Communication in Nursing Practice Questions

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The first-semester nursing student tells the team leader that her clinical assignment for the day is to take vital signs and obtain a client history that will take about 1 or 2 hours to complete. Which clients would the leader recommend that she approach to fulfill her assignment? (Select all that apply.)

  • A. Mr. N (non-Hodgkin lymphoma)
  • B. Mr. L (tracheostomy and partial laryngectomy)
  • C. Mr. B (bladder cancer)
  • D. Ms. C (bowel resection and colostomy)
Correct Answer: B

Rationale: The correct answer is B because Mr. L, who has a tracheostomy and partial laryngectomy, will likely require vital signs monitoring and a detailed client history due to his complex respiratory and communication needs. This assignment will provide the student with valuable experience in caring for clients with specialized needs.

Incorrect choices:
A: Mr. N (non-Hodgkin lymphoma) - While Mr. N may require vital signs monitoring, his condition does not necessarily involve complex care needs that would warrant a 1-2 hour history-taking session.
C: Mr. B (bladder cancer) - Vital signs monitoring and history-taking for a client with bladder cancer may not require as much time as the scenario suggests, as the care needs may not be as complex as those of a client with a tracheostomy and laryngectomy.
D: Ms. C (bowel resection and colostomy) - While Ms. C may require vital signs monitoring and history-taking

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Which assessment finding is the most critical and needs to be addressed first?

  • A. Mr. U has tracheal deviation after a pulmonary resection.
  • B. Mr. B, with bladder cancer, has decreased urinary output.
  • C. Mr. N, with non-Hodgkin lymphoma, is having dysrhythmias.
  • D. Ms. C has severe abdominal pain after a bowel resection.
Correct Answer: A

Rationale: The correct answer is A because tracheal deviation after a pulmonary resection indicates a life-threatening condition like tension pneumothorax. This condition requires immediate intervention to prevent respiratory distress and potential cardiovascular collapse. Tracheal deviation is a red flag sign that signals a medical emergency. Options B, C, and D are important but not as urgent as tracheal deviation. Decreased urinary output in a bladder cancer patient could indicate renal dysfunction, dysrhythmias in a patient with non-Hodgkin lymphoma may need further evaluation, and severe abdominal pain post-bowel resection could signal complications but are not as immediately life-threatening as tracheal deviation.

A client has high blood pressure and needs to learn about a low-sodium diet. Which question if asked by the client would be an indirect request for information?

  • A. "How should I prepare food without adding salt?=
  • B. "What will I do to make food taste better?=
  • C. "What diet changes are needed to control my blood pressure?=
  • D. "What foods should I avoid that are high in sodium?=
Correct Answer: B

Rationale: The correct answer is B because the client is indirectly asking for information on how to make food taste better without explicitly mentioning the need for low-sodium options. By inquiring about making food taste better, the client is seeking alternative ways to enhance flavor without salt, which aligns with the goal of following a low-sodium diet. Choices A, C, and D are more direct in addressing specific aspects of a low-sodium diet, such as food preparation without salt, dietary changes for blood pressure control, and identifying high-sodium foods to avoid, respectively.

The nurse is reviewing Mr. N's (non-Hodgkin lymphoma) medication administration record and sees that the combination therapy aprepitant, dexamethasone, and ondansetron was administered during the last shift. What is the nurse most likely to ask to determine efficacy of the therapy?

  • A. "On a scale of 1 to 10, with 1 being the least and 10 being the worst, what number is your pain? Where is the pain located?"
  • B. "Have the medications improved your appetite? Are there special foods that you would prefer?"
  • C. "Are you having any feelings of nausea right now? When was the last time you vomited?"
  • D. "After taking the medications, have you experienced any improvement in your energy level? Do you feel fatigued?"
Correct Answer: C

Rationale: The correct answer is C. The nurse would ask about feelings of nausea and vomiting to determine the efficacy of the antiemetic therapy. Nausea and vomiting are common side effects of chemotherapy, which Mr. N would receive for non-Hodgkin lymphoma. Improvement in these symptoms indicates the effectiveness of the antiemetic regimen. Choices A, B, and D are not directly related to the medications administered and would not provide valuable information on the efficacy of the therapy for managing chemotherapy-induced nausea and vomiting. Option A focuses on pain assessment, B on appetite and food preferences, and D on energy levels and fatigue, which are not the primary outcomes to evaluate in this context.

Let me know how you're doing and whether you need any help."

  • A. "Give the patient in 204A a shower after breakfast, and call me to check her feet before you get her dressed."
  • B. "Take the vital signs on all the patients in the lounge and tell me whether there are problems." The clarity and brevity of the direction makes the delegated task clear and leaves the responsibility of assessment to the nurse.
Correct Answer: B

Rationale: The correct answer is B because it provides clear instructions to take vital signs on all patients in the lounge and report any problems. This ensures comprehensive assessment and communication. Choice A is incorrect because it lacks specificity and may lead to overlooking important tasks. Choice C and D are incorrect as they are blank. Providing clear and concise directions is crucial in delegation to ensure tasks are completed accurately and efficiently.

One study of Italian primary care physicians caring for diabetic patients showed that those scoring highest on the empathy test had patients with:

  • A. Significantly fewer acute diabetic complications
  • B. Statistically fewer acute diabetic complications
  • C. Higher rates of chronic diabetic complications
  • D. Statistically higher poor outcomes for patients with diabetes
Correct Answer: B

Rationale: The correct answer is B: Statistically fewer acute diabetic complications. This is because the study found a correlation between high empathy scores of physicians and lower occurrences of acute diabetic complications in their patients. The use of the term "statistically" implies a significant and reliable relationship between physician empathy and patient outcomes.

Choice A is incorrect because the study did not specify "significantly" fewer complications, only a correlation with high empathy scores. Choice C is incorrect as there was no evidence of higher rates of chronic complications associated with physician empathy. Choice D is incorrect as the study did not find statistically higher poor outcomes for patients with diabetes, but rather a relationship with fewer acute complications.

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