Deck 2: Communication in the Work Environment

Question 1

SBAR is a convenient tool to use when notifying physicians of a change in patient condition.In which of the following situations could it also be appropriately used?

A)Communication with radiology scheduling
B)Communication with case manager
C)Transferring patient
D)Change of shift report
E)Rapid response team (RRT)

Answer 1

Transferring patient
Change of shift report
Rapid response team (RRT)

Question 2

Which patient should the charge nurse direct the RN to see immediately after the shift report?

A)Patient with a blood sugar of 240 mg/dL
B)Patient complaining of burning on urination
C)Patient in a Posey vest who is trying to get out of bed
D)Patient with a temperature of 38ºC who is scheduled for surgery later that day

Answer 2

Patient with a temperature of 38ºC who is scheduled for surgery later that day

Question 3

Which response by the patient following discharge teaching would require further teaching?

A)"I should weigh myself daily since I started on Lasix (furosemide)for my heart failure."
B)"I need to check my blood glucose after eating."
C)"I should take my Lanoxin (digoxin)with my morning medications."
D)"I need my blood checked frequently now that I am on Coumadin (warfarin)."

Answer 3

"I need to check my blood glucose after eating."

Question 4

It is vital to communicate changes in patient condition to the physician.When using the SBAR process,the nurse knows that what should be included when communicating patient condition? Select all that apply.

A)Problem
B)Current medications
C)Assessment
D)Diagnosis
E)Documentation
F)Lab data

Question 5

A patient is inappropriate when speaking to a UAP.What is the most appropriate action by the nurse?

A)Change the assignment.
B)Ask the UAP what they did to precipitate this.
C)Explain to the patient how what they say is being interpreted.
D)Complain to the physician.

Question 6

Which of the following is an essential part of the shift report?

A)Patient's ECG rhythm
B)Patient's marital status
C)Patient's occupation
D)Patient's insurance status

Question 7

A surgeon approaches the charge nurse in an angry manner after his patient fell out of bed,requiring further surgery.Which of the following approaches is most appropriate for the charge nurse to use?

A)"Can you step over here out of the hearing of the patients and family members?"
B)'I'm sorry,you should have ordered restraints for the patient."
C)"We will accept all liability."
D)"My nurses are all new on the night shift.They didn't know how to handle him."

Question 8

The UAP is given ambulation instructions by a staff nurse for a patient 2 days postoperatively.Which of the following ambulation instructions would require further communication to the UAP to ensure the safety of the patient?

A)"Ambulate the patient the length of the hallway and get me if there are any problems."
B)"Have you ambulated this type of post-op patient before?"
C)"Let me know 1 hour before you are ready to ambulate the patient so I can give him his pain medication."
D)"This patient has been ambulating with minimal assistance,but I would like you to walk with him to be sure he is stable."

Question 9

Which of the following patients should be seen by the nurse first based on the information provided during the shift report?

A)A patient admitted with hypertension complaining of back pain.
B)A patient admitted with mental status changes.
C)A patient complaining of incisional pain postoperatively.
D)A patient asking for assistance in getting back to bed.

Question 10

A staff nurse must leave work for an emergency.The nurse tells the charge nurse that her patients are fine and received all their AM medications.As the day progresses,it becomes apparent to the responsible RN that some things were not completed,especially some necessary AM medications.Which communication principle was not followed in this situation? Select all that apply.

A)Interaction
B)Clarity
C)Simple exact language
D)Feedback
E)Credibility
F)Direct communication

Question 11

Patients are complaining that they are not receiving pain medications on the night shift.The night nurse has charted that they were given.What is the most appropriate action by the charge nurse?

A)Notify the nurse manager.
B)Confront the nurse about the problem.
C)Ask other nurses what they think.
D)Report the suspicion to the State Board of Nursing.

Question 12

The nurse is admitting a patient who speaks very little English.What is the most appropriate method to use to ensure the patient understands the instructions?

A)Obtain a hospital interpreter.
B)Ask a family member to interpret.
C)Ask other staff for help.
D)Incorporate sign language.

Question 13

To avoid transcription errors,the current trend in hospitals is to use the Computerized Physician Order Entry (CPOE).Further instructions should be given to the nurses when which statement is made?

A)"I don't need to review the new orders for accuracy."
B)"The orders will go directly to the appropriate departments."
C)"The risk for transcription errors is less."
D)"I am still responsible for communicating the changes to the appropriate caregivers."

Question 14

A UAP becomes sick at work and asks to leave.Which response by the charge nurse is most appropriate?

A)"You can't leave until all the baths are completed."
B)"Write down what needs to be completed."
C)"Tell me what responsibilities still need to be completed."
D)"Be sure to call by 5 AM if you are still sick tomorrow."

Question 15

A nurse takes a telephone order from a physician.Which procedure is best for the nurse to use to avoid errors?

A)Ask another nurse to listen to the conversation on another telephone.
B)Repeat the order,write the order verbatim,and read the order back to the physician.
C)Ask the physician to come to the unit to write the order.
D)Hold implementation of the order until the order is written by the physician.

Question 16

A staff nurse complains to the nurse manager about an employee of another department constantly asking her out on a date even though she has told him she is not interested.Which action by the nurse manager is most appropriate?

A)Confront the employee and ask him to stay away from the staff nurse.
B)Observe future interaction to confirm the reported harassment.
C)Contact the supervisor to decide on the next step.
D)Review the personnel manual to decide on the next step.

Question 17

The end of shift report is vital for the coordination of patient care.Which of these statements would require an intervention if overheard by the charge nurse during report?

A)"Mr.Smith is quite afraid of the outcome of his procedure today.I had to give him an anti-anxiety medication."
B)"Mr.Smith is quite afraid of the outcome of his procedure today.I called his wife to come in early."
C)"Mr.Smith is quite afraid of the outcome of his procedure today.I called the chaplain to see him and his wife today."
D)"Mr.Smith is quite afraid of the outcome of his procedure today.I was in the room most of the day."

Question 18

A float nurse is assigned four patients on the day shift.Which of the following reports by the float nurse would require immediate intervention by the charge nurse?

A)"Dr.Smith,your patient,Mr.Jones is complaining of a headache."
B)"Dr.Smith,this is nurse Sandy from xyz and your patient,Mr.Jones in 222,admitted with hypertension,is complaining of a headache."
C)"Dr.Smith,this is nurse Sandy from xyz and your patient,Mr.Jones in 222,admitted with hypertension,is complaining of a headache but has just been started on isosorbide (Isordil).What can I give him to relieve his headache?"
D)"Dr.Smith,this is nurse Sandy from xyz and your patient,Mr.Jones in 222,is complaining of a headache but has just been started on isosorbide (Isordil).What can I give him to relieve his headache?"

Question 19

In the change of shift report,what should be included? Select all that apply

A)Family contact telephone numbers
B)Current assessment
C)Plan of care
D)Change in condition
E)Discharge plan
F)Personal comments

Question 20

Which exchange between the RN and the UAP requires intervention by the charge nurse?

A)"Take the patient's blood pressure every 15 minutes and inform me of the results."
B)"Check the patient's blood glucose before breakfast and lunch and inform me of the results."
C)"Ambulate the patient in 2210 as far as he can walk."
D)"Shave the patient in 2210.His beard is long."

Question 21

Which of the following are true when communication is effective? Select all that apply.

A)The sender is credible.
B)There is clarity.
C)Simple,exact language is used.
D)Slang is used.
E)The receiver rolls her eyes when asked to complete a task.

Question 22

Informal ("grapevine")communication in health care is used to properly inform staff of (select all that apply):

A)Changes in practice.
B)Christmas party celebration.
C)Patient survey results.
D)Girl Scout cookie order pick-up.
E)Termination of an employee.

Question 23

Walking rounds are currently being implemented to avoid errors or omissions in shift reports.Which observations made during walking rounds would be seen as an advantage to the shift report? Select all that apply.

A)Foley bag is not emptied on a patient on strict I&O.
B)Patient needs assistance to bathroom.
C)IV infusion bag is nearly dry.
D)Patient with a PCA requests instructions to avoid increased pain.
E)Patient's family member is caught smoking in the bathroom.
F)IV line is not infusing what is currently ordered.

Question 24

The end of shift report is the appropriate time to communicate (select all that apply):

A)The frequency of which the call light was used.
B)Patient's relationship to a staff member.
C)New patient orders.
D)Impending procedures.
E)Evaluation of medication response.

Question 25

Formal communication in health care is used to properly inform staff of (select all that apply):

A)Changes in CPR certification dates.
B)Christmas party celebration.
C)Patient survey results.
D)Girl Scout cookie order pick-up.
E)Termination of an employee.