Chapter 02: Communication and Collaboration

Chapter 02: Communication and Collaboration

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse interviews a female patient during admission. Which observation by the nurse identifies congruency in the patient’s communication?

a.	Asserts she is eager to answer questions while reading a magazine
b.	States that she wants information while frequently changing the subject
c.	Asks the nurse to explain a surgical procedure while listening intently
d.	Explains that she is relaxed while continuously shifting in her chair

 

 

ANS:  C

The patient demonstrates congruency, or consistency, between her verbal statement asking for an explanation and her nonverbal cue of listening intently. The verbal and nonverbal messages match; each indicates that the nurse’s response is important to her. If she is eager to answer questions, the patient should focus on the nurse’s questions or note taking; reading a magazine is a distraction and indicates a lack of interest. Changing the subject may indicate discomfort or reluctance to address the issue. Continually shifting position may be an indication of anxiety.

 

DIF:    Cognitive Level: Apply                   REF:   Page 19

OBJ:   NCLEX: Safe and Effective Care     TOP:   Nursing Process: Assessment

 

2. The nurse is interviewing a patient about his health history. Which statement by the nurse is most likely to result in effective patient communication?

a.	“I’m not sure why you’re here. Can you explain it to me?”
b.	“Tell me about things and people that are important to you.”
c.	“Tell me more about your pain. Where does it start?”
d.	“If you think it’s important, I’ll try to notify the provider.”

 

 

ANS:  C

The nurse communicates effectively by using focused questions. This encourages the patient to give more information about the specific topic of concern. The remaining options are ineffective communication techniques because each impairs the exchange of information between the nurse and the patient. The patient may be unwilling to express concerns openly after the nurse expresses lack of understanding and empathy. The patient will also likely lose confidence in the nurse if the nurse expresses confusion about suitability of the patient’s presence. By asking what is important to the patient, the nurse loses focus of the objective of the communication and is likely to confuse the patient.

 

DIF:    Cognitive Level: Apply                   REF:   Page 14

OBJ:   NCLEX: Safe and Effective Care     TOP:   Nursing Process: Evaluation

 

3. After a male patient receives a diagnosis of a fatal disease, he expresses sadness and states that he does not know what to do next. Which is the most effective response by the nurse to facilitate communication?

a.	Ask the patient what he finds comforting in his life.
b.	Reassure the patient that his family will take care of him.
c.	Refer the patient to a church for spiritual counseling.
d.	Tell the patient that hospice care is available immediately.

 

 

ANS:  A

Because of the grim diagnosis, the patient expresses confusion and lacks a clear direction. To reduce anxiety, enhance coping skills, and facilitate communication, the nurse provides a calm atmosphere by redirecting and focusing the patient to identify comforting things. The nurse should use comfort measures, hoping that they will reduce tension so the patient can process information and make decisions. Discussing hospice is premature until end-stage disease and because the patient is not thinking clearly. The patient can benefit from a calming atmosphere and time to process the new information. Besides, informing the patient about hospice implies that end of life is imminent. Assuring the patient of family involvement requires consultation with the family first. Spiritual counseling may not be indicated for this patient if the patient does not wish to participate.

 

DIF:    Cognitive Level: Analyze                REF:   Page 14| Page 24

OBJ:   NCLEX: Safe and Effective Care     TOP:   Nursing Process: Evaluation

 

4. A female patient sobs uncontrollably when talking about the recent death of a pet. Which response should the nurse implement to best provide for her immediate needs?

a.	Sit with the patient quietly and allow her to cry.
b.	Provide tissues and promise to come back later.
c.	Ask why the patient is upset over the pet’s death.
d.	Encourage her to describe the day she got her pet.

 

 

ANS:  A

Sitting with the patient demonstrates acceptance, caring, and value for the patient’s experience as she expresses her grief. This is more likely to promote effective communication later because the nurse establishes a foundation of trust by respecting, caring, and staying with her. Providing tissues is indicated; however, leaving the room indicates that the nurse does not value what the patient is experiencing, the nurse does not care, or the nurse is uncomfortable with crying. Questions beginning with “why” ask the patient to justify feelings or actions and thereby can inhibit effective communication as she assumes a defensive position. The patient needs to be able to experience the grief. She will talk when she is ready.

 

DIF:    Cognitive Level: Apply                   REF:   Page 14| Page 17| Page 19| Page 24

OBJ:   NCLEX: Safe and Effective Care     TOP:   Nursing Process: Implementation

 

5. The nurse is preparing to begin the patient hand-off procedure for five patients. Who should the nurse include in this process?

a.	Only the licensed nurses
b.	The unit health care personnel
c.	The entire interdisciplinary team
d.	The nurses and healthcare provider

 

 

ANS:  B

All the healthcare personnel on the unit who will be interacting with this group of patients should actively participate in the patient hand-off. This would include nursing assistive personnel (NAP) and the nurses. An interdisciplinary team usually meets when there is a problem with a patient and all the team members need to discuss approaches and plans with and for a patient. The healthcare provider does not participate in the patient hand-off procedure. The provider makes rounds on a specific group of patients.

 

DIF:    Cognitive Level: Remember            REF:   Page 27-28

OBJ:   NCLEX: Safe and Effective Care     TOP:   Nursing Process: Planning