the nurse will be unavailable, how to contact the nurse
C) Nurse's name, physician's name, possible discharge date
D) Plan for discharge, teaching needs, goals for the day

Question 18

When should the preparation for the termination phase of the nurse-patient relationship begin?

A) In the orientation phase
B) During the working phase
C) As part of the termination phase
D) Right before termination

Question 19

Which behaviors help patients develop trust in the nurse?

A) Answering questions with authority
B) Sharing personal information to indicate openness
C) Conveying acceptance of the patient and a nonjudgmental attitude
D) Meeting with the patient spontaneously because that indicates caring

Question 20

Which of the following suggests that a successful contract has been established between the nurse and patient in the orientation phase of the nurse-patient relationship?

A) Patient has agreed to learn to change his colostomy bag.
B) Patient ambulates in the hall without assistance.
C) Patient allows the nurse to inject his daily insulin.
D) Patient asks the charge nurse to verify that the staff nurse's teaching is correct.

Question 21

In which of the following examples is the nurse demonstrating empathy for the postoperative mastectomy patient?

A) "With today's advanced reconstruction techniques, you'll quickly forget you ever had surgery."
B) "You'll be back to your busy routine sooner than you think."
C) "This must be a very difficult time for you."
D) "I know how you feel; I also had breast cancer."

Question 22

A patient states, "The harder I try to get along with my son, the more I feel he just wants to be left alone," and the nurse responds, "I guess parents have to expect these problems as children get older." The nurse's response is an example of a communication breakdown known as

A) failing to see the uniqueness of the individual.
B) failing to recognize levels of meaning.
C) using value statements
D) failing to clarify unclear messages.

Question 23

Context is one of the five major elements of communication identified by Ruesch. Which of the following is part of the context of communication?

A) Information about the sender
B) Attitude of the receiver
C) Response of the receiver
D) Content of the message

Question 24

When a co-worker tells the nurse, "I am not sure I will be able to give the right answers in the job interview," the nurse replies, "I know what you mean. Interviews have always been a problem for me, too." This response can be evaluated as lacking

A) appropriateness.
B) efficiency.
C) feedback.
D) flexibility.

Question 25

Which behaviors foster active listening? (Select all that apply.)

A) Encouraging the speaker by saying, "Tell me more"
B) Limiting verbal ventilation because it is not focused
C) Sitting in an open posture such as leaning forward
D) Engagement in a task
E) Good eye contact at eye level and nodding of the head

Question 26

How would a nurse's use of the technique of reflection help a person?

A) Showing an awareness of the person's feelings
B) Causing the person to answer more fully than yes or no
C) Showing knowledge the person is not expected to know
D) Encouraging the person to think through problems for himself or herself

Question 27

A patient states, "The thing that scares me the most about surgery is the spinal anesthesia. I'm afraid it'll leave me paralyzed," and the nurse responds, "Everything will be fine. The anesthesiologists are very skilled in administering spinal anesthesia." The nurse's response is an example of a communication breakdown known as

A) failing to see the uniqueness of the individual.
B) failing to recognize levels of meaning.
C) using value statements.
D) using false assurance.

Question 28

Which of the following demonstrates giving information versus opinion?

A) "Mrs. Khan, let's practice together the breathing techniques you learned in Lamaze classes. That will help us to work together more effectively later when your labor is stronger."
B) "You learned breathing techniques in Lamaze classes. I really believe the breathing techniques make labor easier."
C) "Mrs. Khan, have you been practicing the breathing techniques you learned? It is very important to practice if you wish to use them effectively in labor."
D) "Using breathing techniques in labor is really to your benefit because you feel in control."

Question 29

The nurse plans to teach a patient about the care of her mastectomy site. The nurse finds the patient crying. The best response by the nurse is,

A) "It is time to discuss how to care for the surgical site."
B) "You seem upset. You should start looking forward to going home and being a wife and mother again."
C) "I see you are upset. Is there something on your mind you'd like to talk about?"
D) "Dr. Abrams said you can go home tomorrow, and we need to talk about the care of your surgical site."

Question 30

The patient says to the nurse, "The staff treats me like I'm a child. Everyone tells me what to do. No one ever asks my opinion. After all, it is my body." Which response by the nurse indicates active listening?

A) "Well, you're sick. Don't you think you should let us take care of you?"
B) "I don't think I can help you with this. This is a personal matter between you and the rest of the staff."
C) "It makes you angry not to be included in your health care decisions. Let's talk about how you can vent your anger appropriately."
D) "Let me see if I understand. It bothers you not to be recognized for your abilities to handle your life. I can discuss this with the staff if you wish so that everyone involves you in planning your care."

Question 31

A new mother says to the nurse, "It really hurts me to breastfeed. I think I should wean my baby." The nurse responds, "If I understand you, it hurts when you breastfeed. Tell me how and when it hurts." This response best represents which criterion of successful communication?

A) Appropriateness
B) Efficiency
C) Feedback
D) Flexibility

Question 32

Within nurse-patient communication, the use of silence can

A) block further therapeutic communication.
B) allow the patient to not feel pressured to provide information.
C) demonstrate trust.
D) provide the nurse with an opportunity to complete the patient's care.

Question 33

Which of the following examples illustrates the nurse's failure to use flexibility effectively in professional communication?

A) Asking on the admission assessment, "You don't smoke, do you?"
B) When updating a family member on a patient's condition stating, "Your wife's ABG report indicates significant hypoxia."
C) Continuing to follow the agenda in a staff meeting when people are obviously upset by a recent death on the unit
D) Requiring nurses to read back phone orders to physicians

Question 34

A new mother says to the nurse, "It really hurts me to breastfeed. I think I should wean my baby." The most appropriate response by the nurse is,

A) "It is good to wean the baby early because it is easier on you."
B) "If I understand you, it hurts when you breastfeed. Tell me how and when it hurts."
C) "It is your decision to make whether you breastfeed."
D) "You should continue to breastfeed because it is much better for the baby."

Question 35

Using simple, clear words to explain the details of a colonoscopy procedure shows sensitivity to which successful communication criterion?

A) Appropriateness
B) Efficiency
C) Feedback
D) Flexibility

Question 36

Collaboration among health care professionals most importantly results in

A) the development of esprit de corps.
B) benefits to the organization alone.
C) positive patient outcomes.
D) maintenance of employee satisfaction.

Question 37

A 4-year-old child is going to have an abdominal x-ray examination. The child asks, "Why do they have to do this? Will it hurt?" Which of the following is the most appropriate response by the nurse?

A) "The doctor needs you to have the x-ray so she knows what is wrong with you."
B) "You will go to the x-ray department so they can take pictures of your tummy to find out why you have a tummy ache. The bed you lie on may be cool, but you will have a blanket to keep you warm. The test will not hurt."
C) "You will go downstairs on a stretcher. You will need to lie very still on a hard table while the x-ray machine goes over you. It will not take very long."
D) "X-rays do not hurt. The machine takes a picture but will not touch you."

Question 38

Collaboration in health care settings involves

A) professionals respected for their unique knowledge and abilities.
B) professionals educated in a collaborative model of education.
C) recognition of individual professional accomplishments.
D) a multitiered system hierarchy.

Question 39

A new mother says, "My baby is being kept in the nursery. I'm really worried about him. I'm also worried that the separation will interfere with breastfeeding." The most appropriate response by the nurse is,

A) "Well, that's not my territory. You'll have to deal with the nursery staff about breastfeeding."
B) "As a nurse on this unit, I can assure you that we will do all we can to help you."
C) "I can see you're upset about this, but to be honest with you, I'm a new nurse here, and I'm not sure how I can help you."
D) "I can see this is a problem for you. I will go to the nursery and see if I can get some answers for you."

Question 40

A nurse is irrigating pressure ulcers on a patient's coccyx. When the patient asks how they are healing, the nurse grimaces and says, "Oh, they're doing just fine." This is

A) incongruence between verbal and nonverbal messages.
B) a confirming statement.
C) objectivity in responding to the question.
D) the therapeutic use of humor.

Question 41

Which of the following are examples of open-ended questions? (Select all that apply.)

A) "Ms. Goode, did you have a productive therapy session?"
B) "How are you?"
C) "How do you feel about staying with your daughter?"
D) "What would you like to discuss today while we take a walk?"
E) "Are you having that problem with arthritis in your hand again?"