Question 1

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.

Accepted Answer

Following this procedure will reduce errors in communication between the health care provider and the nurse.The other options are not practical methods to use to avoid errors.

Question 2

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.

Accepted Answer

This patient may be experiencing angina.The other options are incorrect because this patient does not require an urgent assessment.

Question 3

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 38°C who is scheduled for surgery later that day

Accepted Answer

This patient is unstable and requires urgent assessment.The other assessments can be delayed.

Question 4

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."

Accepted Answer

It illustrates the nurse making an inappropriate judgment regarding this patient's anxiety and therefore would require intervention.The other options are appropriate communication regarding a patient and his anxiety and therefore does not require intervention.

Question 5

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."

Accepted Answer

Direct communication is the best method to avoid errors and allow for questions regarding remaining tasks.Options A and D are not appropriate for determining continuity of care.Options B is not the most effective means of communication and does not allow for questions and feedback.

Question 6

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 care givers."

Accepted Answer

Orders entered into the CPOE still require the nurse to review and therefore would need further instructions.The other options are correct statements and therefore do not require further instructions.

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."

Accepted Answer

It is always the best practice to remove the angry person from the audience.Usually, when removed, the person settles down and becomes more reasonable.The other options are not appropriate to the situation and could antagonize the angry physician.

Question 8

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.

Accepted Answer

The most appropriate means for interacting with a patient whose language is not English is to obtain an interpreter.The other options are not appropriate alternatives.

Question 9

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

Accepted Answer

Options B, C, D, and E are correct because only pertinent information required for delivery of care should be transmitted during the change of shift report.Family contact telephone numbers may, at times, be pertinent but not as a routine.Personal comments are almost never appropriate.

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

Accepted Answer

In this scenario, the staff nurse leaving the unit does not interact directly with the RN who will now become responsible for the care of the patients and thus no questions could be asked and feedback could not obtained.The other options do not apply to this situation.

Question 11

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.

Accepted Answer

Sometimes patients are not aware of how their comments are interpreted by staff.Informing them may correct the situation.The other options do not address the underlying problem of inappropriate communication.

Question 12

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

Accepted Answer

Options A, C, D, and F should be provided to any health care provider when reporting changes in patient conditions and obtaining new orders.Options B and E may not be required in all circumstances.

Question 13

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."

Accepted Answer

Option C is inadequate because it does not provide enough information to the UAP and requires intervention.The other options are appropriate communication and therefore do not require intervention.

Question 14

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?"

Accepted Answer

This answer gives no information to the physician about the patient or his condition and thus would require further teaching.The other options give a different level of information, which is better and more informative than answer A and therefore does not require further teaching.

Question 15

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

Accepted Answer

The patient's ECG rhythm is an essential part of the shift report.The other options may not always be appropriate to the shift report.

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.

Accepted Answer

If unfamiliar with the approved actions in a sexual harassment situation, the nurse manager should refer to the official references for action.The other actions are not appropriate in this case.

Question 17

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."

Accepted Answer

Delegation requires thorough communication including specific instructions regarding task ("ambulate the length of the hallway") and information about possible adverse effects and what to do about them.The other options are incorrect because they only give limited instructions.

Question 18

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)

Accepted Answer

Options C, D, and E are circumstances in which the SBAR tool of communication can be used effectively.Options A and B are not necessarily appropriate circumstance for the use of SBAR.

Question 19

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.

Accepted Answer

This question illustrates the concern for illegal charting of pain medications and substance abuse in nurses.It is essential for the nurse identifying this issue to report it to her nurse supervisor (chain of command).The other options are not appropriate responses to the implied illegalities in this question.

Question 20

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)."

Accepted Answer

Option B is not correct and therefore requires further teaching.The other options are correct statements and therefore does not require further teaching.

Quiz 8: Communication in the Work Environment

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

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

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

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

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 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?

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?

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

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

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.)

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

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?

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

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?

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?

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?

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?

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