Chapter 09: Communicating With Patients and Co-Workers
Claywell: LPN to RN Transitions
MULTIPLE CHOICE
1. The student nurse is listening to a lecture on therapeutic communication. Which statement
indicates that teaching has been effective?
a. “The purpose of therapeutic communication is psychotherapy.”
b. “The purpose of therapeutic communication is social communication.”
c. “The purpose of therapeutic communication is to develop a trusting relationship.”
d. “The purpose of therapeutic communication is emotional commitment to another.”
ANS: C
The purpose of therapeutic communication is to establish a trusting relationship. The RN
should try to understand with sensitivity. Therapeutic communication and the establishment of
the therapeutic relationship require empathy, genuineness, positive regard, and self-awareness.
Psychotherapy, social communication, and emotional commitment to another are not
definitions of therapeutic communication.
DIF: Cognitive Level: Evaluation
OBJ: State the purpose of the therapeutic relationship and apply therapeutic communication to the
clinical setting. TOP: The RN as Communicator
MSC: NCLEX: Psychosocial Integrity
2. The student nurse is listening to a lecture on communication. Which statement indicates that
the teaching has been effective?
a. “A communication blockerNis silence.”
b. “A communication blocker is eye contact.”
c. “A communication blocker is advising.”
d. “A communication blocker is clarifying.”
ANS: C
Communication blockers tend to stop conversation and build mistrust. Giving advice fosters
dependency and conveys to the patient that the nurse knows best. Silence, eye contact, and
clarifying are techniques that enhance (facilitate) communication.
DIF: Cognitive Level: Evaluation
OBJ: Compare and contrast facilitators and blockers of communication.
TOP: The RN as Communicator MSC: NCLEX: Psychosocial Integrity
3. The nurse is caring for a patient 2 hours after a left above-the-knee amputation. The patient
states, “My left leg is really hurting, and that medicine you gave me earlier didn’t help.”
Which response is the most therapeutic, if made by the nurse?
a. “That’s impossible!”
b. “You’ll have to talk to your doctor.”
c. “Keep your chin up.”
d. “I will call your physician.”
ANS: D
, “I will call your physician” is validating the patient’s perception of pain. “That’s impossible!”
minimizes the patient’s feelings. “You’ll have to talk to your doctor” may cause the patient to
feel rejected by the nurse. Making a stereotypical comment such as “Keep your chin up” is
never therapeutic.
DIF: Cognitive Level: Application
OBJ: Demonstrate effective communication skills to resolve conflict in the health care setting.
TOP: The RN as Communicator MSC: NCLEX: Psychosocial Integrity
4. The RN is documenting the patient’s complaint of pain rated 6 on a scale of 0 to 10. Which
chart entry would be the most appropriate, if made by the nurse?
a. Pt. complaining of pain. MD notified.
b. Pt complaining of pain rated at 6 on a scale of 0–10, states “My left leg is really
hurting.” Pt. grimacing, voice elevated. MD notified.
c. Pt. complaining of pain rated at 6 on a scale of 0–10. Appears to be in pain. MD
notified.
d. Pt. complaining of pain rated 6. Wants more pain medication; appears to be
drug-seeking. MD notified.
ANS: B
With “Pt complaining of pain rated at 6 on a scale of 0–10, states ‘My left leg is really
hurting.’ Pt. grimacing, voice elevated. MD notified,” the entry contains the problem, the
assessment, subjective comments, observations, and the plan. The entry “Pt. complaining of
pain. MD notified,” does not define the patient’s pain. The entries “Pt. complaining of pain
rated at 6 on a scale of 0–10. Appears to be in pain. MD notified” and “Pt. complaining of
pain rated 6. Wants more pain medication; appears to be drug-seeking. MD notified” reflect
opinions of the nurse.
N
DIF: Cognitive Level: Application
OBJ: Utilize SBAR to assertively communicate with co-workers within the health care team to
minimize risks associated with handoffs. TOP: The RN as Communicator
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
5. The RN has assigned the nursing assistant (NA) a task. The NA becomes angry and begins
yelling at the RN. What is the best approach for the RN to take?
a. Tell the NA that you will let her leave early if she will do this for you.
b. Ignore her and reassign the task.
c. Meet with the NA to explore his or her feelings and the reason for resistance.
d. Call the nursing supervisor and report the NA for insubordination.
ANS: C
Meeting with the NA to explore the reason for resisting the request is the best approach in
order to address the underlying issue. Telling the NA that you will let her leave early if she
will do this for you and ignoring her and reassigning the task are negative reinforcements and
will likely perpetuate the behavior. Calling the nursing supervisor and reporting the NA for
insubordination should occur if the RN has been unsuccessful in resolving the problem.
DIF: Cognitive Level: Application
OBJ: Demonstrate effective communication skills to resolve conflict in the health care setting.
TOP: The RN as Communicator
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
Claywell: LPN to RN Transitions
MULTIPLE CHOICE
1. The student nurse is listening to a lecture on therapeutic communication. Which statement
indicates that teaching has been effective?
a. “The purpose of therapeutic communication is psychotherapy.”
b. “The purpose of therapeutic communication is social communication.”
c. “The purpose of therapeutic communication is to develop a trusting relationship.”
d. “The purpose of therapeutic communication is emotional commitment to another.”
ANS: C
The purpose of therapeutic communication is to establish a trusting relationship. The RN
should try to understand with sensitivity. Therapeutic communication and the establishment of
the therapeutic relationship require empathy, genuineness, positive regard, and self-awareness.
Psychotherapy, social communication, and emotional commitment to another are not
definitions of therapeutic communication.
DIF: Cognitive Level: Evaluation
OBJ: State the purpose of the therapeutic relationship and apply therapeutic communication to the
clinical setting. TOP: The RN as Communicator
MSC: NCLEX: Psychosocial Integrity
2. The student nurse is listening to a lecture on communication. Which statement indicates that
the teaching has been effective?
a. “A communication blockerNis silence.”
b. “A communication blocker is eye contact.”
c. “A communication blocker is advising.”
d. “A communication blocker is clarifying.”
ANS: C
Communication blockers tend to stop conversation and build mistrust. Giving advice fosters
dependency and conveys to the patient that the nurse knows best. Silence, eye contact, and
clarifying are techniques that enhance (facilitate) communication.
DIF: Cognitive Level: Evaluation
OBJ: Compare and contrast facilitators and blockers of communication.
TOP: The RN as Communicator MSC: NCLEX: Psychosocial Integrity
3. The nurse is caring for a patient 2 hours after a left above-the-knee amputation. The patient
states, “My left leg is really hurting, and that medicine you gave me earlier didn’t help.”
Which response is the most therapeutic, if made by the nurse?
a. “That’s impossible!”
b. “You’ll have to talk to your doctor.”
c. “Keep your chin up.”
d. “I will call your physician.”
ANS: D
, “I will call your physician” is validating the patient’s perception of pain. “That’s impossible!”
minimizes the patient’s feelings. “You’ll have to talk to your doctor” may cause the patient to
feel rejected by the nurse. Making a stereotypical comment such as “Keep your chin up” is
never therapeutic.
DIF: Cognitive Level: Application
OBJ: Demonstrate effective communication skills to resolve conflict in the health care setting.
TOP: The RN as Communicator MSC: NCLEX: Psychosocial Integrity
4. The RN is documenting the patient’s complaint of pain rated 6 on a scale of 0 to 10. Which
chart entry would be the most appropriate, if made by the nurse?
a. Pt. complaining of pain. MD notified.
b. Pt complaining of pain rated at 6 on a scale of 0–10, states “My left leg is really
hurting.” Pt. grimacing, voice elevated. MD notified.
c. Pt. complaining of pain rated at 6 on a scale of 0–10. Appears to be in pain. MD
notified.
d. Pt. complaining of pain rated 6. Wants more pain medication; appears to be
drug-seeking. MD notified.
ANS: B
With “Pt complaining of pain rated at 6 on a scale of 0–10, states ‘My left leg is really
hurting.’ Pt. grimacing, voice elevated. MD notified,” the entry contains the problem, the
assessment, subjective comments, observations, and the plan. The entry “Pt. complaining of
pain. MD notified,” does not define the patient’s pain. The entries “Pt. complaining of pain
rated at 6 on a scale of 0–10. Appears to be in pain. MD notified” and “Pt. complaining of
pain rated 6. Wants more pain medication; appears to be drug-seeking. MD notified” reflect
opinions of the nurse.
N
DIF: Cognitive Level: Application
OBJ: Utilize SBAR to assertively communicate with co-workers within the health care team to
minimize risks associated with handoffs. TOP: The RN as Communicator
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
5. The RN has assigned the nursing assistant (NA) a task. The NA becomes angry and begins
yelling at the RN. What is the best approach for the RN to take?
a. Tell the NA that you will let her leave early if she will do this for you.
b. Ignore her and reassign the task.
c. Meet with the NA to explore his or her feelings and the reason for resistance.
d. Call the nursing supervisor and report the NA for insubordination.
ANS: C
Meeting with the NA to explore the reason for resisting the request is the best approach in
order to address the underlying issue. Telling the NA that you will let her leave early if she
will do this for you and ignoring her and reassigning the task are negative reinforcements and
will likely perpetuate the behavior. Calling the nursing supervisor and reporting the NA for
insubordination should occur if the RN has been unsuccessful in resolving the problem.
DIF: Cognitive Level: Application
OBJ: Demonstrate effective communication skills to resolve conflict in the health care setting.
TOP: The RN as Communicator
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
