Question 1

Which statement reflects a possible barrier to effective listening?

Accepted Answer

1. The staff's perception of the ability of the manager to communicate with them is the most important issue.
2. In this situation, assumptions could be made without really listening since those involved may think they already know what the person is going to say.
3. Open-ended questions always encourage additional information sharing. It also encourages active listening because the staff may be asked a question.
4. This situation gives the staff an opportunity to disclose information and encourages staff to listen carefully to the manager's comments.

Question 2

The nurse team leader asks the nursing assistant to ambulate a patient after morning care. This is an example of which type of communication?

Accepted Answer

1. Upward communication occurs when the receiver is at a higher position in the organization's hierarchy than is the sender.
2. Lateral communication occurs between two persons at the same level of hierarchy in the organization.
3. Diagonal communication occurs when persons at two different levels in the organization's hierarchy are working together on a project in which position in the hierarchy is not considered.
4. Downward communication occurs when the sender is at a higher position in the organization's hierarchy than is the receiver.

Question 3

The nurse is using effective communication by summarizing the other person's position, reading body language and nonverbal messages, and demonstrating curiosity about the other person's views. These features demonstrate which critical element of effective communication?

Accepted Answer

1. The nurse is not using decision making in this situation.
2. Exploring is not the best answer to this question because the nurse is not attempting to understand the scope of a problem, but is learning about the other person's ideas.
3. The nurse is not explaining ideas, goals, or feelings.
4. The elements given show that the nurse is working to understand the other person's ideas. This is active listening.

Question 4

Which statements illustrate the benefits of productive communication? Select all that apply.

Accepted Answer

1. If there are misunderstandings, productive communication is likely to lead to a quick resolution. Less "failure to communicate" excuses are given.
2. If communication is productive, the climate is more comfortable. A comfortable climate is motivational.
3. There is less conflict and less staff turnover.
4. Productive communication allows free expression of differing points of view.
5. Productive communication leads to a decreased need for a rumor mill.

Question 5

Evaluate these statements and choose the response that indicates summarization.

Accepted Answer

1. This statement increases stress and may elicit a defensive response. It is not an example of summarizing content and feelings.
2. Summarization confirms the content and the feelings.
3. This sentence is a simple statement of fact, not a summarization.
4. This is not summarizing content or feelings. It is a method to gain trust with the patient.

Question 6

Which statement demonstrates correct supervisory feedback?

Accepted Answer

1. This is an inflammatory statement and is not helpful in redirecting the staff member.
2. This is the manager's opinion, but is really fairly general with no direction as to how the nurse should accomplish this task.
3. Supervisory feedback should focus on behavior and should be specific.
4. This statement is too general and nonspecific.

Question 7

A physician is giving orders to a nurse regarding a newly admitted patient. The physician is gesturing, maintaining eye contact, and using a loud tone of voice. These factors illustrate primarily which type of communication?

Accepted Answer

1. There is no evidence that these factors are cultural in this situation.
2. Nonverbal communication includes facial expressions, body movements and gestures, tone and volume of voice, eye movements, and posture.
3. Verbal communication includes written communication, oral communication, tone, language, volume, rate, and accent.
4. Metacommunication includes all the factors used to influence how a message is perceived.

Question 8

The hospital has established a nursing work team to develop a new system for delivering shift reports information. Which line of communication will be used for most of this team's work?

Accepted Answer

1. There will likely be some upward communication as reports are made to superiors, but this is not the major line of communication that will be used.
2. There will be downward communication as the team receives its charge, but this is not the major line of communication that will be used.
3. While all four lines of communication will likely be used in this work, the majority will be between staff members that are in the same or similar hierarchical levels. This is the definition of lateral communication.
4. There may be some diagonal communication if the team works with staff members that are from different hierarchical levels, but this will not be the major line of communication used.

Question 9

Which option illustrates the manager's role in supporting effective communication?

Accepted Answer

1. Overuse of reassuring statements comes across as phony and condescending.
2. The manger should use active listening. Selective listening may result in missing important information.
3. Personal space is a critical issue in communication. The manager should not enter an employee's personal space without being certain the touch will be accepted.
4. This is an essential task of the manager. If the manager does not clarify this information, errors in judgment may be made.

Question 10

The Institute for Medicine (IOM) includes communication in the core competency of providing patient-centered care. Which option reflects the IOM's position on communication?

Accepted Answer

1. The IOM states that communication with patients should be done in a shared and fully open manner.
2. The IOM states that communication should be offered in the patient's preferred channel.
3. The IOM states that healthcare providers should communicate accurately in a language that patients can understand.
4. Many patients have difficulty understanding medical terminology, which violates the IOM's message that communication should be in a language the patient understands.

Question 11

Which staff action would indicate a staff communication problem?

Accepted Answer

1. If the staff is engaged in participative management, there is likely not a communication problem.
2. Metacommunication is the perception of verbal and nonverbal communication and does not indicate a problem is present.
3. Silence can be a healthy part of the communication process, but can also indicate a problem. The manager should investigate for issues.
4. Asking for information to be repeated is a form of clarifying the message. This is a healthy response.

Question 12

Analyze these statements and choose the response that best reflects paraphrasing.

Accepted Answer

1. Paraphrasing is restating what the patient said to clarify the comments.
2. With this statement, the nurse is asking for information.
3. This statement may be construed as defensive. It is not a restatement of what the patient told the nurse.
4. This statement is asking for information.

Question 13

Which situations illustrate barriers to communication? Select all that apply.

Accepted Answer

1. Active listening is helpful in understanding the message being delivered.
2. This posture is a defensive stance and sends a message of disapproval, which can shut down or change communication.
3. This is an open-ended question that should encourage elaboration by the patient.
4. This is a direct question that requires a direct answer. This style is helpful when asking for direction.
5. This overuse of reassuring statements can cut off communication.

Question 14

The nurse manager would like to increase staff feedback. Which action would encourage the staff to give feedback to the manager?

Accepted Answer

1. Using the grapevine can be damaging. The grapevine consists of comments that are not documented, that can be falsely reported, or easily misunderstood.
2. This type of communication is more cumbersome and will not allow spontaneous feedback to the manger.
3. Downward communication focuses on the superior telling the subordinate what to do. It does not allow for feedback unless feedback is requested.
4. Walk-around management allows the manager to be present on the unit so that staff can approach the manager with comments and issues.

Question 15

The nurse manager smiles constantly during a staff meeting in which changes to the holiday work schedule are announced. What is the probable result of this presentation?

Accepted Answer

1. This is not the result of constant smiling during the delivery of bad news. The nurse manager's demeanor should match the message to some extent.
2. This is not necessarily the case.
3. Constant smiling when it is not appropriate may make the nurses mistrust the manager.
4. The nurse manager should convey this support by being supportive and understanding the issues, not by smiling while delivering the message.

Question 16

The nurse observes the patient to be smiling, nodding, and saying "OK" when the physician explains a painful procedure that is planned for the patient. How should the nurse react to this observation?

Accepted Answer

1. The nurse has observed a disconnect between verbal and nonverbal communication and should clarify that the patient understands the explanation.
2. The nurse should first find out if the patient understands the explanation before discussing the situation with the physician.
3. The nurse should first see if the patient understands the explanation. If not, and if the problem stems from not understanding the language, contacting an interpreter would be appropriate.
4. This may be true, but the nurse needs to make certain before making this assumption.

Question 17

Analyze these statements and choose the response that indicates reflection.

Accepted Answer

1. The focus of this question is the test results. The sender is seeking information.
2. This statement only indicates that the nurse heard something the patient said, not that the nurse understood the patient's meaning.
3. Reflection focuses on the speaker's feelings and the receiver of the message restates what the receiver thinks are the feelings expressed.
4. The nurse is seeking clarification with this statement.

Question 18

The nurse says to the nursing assistant, "Please bathe this patient first today." This message is delivered in the hallway as the nursing assistant is unloading breakfast trays for the unit. Which element of communication is most likely to result in miscommunication in this scenario?

Accepted Answer

1. There is nothing to indicate that the sender is inadequate in this scenario.
2. The message is clear.
3. There is nothing to indicate that the receiver is not competent to receive the message.
4. The context or environment where this message is delivered is likely to cause miscommunication. There are many distractions occurring that could cause the receiver to misunderstand or mishear the message sent.

Question 19

Place the steps of the communication process in the order in which they generally occur. 
A) Medium 
B) Encoding 
C) Feedback 
D) Decoding

Accepted Answer

The answer of Place the steps of the communication process...

Question 20

Which options illustrate an open communication environment? Select all that apply.

Accepted Answer

1. People sometimes need time to formulate a correct response. Expecting immediate response can put pressure on the relationship and close down communication.
2. It is good to reinforce positive behaviors.
3. Secrecy is very destructive to communication and to organizations.
4. These false inferences lead the manager to jump to the wrong conclusion and opens up the potential for making mistakes.
5. Communication is critical to a positive work environment and patient-centered care and should be a part of performance evaluations.

Quiz 14: Effective Staff Communication and Working Relationships