NCLEX - W7 - Communication

Question 1

A nurse is concerned about a medication order written by a physician. The dosage seems too high. What is the most appropriate action for the nurse to take?
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A. Administer the medication as ordered, documenting concerns in the patient’s chart.
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B. Contact the physician to discuss the order, using CUS language.
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C. Consult with another nurse to get a second opinion.
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D. Refuse to administer the medication.

Answer: B. Contact the physician to discuss the order, using CUS language.

Rationale: Using CUS language (“Concerned, Uncomfortable, Safety issue”) is a structured way to escalate concerns effectively. Directly communicating with the physician is crucial for patient safety and collaborative care.

Answer 1

Answer: B. Contact the physician to discuss the order, using CUS language.

Rationale: Using CUS language (“Concerned, Uncomfortable, Safety issue”) is a structured way to escalate concerns effectively. Directly communicating with the physician is crucial for patient safety and collaborative care.

Question 2

Which of the following is an example of effective use of the SBAR communication tool?
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A. “I think we should order a CT scan. What do you think?”
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B. “This patient has a history of hypertension. Their blood pressure is currently 180/110 mmHg. I recommend administering an antihypertensive medication.”
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C. “The patient is complaining of pain. I don’t know what’s causing it.”
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D. “I’m really busy right now. Can you deal with this patient?”

Answer 2

Answer: B. “This patient has a history of hypertension. Their blood pressure is currently 180/110 mmHg. I recommend administering an antihypertensive medication.”

Rationale: This response effectively uses all elements of SBAR: Situation (high blood pressure), Background (history of hypertension), Assessment (current blood pressure reading), and Recommendation (administering medication).

Question 3

A nurse is caring for a patient who is anxious about an upcoming procedure. Which nonverbal communication technique would be most therapeutic?
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A. Sitting at eye level with the patient and maintaining eye contact.
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B. Standing with arms crossed while speaking to the patient.
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C. Avoiding eye contact to prevent making the patient uncomfortable.
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D. Speaking quickly to convey a sense of efficiency.

Answer 3

Answer: A. Sitting at eye level with the patient and maintaining eye contact.

Rationale: Sitting at eye level and maintaining eye contact (considering cultural appropriateness) conveys attentiveness, empathy, and a willingness to listen.

Question 4

When communicating with a patient who has limited English proficiency, what is the most important action for the nurse to take?
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A. Speak loudly and slowly.
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B. Use a qualified medical interpreter.
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C. Rely on family members for translation.
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D. Use gestures and simple phrases.

Answer 4

Answer: B. Use a qualified medical interpreter.

Rationale: Using a qualified medical interpreter ensures accurate communication and respects the patient’s right to receive healthcare information in a language they understand. Family members may not be familiar with medical terminology or may misinterpret critical information.

Question 5

A patient is crying and upset after receiving a difficult diagnosis. Which of the following responses by the nurse demonstrates empathy?
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A. “Don’t worry, everything will be okay.”
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B. “I understand that this is a lot to process. I’m here to answer any questions you may have.”
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C. “I know exactly how you feel.”
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D. “At least it’s not worse than it could be.”

Answer 5

Answer: B. “I understand that this is a lot to process. I’m here to answer any questions you may have.”

Rationale: This response acknowledges the patient’s feelings, offers support, and avoids minimizing or dismissing their emotional distress.

Question 6

Which of the following is a barrier to effective communication?
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A. Active listening
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B. Using jargon or technical language
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C. Restating and clarifying messages
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D. Maintaining eye contact

Answer 6

Answer: B. Using jargon or technical language

Rationale: Using jargon or technical language that the patient may not understand can hinder communication and create confusion.

Question 7

What is the purpose of the “CUS” tool in healthcare communication?
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A. To document patient complaints.
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B. To escalate concerns about patient safety.
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C. To provide a standardized handoff report format.
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D. To schedule meetings between healthcare providers.

Answer 7

Answer: B. To escalate concerns about patient safety.

Rationale: CUS (Concerned, Uncomfortable, Safety issue) is a tool for nurses and other healthcare providers to voice concerns effectively, especially when patient safety is at risk.

Question 8

During a handoff report, which information is critical for the nurse to include?
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A. The patient’s favorite television shows.
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B. The patient’s dietary preferences.
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C. Recent laboratory test results and vital signs.
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D. The patient’s visitor log.

Answer 8

Answer: C. Recent laboratory test results and vital signs.

Rationale: Critical patient information, such as recent lab results, vital signs, allergies, code status, and medication lists, is essential for ensuring continuity of care and patient safety during handoff reports.

Question 9

A nurse is caring for a patient who is nonverbal. Which communication strategy would be most appropriate?
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A. Ignoring the patient’s nonverbal cues.
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B. Speaking loudly and slowly as if the patient were hearing impaired.
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C. Using a picture board or other assistive communication devices.
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D. Assuming the patient understands everything being said.

Answer 9

Answer: C. Using a picture board or other assistive communication devices.

Rationale: Picture boards, communication boards, and other AAC devices provide alternative ways for nonverbal patients to express their needs and communicate.

Question 10

Which of the following is an example of closed-loop communication?
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A. A nurse gives a medication and then leaves the room.
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B. A physician gives an order, and the nurse repeats the order back to confirm understanding.
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C. A nurse asks a patient how they are feeling and receives no response.
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D. A nurse documents an assessment finding in the patient’s chart.

Answer 10

Answer: B. A physician gives an order, and the nurse repeats the order back to confirm understanding.

Rationale: Closed-loop communication involves confirming that the information transmitted is received and understood correctly, reducing the risk of errors.

Question 11

A nurse is caring for a patient who is experiencing pain. Which of the following is an example of an open-ended question the nurse could ask?
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A. “Are you in pain?”
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B. “Is your pain better or worse than yesterday?”
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C. “On a scale of 0 to 10, with 0 being no pain and 10 being the worst pain imaginable, how would you rate your pain?”
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D. “Tell me about your pain.”

Answer 11

Answer: D. “Tell me about your pain.”

Rationale: This open-ended question encourages the patient to describe their pain in detail, providing valuable information for assessment and pain management.

Question 12

A nurse is communicating with a patient who is from a different culture. The patient avoids direct eye contact. What is the most appropriate interpretation of this behavior?
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A. The patient is not interested in the conversation.
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B. The patient is being disrespectful.
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C. The patient’s cultural norms may dictate that eye contact is inappropriate in this situation.
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D. The patient is hiding something.

Answer 12

Answer: C. The patient’s cultural norms may dictate that eye contact is inappropriate in this situation.

Rationale: Eye contact preferences vary across cultures. It’s important to be aware of cultural differences and avoid making assumptions or judgments.

Question 13

A nurse is preparing to give a presentation to a group of patients about heart-healthy living. What is an important consideration for effective public speaking?
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A. Speaking in a monotone voice to avoid sounding too emotional.
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B. Using complex medical terminology to establish credibility.
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C. Avoiding eye contact with the audience to prevent them from feeling uncomfortable.
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D. Varying the pace and tone of voice to keep the audience engaged.

Answer 13

Answer: D. Varying the pace and tone of voice to keep the audience engaged.

Rationale: Engaging the audience requires a dynamic presentation style, including varying the pace, tone, and volume of the voice.

Question 14

During a team huddle, a nurse shares a concern about a potential safety issue. The team leader responds dismissively. What is the most appropriate action for the nurse to take?
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A. Remain silent to avoid conflict.
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B. Reiterate the concern, emphasizing the potential safety implications.
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C. Report the incident to the nurse manager.
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D. Agree with the team leader to avoid further discussion.

Answer 14

Answer: B. Reiterate the concern, emphasizing the potential safety implications.

Rationale: It’s crucial to advocate for patient safety, even when faced with resistance. Assertively communicating the concern a second time may prompt the team leader to take it more seriously.

Question 15

Which communication technique can help prevent medication errors during medication administration?
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A. Speaking in a casual and informal tone.
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B. Using abbreviations and acronyms freely.
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C. Reading back medication orders to the prescriber.
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D. Relying on memory when administering medications.

Answer 15

Answer: C. Reading back medication orders to the prescriber.

Rationale: Reading back medication orders is a closed-loop communication technique that verifies the accuracy of orders and reduces the risk of medication administration errors.

Question 16

A nurse is working with a patient who has aphasia following a stroke. What communication strategy would be helpful?
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A. Using complex sentences to provide detailed explanations.
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B. Speaking loudly and rapidly.
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C. Avoiding eye contact to minimize the patient’s frustration.
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D. Using simple phrases and allowing time for the patient to respond.

Answer 16

Answer: D. Using simple phrases and allowing time for the patient to respond.

Rationale: Patients with aphasia may have difficulty understanding complex language or speaking fluently. Simple phrases and patience facilitate communication.

Question 17

A nurse is caring for a patient who is unconscious. Which of the following is appropriate communication?
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A. Avoiding speaking to the patient because they cannot hear.
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B. Talking to the patient as if they were awake, explaining procedures and providing updates.
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C. Playing loud music to stimulate the patient’s senses.
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D. Speaking in a condescending tone because the patient is unresponsive.

Answer 17

Answer: B. Talking to the patient as if they were awake, explaining procedures and providing updates.

Rationale: Even unconscious patients may be able to hear. Speaking to them respectfully and explaining care provides comfort and reduces anxiety.

Question 18

What is the primary purpose of therapeutic communication in nursing?
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A. To gather assessment data and establish the nurse-patient relationship.
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B. To provide social interaction and entertainment for patients.
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C. To give advice and solve the patient’s problems.
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D. To control the conversation and direct the patient’s responses.

Answer 18

Answer: A. To gather assessment data and establish the nurse-patient relationship.

Rationale: Therapeutic communication is a key component of nursing care, used to gather information, build rapport with patients, and address their physical, emotional, and psychosocial needs.

Question 19

A patient says, “I’m so scared about this surgery.” Which response by the nurse demonstrates active listening?
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A. “Everything will be fine. You have nothing to worry about.”
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B. “You’re scared about the surgery? Tell me more about what’s worrying you.”
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C. “I know exactly how you feel.”
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D. “Lots of people have this surgery. It’s a routine procedure.”

Answer 19

Answer: B. “You’re scared about the surgery? Tell me more about what’s worrying you.”

Rationale: Active listening involves reflecting on the patient’s words, seeking clarification, and encouraging further discussion.

Question 20

A nurse notices that a colleague is using patronizing language when interacting with an elderly patient. What is the most appropriate action?
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A. Ignore the situation.
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B. Speak privately with the colleague about the use of elderspeak and its potential negative impact.
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C. Report the colleague to the nurse manager.
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D. Confront the colleague in front of the patient.

Answer 20

Answer: B. Speak privately with the colleague about the use of elderspeak and its potential negative impact.

Rationale: Directly addressing the colleague privately provides an opportunity for education and behavior change, while maintaining professionalism and respect.

Question 21

Which of the following communication techniques is most likely to hinder the development of trust between a nurse and patient?
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A. Using humor appropriately to ease tension.
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B. Maintaining a professional appearance.
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C. Providing false reassurance.
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D. Asking open-ended questions.

Answer 21

Answer: C. Providing false reassurance.

Rationale: False reassurance can damage trust because it minimizes the patient’s concerns and conveys a lack of honesty or genuineness.

Question 22

What is the purpose of using a checklist during a patient handoff?
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A. To ensure that all necessary information is communicated consistently.
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B. To provide entertainment for the healthcare team.
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C. To document patient complaints.
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D. To evaluate the performance of individual nurses.

Answer 22

Answer: A. To ensure that all necessary information is communicated consistently.

Rationale: Checklists promote thoroughness and standardization, reducing the risk of omissions or errors during handoff communication.

Question 23

Which of the following nonverbal cues suggests that a patient may be anxious or distressed?
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A. Relaxed posture and steady eye contact.
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B. Fidgeting, trembling hands, and rapid breathing.
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C. Smiling and nodding in agreement.
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D. Speaking in a calm, even tone of voice.

Answer 23

Answer: B. Fidgeting, trembling hands, and rapid breathing.

Rationale: Nonverbal cues can provide valuable insights into a patient’s emotional state. These physical signs may indicate anxiety or distress.

Question 24

A nurse is concerned about a patient’s deteriorating condition but is hesitant to contact the physician because of a past negative interaction. What should the nurse do?
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A. Wait for the next scheduled rounds to discuss the patient with the physician.
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B. Ask a more experienced colleague to contact the physician.
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C. Contact the physician and assertively communicate the patient’s status and concerns.
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D. Document concerns in the patient’s chart without contacting the physician.

Answer 24

Answer: C. Contact the physician and assertively communicate the patient’s status and concerns.

Rationale: Patient safety must always be the priority. Nurses have a professional obligation to advocate for their patients, even when it involves difficult conversations

Question 25

What is a key benefit of using the I-PASS mnemonic during patient handoffs?
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A. It simplifies complex medical terminology.
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B. It provides a structured framework for communicating critical information about a patient’s care.
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C. It eliminates the need for verbal communication during handoffs.
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D. It replaces the need for electronic health records.

Answer 25

Answer: B. It provides a structured framework for communicating critical information about a patient’s care.

Rationale: I-PASS (Illness severity, Patient summary, Action list, Situation awareness and contingency plans, Synthesis by receiver) is a mnemonic that promotes thoroughness and consistency in handoff communication

Question 26

During a code blue situation, a nurse is asked to administer a medication that the nurse is unfamiliar with. What should the nurse do?
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A. Administer the medication as instructed without question.
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B. Politely refuse to administer the medication because of lack of familiarity.
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C. Ask another nurse to administer the medication.
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D. Seek clarification from the physician, stating the nurse’s unfamiliarity with the medication.

Answer 26

Answer: D. Seek clarification from the physician, stating the nurse’s unfamiliarity with the medication.

Rationale: It’s crucial to be assertive and prioritize safety in high-pressure situations. Seeking clarification ensures that the right medication is administered correctly

Question 27

A nurse is caring for a patient who is terminally ill. The patient says, “I’m afraid of what will happen when I die.” What is a therapeutic response by the nurse?
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A. “Don’t worry, everything will be fine.”
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B. “You’ll go to a better place.”
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C. “It’s normal to feel afraid. I’m here to listen if you want to talk about your fears.”
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D. “You shouldn’t think about that. Focus on getting better.”

Answer 27

Answer: C. “It’s normal to feel afraid. I’m here to listen if you want to talk about your fears.”

Rationale: Acknowledging the patient’s feelings and offering support without judgment or false reassurance creates a space for open communication.

Question 28

What is a key characteristic of assertive communication in nursing?
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A. Being aggressive and demanding.
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B. Expressing thoughts and feelings directly and honestly, while respecting the views of others.
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C. Avoiding conflict at all costs.
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D. Being passive and submissive.

Answer 28

Answer: B. Expressing thoughts and feelings directly and honestly, while respecting the views of others.

Rationale: Assertive communication strikes a balance between being direct and respectful, allowing nurses to advocate for patients and themselves effectively

Question 29

Which of the following is a potential benefit of incorporating humor into therapeutic communication?
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A. It can create a more relaxed atmosphere and reduce tension.
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B. It can be used to make light of serious medical conditions.
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C. It can be directed at patients to distract them from their pain.
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D. It can be used to avoid discussing sensitive topics.

Answer 29

Answer: A. It can create a more relaxed atmosphere and reduce tension.

Rationale: Humor, used appropriately and sensitively, can help to establish rapport and reduce stress in healthcare settings.

Question 30

What is a potential consequence of inadequate handoff communication?
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A. Increased patient satisfaction.
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B. Reduced medical errors.
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C. Improved teamwork and collaboration.
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D. Patient safety risks, including adverse events and sentinel events.

Answer 30

Answer: D. Patient safety risks, including adverse events and sentinel events.

Rationale: Inadequate communication during handoffs can lead to a breakdown in continuity of care, increasing the likelihood of errors and adverse outcomes for patients