Question 1

The public health nurse recognizes that proper communication is vitally important to ensure successful results when educating the community about health concerns. Which aspect of communication is most important for the nurse to ensure?

Accepted Answer

A major component of the communication process is the feedback loop, which allows both the sender and the receiver to check on the success of the transference of meaning and to renegotiate the message to allow for clarity and better understanding. Limiting the setting, such as eliminating distractions, may or may not be appropriate. Although therapeutic communication is goal-directed and involves nonverbal expressions, these are not parts of the communication, and they are not as important as making sure that the message has been understood correctly.

Question 2

A group of students is discussing the various parts of effective communication with a nurse at a health care organization in the community. The nurse recognizes that the students understand the discussion when they correctly identified an e-mail request to the local health department is which part of communication?

Accepted Answer

The channel is the medium through which the sender conveys the message. It may be written, spoken, or nonverbal. Sending an e-mail is an example. The sender is the person conveying the message. The message is the expression of the purpose of the communication. Decoding is the translation of the message into an understandable form by the receiver.

Question 3

A public health nurse is meeting with student nurses to discuss the importance of effective communication. Which aspects of communication should the nurse indicate are under the most control of the nurse? Select all that apply.

Accepted Answer

The community health nurse who is serving as the sender in the communication process has the most control over the sender, the message, the channel (the medium through which the sender conveys the message), and the encoding (the sender decides which specific signals or codes such as language, words, gestures, and body language to use). The community health nurse does not have much control over the receiver, the decoding (the receiver's interpretation of the message), or the feedback loop (a way for the sender and receiver to check on the success of the transference of meaning and to renegotiate the message to allow for clarity and better understanding), all of which are controlled by the receiver.

Question 4

A new graduate nurse is expressing frustration with the supervisor concerning the apparent lack of clients taking conversations seriously or following care plans. Which skill will be most important for the supervisor to evaluate?

Accepted Answer

Two main channels to send messages are nonverbal and verbal messages. Active listening and paraphrasing are involved with receiving skills. Rapport is an interpersonal skill.

Question 5

A community health nurse is meeting with a group of clients and notes that some clients are misinterpreting the information. What does the nurse recognize as the most likely barrier to communication for this group?

Accepted Answer

Selective perception is the interpretation of a message through their own perceptions and projects this onto the communication process as they decode a message. Sharing complete and accurate information, clients' use of medical terminology, and offering of feedback are important skills of effective communication.

Question 6

The nurse is discussing smoking cessation options with a client who is having difficulty quitting due to pressures at work and with family and friends. Which statement used by the nurse displays active listening skills?

Accepted Answer

Active listening involves a variety of interventions. In the correct response, the nurse prepares to summarize the key points the client has made. By doing so, the nurse demonstrates a desire to fully understand the client's concerns. The statement "I am trying to determine why you are sharing this information" does not reflect any active listening skills and may be viewed by the client as confrontational. Clients who feel criticized or judged may disengage from communication. Commenting that the client seems engaged in the community or should focus on prioritization is more a reflection of the nurse's personal feelings than a therapeutic response. The nurse should only share ideas and feelings if the client has asked for advice or input.

Question 7

Which is the first step in active listening?

Accepted Answer

The first step in active listening is being observant and aware. The nurse must be attentive when the client speaks and mindful of what the client is communicating through words or body language. The next step is conveying a nonjudgmental attitude by keeping an open mind without arguing and then demonstrating understanding to the client by paraphrasing key points and asking for clarification on anything not understood. After waiting patiently for the client to finish speaking, the nurse will summarize the main ideas the client has presented to keep the conversation focused and ensure mutual understanding. The nurse may have the opportunity to share feelings and ideas, but only if the client feels comfortable and understood, and has asked for feedback.

Question 8

A community health nurse is remaining calm and firmly reassuring when dealing with a family in acute crisis. The nurse recognizes this is the best defense against which barrier to communication?

Accepted Answer

The nurse is avoiding emotional influence, that is, how a person feels at the time a message is sent or received, which can influence its meaning. Senders can distort messages, and receivers can interpret messages incorrectly when emotions cloud their perception. Emotions can interfere with rational and objective reasoning, thus blocking communication. Filtering information means manipulating information by the sender to influence the receiver's response. Language barriers involve the different interpretations of words by people. Selective perception involves the receivers interpreting a message through their own perceptions, which are influenced by their own experiences, interests, values, motivations, and expectations.

Question 9

A public health nurse working with a young mother is concerned the mother is not providing accurate information during the assessment. What is the best response by the nurse in this situation?

Accepted Answer

Filtering is the manipulation of information by the sender to make it seem more favorable to the receiver. It leads to miscommunication and misinterpretation. Filtering can be intentional or unintentional and may be used by clients or nurses. Clients sometimes use filtering during a needs assessment process, giving only partial or distorted information because they think this is what health professionals want to hear. The other choices would be inappropriate as they either belittle the client or suggest the client is possibly lying about the situation.

Question 10

A public health nurse is tasked with establishing a local health clinic in a rural community, which currently only has a small hospital that is struggling to adequately assist all in the emergency department. Which goal should be a priority for the nurse?

Accepted Answer

Using the emergency department as a walk-in clinic for minor and/or chronic conditions is often due to poor health literacy. The nurse can use various methods to educate the community such as local advertising, meeting with various groups to let them know what will be available, and mailing information describing what will be available. The other choices may be options that the nurse can utilize to inform the public; however, the priority would be to address the health literacy situation first.

Question 11

A public health nurse has been working with a small community group for several months, and although things were progressing well, the nurse notes a subtle shift in the group with increasing lack of cooperation. After a recent meeting, the nurse recognizes which situation needs to be addressed to bring the group back to working successfully?

Accepted Answer

When someone in the group rejects a suggestion before it is even discussed, this can result in others not wanting to participate or cooperate to reach the stated goals of the group. Each individual should feel safe in suggesting ideas or possible solutions and each one should be thoroughly discussed before being rejected. The other choices are positive approaches or tasks that should be occurring in any group to ensure that the group achieves it goals.

Question 12

A community health nurse is concerned that certain members of the local community do not comprehend the educational material due to low literacy. The nurse recognizes which approach to this problem is the most appropriate?

Accepted Answer

It is very important for clients who have low literacy to have ample opportunity to provide feedback that will demonstrate understanding. Communication with low-literacy, high-risk groups should be simplified and easy-to-read materials. At the same time, there is the danger of making the communication so simple that the reader feels insulted. It has been well documented that most health information pamphlets, brochures, and other materials cannot be read or comprehended by adults who have low literacy. Those who have the lowest literacy levels have the highest mortality and morbidity.

Question 13

A group of student nurses is discussing the effect of health literacy on health care and how it may impact their future clients. Which key issues should these future nurses be most aware of? Select all that apply.

Accepted Answer

Health literacy is characterized as critical to health promotion and disease prevention. Limited health literacy affects people of all races, incomes, ages, and educational levels. Poor health literacy skills have been associated with poorer health status and increased health care costs because people with a low-literacy level are less knowledgeable about their health conditions and are less likely to seek preventative care. Health literacy involves the ability to read, understand, and act on health information. Health literacy goes beyond the basic definitions of literacy and includes cultural literacy, computer literacy, and scientific, media, and technological literacy.

Question 14

A community health nurse leading a community group notes that the group has moved into the norming stage. Which action by the group does the nurse most anticipate at this time?

Accepted Answer

During the norming stage, trust and openness are more apparent, and there is a sharing of ideas and opinions and creativity. The forming stage is characterized by members becoming oriented to each other. The storming stage involves conflict and competition with the group getting down to sharing more sensitive issues. The performing stage is characterized by the ability to work as a total group, in subgroups, or independently.

Question 15

The public health nurse is often involved with leading community groups and recognizes leading a successful group involves going through various stages. Which statements best describe some of these stages? Select all that apply.

Accepted Answer

During the adjourning stage, the group must disengage, and this may cause feelings of loss. The group begins to focus more on maintenance rather than just tasks during the norming stage. Not all groups do reach the performing stage. The storming stage is necessary to allow group members to identify roles, expectations, and get a feel of how the group will work together. Conflict is to be avoided at the forming stage but must occur at the storming stage.

Question 16

A public health nurse is seeking grants to assist with providing low- to no-cost influenza shots for a small rural community, which routinely experiences high rates of influenza each winter. Which action by the nurse will help improve the chances of a grant being awarded to this community?

Accepted Answer

Outside funding agencies, both government and nonprofit, are increasingly looking for proof of effective collaboration and coalition-building before approving grants or government funding. Being able to demonstrate fiscal responsibility and evidence-based outcomes will assist community health nurses in sustaining health promotion efforts on a long-term basis, and this may be facilitated by collaborative partnerships. The other choices would not demonstrate the collaboration and coalition-building desired.

Question 17

A public health nurse is preparing to work with a group of college students to help decrease the incidence of STIs. What is the best response from the nurse when asked why a contract is needed?

Accepted Answer

The contract is not a binding agreement in the legal sense, but it is a pledge of trust and dedication. It provides the motivation to see the contract through to completion. All parties feel responsible for keeping promises; all want to achieve the intended outcomes. A legal contract would specify the consequences if it is not fulfilled. It is also more than just a written plan, and it would not be used to request grants or funding.

Question 18

The community health nurse is a member of a collaborative partnership interdisciplinary team, which is working to improve health care to a rural community. As the group continues to work as a unit, which outcome does the nurse most anticipate?

Accepted Answer

The main goal of a collaborative partnership of an interdisciplinary team should be one to benefit and improve the health of the local community that they serve. This team will be most effective when each member clearly understands their own responsibilities and can complete them. Identifying the basic goals and identifying the group leader are important but do not benefit the community the most. Securing grants is also not a top priority and may not be something that every member of the group can accomplish.

Question 19

A collaborative community health group working with the teenage population to improve health draws on the expertise of school nurses and others working with adolescents to develop a plan. The group is demonstrating which characteristic of collaboration?

Accepted Answer

Maximizing the use of community resources involves drawing on the expertise of those who are most knowledgeable and in the best positions to influence a favorable outcome. In this case, it would be school nurses and others working with adolescents. Shared goals are demonstrated by recognition of the specific reasons for entering into the relationship, that is, the improved health of adolescents. Mutual participation involves the reciprocal exchange among team members, with all team members contributing and receiving mutual benefit. Clear responsibilities involve each member playing a specific role with related tasks.

Question 20

A public health nurse is organizing a group consisting of health care providers from other clinics and facilities in the community to address various challenges in providing adequate care to the community. The nurse recognizes that inadequate sharing of health records among the facilities can be addressed best by which solution?

Accepted Answer

A common obstacle is the use of various software programs that are incompatible. This can even occur within the same facility or institution and delays the sharing of information. This would require permission from each citizen as well as follow HIPAA regulations to maintain the privacy of medical information. The use of a local IT company would present legal challenges and would not be the first choice. Some older adults would be unable to provide a portable electronic device as they do not use computers and would be unable to maintain them.

Quiz 10: Communication, Collaboration, and Technology