1.
1.An 84-yr. old cognitively impaired transferred from nursing home to an acute care facility.Hx. of vascular dementia from a series of strokes.Patient has become increasingly agitated and combative in the last few days; this is unusual for the patient.Laboratory test reveals a urinary tract infection.The patient is beginning to receive antibiotics for the infection.You are the nurse caring for the patient. Which of the following would be an example of an ineffective communication?
Correct Answer
B. Challenge the patient if patient is confused
Explanation
This is an example of an ineffective/non therapeutic communication technique and will likely result in increased agitation and frustration in the patient. You should never challenge the patient
2.
How would you handle communicating with the nursing home during the transfer of care when you discharge this patient? Select the approiate order of hand-off communication
Correct Answer
C. SBAR
Explanation
SBAR is Situation, backgroud, assessment, and recommendation. The other acronyms do not mean anything
3.
What should the nurse know when observing and interpreting a patient’s nonverbal communication?
Correct Answer
D. Nonverbal cues provide significant informationand need to be validated.
Explanation
Non-verbal communication is very powerful; however, the nurse must validate that the message perceived is the intended message.
4.
A patient has been withdrawn, suspicious, and explosive since admission. He is wary of staff and other patients. Which approach is most appropiate?
Correct Answer
A. Refraining from touch.
Explanation
Touch is can be a therapeutic nonverbal communication technique, but it should not be used with suspicious patients. This may be perceived as an invasion of personal space and may heighten the level of suspiciousness.
5.
The nurse in the mental health unit reviews therapeutic and nontherapeutic communication techniques with a nursing student. Which of the following are therapeutic communication techniques? Select all that apply.
Correct Answer(s)
A. Restating
B. Listening
D. Maintaining neutral responses
F. Providing acknowledgement
Explanation
restating, listening, maintaining neutral responses and providing acknowledgement are the correct answer. They are all therapeutic techniques.
6.
Which of the following approaches creates a barrier to communication?
Correct Answer
B. Giving advice rather than encouraging the patient to problem solve.
Explanation
Nurses should never give advice to patients, even if it is solicited by patients. The nurse-patient relationship is patient centered; patients should make decisions on their own, without such input from nurse.
7.
The patient states,”I get pretty discouraged when I realized I have been struggling with these issues for over a year.” The nurse responds, Yes you have, but lots of other people take even longer to resolve their problems; don’t be so hard on yourself.” What does this interaction reprsent?
Correct Answer
C. The nurse has responded ineffectively to the patient’s concerns.
Explanation
The nurse is brushing off the patient's concerns and minimizing them. The issue is a concern of the patient and should be addressed by the nurse.
8.
Which of the following techniques are examples of non-therapeutic communication? Select all that apply.
Correct Answer(s)
B. Challenging
D. Asking “Why” questions.
Explanation
Asking why questions in non-therapeutic. and sets up a feeling of defensiveness in the patient. Information may be obtained by asking questions using other words such as how, where, what and when. It is not therpeutic to challenge patients, demanding proof from them.
9.
Which of the following factors has documented negative effects on patient outcomes?
Correct Answer
D. All the above
Explanation
Many factors may adversely affect patient outcomes, all of the factors listed have the potential to negatively affect patients.
10.
Which of the following methods would you use when communicating with an angry patient;
Correct Answer
C. Use therapeutic silence
Explanation
Maintaining personal space, encouraging safe coping behaviors, and using silence are all therapeutic techniques. The use of touch is discouraged with angry patients because it may escalate the situation