Question 1

The staff nurse is unsure of the correct protocol for calling in sick to work. The nursing supervisor told the nurse to call the nursing office; however, the nurse manager told the nurse to call the unit. This issue is likely the result of which distorted communication?

Accepted Answer

1. Intersender conflict occurs when a person receives two conflicting messages from different sources.
2. Intrasender conflict occurs when a verbal message differs from the nonverbal message; the recipient has difficulty interpreting the intended meaning.
3. Metacommunication is the combination of oral messages with nonverbal messages.
4. Downward communication occurs from manager to staff and is often directive.

Question 2

The nurse manager has determined that two staff nurses need to be hired. Which factor is most critical as the nurse manager prepares to submit the request to administration?

Accepted Answer

1. The nurse manager should plan to meet with administration when there is sufficient time and the supervisor seems receptive.
2. Negative inquiry is used after a request has been denied.
3. Compromise occurs after a request has been denied. Persistence and repetition are used after a request has been denied.
4. Persistence and repetition are used after a request has been denied.

Question 3

The staff nurse would like to improve personal communication with peers, patients, and the medical staff. Which strategy would be most effective for this nurse?

Accepted Answer

1. Although being more assertive in communication could help this nurse, this is not the most complete option.
2. Working to manage fear of conflict is not the most complete option.
3. Learning to delegate clearly would help the nurse learn to communicate better, but this is not the most effective strategy.
4. Attending training on communication would be the best plan for this nurse. The strategies described in the other options would likely be included in this training.

Question 4

Which example represents a qualifier that may interfere with the message being communicated?

Accepted Answer

1. This is a direct command or request and does not contain a qualifier.
2. This is a valid inquiry that does not include a qualifier.
3. Qualifiers are often used as "entry statements" into important discussions, but they can interfere with the message being communicated. This qualifier ("I hate to bother you") sets up the receiver of the message to feel bothered. Qualifiers also reveal a lack of confidence in the sender.
4. This is a valid inquiry and does not include a qualifier.

Question 5

The nurse manager has instituted a policy of sending information to the staff in emails. Many misunderstandings have occurred since this policy was implemented. What technique should the manager use to reduce this miscommunication?

Accepted Answer

1. Text messaging can make the problem worse because it implies the need to respond quickly.
2. Having everyone send a return email will set the nurse manager up for an onslaught of messages that really are not important.
3. Email communication is fraught with difficulties. The best of these options is to be certain that emails go only to the intended recipients. The use of "reply to all" or distribution lists is convenient, but it can result in sending the email to people that it does not affect. When this happens, people begin to ignore email.
4. Sending the message line "Important" with each email is much like crying wolf, and recipients will soon realize that the term Important is meaningless.

Question 6

When the nurse manager orders supplies for the unit, which communication mode is best?

Accepted Answer

1. Telephoning an order leaves room for misinterpretation or inaccuracy in recording what was ordered.
2. To avoid misunderstanding what supplies are needed, a written request is the most appropriate choice. It avoids misunderstanding because the items can be checked off a list.
3. A verbal order in person may still result in double orders because there is no written record of what was ordered.
4. Voice mail may result in a mistake because there is no written record of what was ordered.

Question 7

A nurse has made several "near errors" in client care in the last 2 months. The nurse manager says, "These are simple errors. You just aren't listening." How could the nurse improve listening skills in this situation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

1. Thinking ahead in the conversation interferes with the ability to listen and comprehend.
2. Eye contact does not mean the nurse is listening.
3. When many people are talking at one time, it is difficult to listen and comprehend.
4. Being tired and stressed from too much time at work can cause energy to flag, resulting in difficulty listening.
5. Preconceived beliefs about what the speaker is going to say makes it more likely that the nurse is not going to listen effectively.

Question 8

What is the most important reason that excellent communication skills are essential for nurses?

Accepted Answer

1. Although nurses do communicate with all disciplines, the correct reason is broader.
2. Nursing activities occur in relationships, making communication skills essential.
3. Excellent communication skills can get the work done more quickly and effectively, but the correct reason is broader.
4. Excellent communication skills do not keep problems from occurring.

Question 9

In which situation should the nurse be most concerned that communication was distorted?

Accepted Answer

1. Just because this child is adopted does not mean that the admission history will not be correct or that communication with the child or parents will be impaired.
2. Just because a person is older does not mean that communication is impaired.
3. Just because the person is from another country does not mean that communication will be distorted.
4. Communication will be most affected by the confusion of the client because the nurse cannot be sure of anything the client said or that the client understood anything the nurse tried to communicate.

Question 10

The person who has just been promoted to nurse manager is male. If this nurse communicates in a way that is considered typical for men, what can the staff expect?

Accepted Answer

1. Men have been socialized to remain focused on the issue and avoid self-disclosure about personal experiences.
2. Men can tolerate disagreement within the group.
3. Men may be more apt to tolerate conflict than women are.
4. Women are more apt to ask questions to seek input.

Question 11

The nurse manager is counseling a male nurse about several recent incidents in which female nurses complained that he was abrupt and condescending. What advice should the manager give this nurse?

Accepted Answer

1. Males tend to communicate clearly and concisely, especially in professional relationships.
2. There are many gender differences in communication. Males tend to take responsibility and feel the need to "fix" things.
3. Using phrases such as "sort of" is a more common trait of female conversation than of male conversation.
4. Women tend to personalize, whereas men are more focused on the issues.

Question 12

During an evaluation conference, the nurse manager observes nonverbal messages, including nodding in agreement and smiling. These behaviors are examples of which aspect of communication?

Accepted Answer

1. Metacommunications are nonverbal messages conveyed by body language and environmental factors.
2. Intrasender conflict occurs when there is a difficulty in the interpretation of an intended message due to disparity between verbal and nonverbal communication.
3. Fogging is a communication technique in which one partially agrees with what was said.
4. Intersender conflict occurs when there is a difficulty in the interpretation of an intended message due to disparity between different sources.

Question 13

An inexperienced speaker is practicing delivering a speech. Which statement indicates a lack of understanding about how easily communication is distorted?

Accepted Answer

1. Eye contact can assist in keeping the message clear.
2. Repeating the message can assist in keeping the message clear.
3. Tailoring the message can assist in keeping it clear.
4. It does not matter how uncomplicated the topic is; misunderstandings and distortions can still occur.

Question 14

An employee is sabotaging the work of a newly oriented charge nurse, and the charge nurse has not been successful in addressing the problem. When the nurse manager addresses the issue, which is the most appropriate statement?

Accepted Answer

1. Acknowledging the person's frustration validates his or her feelings, and asking for input helps make him or her part of the solution.
2. This statement is confrontational and is unlikely to result in a positive response from the employee.
3. Threatening the employee, no matter how veiled the threat, is confrontational and is unlikely to result in a positive response.
4. Patronizing remarks are condescending and are not likely to result in a positive employee response.

Question 15

The nurse has been concentrating on improving personal communication skills. Which option represents the final step in this nurse's work to improve communication?

Accepted Answer

1. Thinking about the goals is assessment.
2. Developing an appropriate response is an implementation.
3. Deciding how to say what you want conveyed or how to deliver your response is an implementation or plan.
4. Ensuring all parties understand the communication is the last step as it involves evaluation.

Question 16

A problem has arisen on a unit with primarily Generation X nursing staff. Which strategies should the nurse manager employ to get staff input into solving this problem? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

1. Generation X members do not like group problem solving and decision making. This is more the style of Baby Boomers.
2. Generation X members would be more likely to read the information, formulate an opinion, and share it with the manager. They like decisions to be made without unnecessary discussion.
3. Generation X members do not like unnecessary discussion, so asking for input individually would be a good strategy.
4. Traditionalists are more likely to respond to a suggestion from someone higher in the chain of command. They also tend to be more formal.
5. Generation Y is more likely to want immediate feedback from emails or text messages.

Question 17

After several near-incidents during procedures, the nurse manager is increasingly concerned about how nursing staff members communicate with physician staff. Which advice from the manager would be most beneficial to the nursing staff?

Accepted Answer

1. This statement sets up an "us against them" mentality. This mindset does not support respect for the physicians and could make communication more difficult.
2. This statement sets up an "us against them" mentality. This mindset does not support communication.
3. The nurse manager should ensure that the nursing staff is competent in the procedures that are causing problems by reviewing the steps of the procedures with them.
4. The preconceived notion that the problems are the fault of the physicians would make open and honest communication more difficult.

Question 18

The nurse manager is concerned about a family member's complaint regarding the professional behavior of a nurse on the unit. Which is the most effective method to address this issue?

Accepted Answer

1. The purpose of a memo is to convey general information to a group; it has a low level of personal intimacy.
2. The purpose of email is to broadcast information to large groups; it has a low level of personal intimacy.
3. A telephone conversation is less intimate than face-to-face communication, and the individual's response cannot be seen.
4. More important or difficult issues should be communicated face-to-face to the nurse involved so that the individual's response can be seen and questions can be answered appropriately.

Question 19

The hospital chief operating officer holds monthly focus groups with the purpose of gaining ideas and insights from nursing administration and staff nurses. Which type of communication does this indicate?

Accepted Answer

1. Lateral communication involves discussion among individuals at the same hierarchical level (e.g., all nurse supervisors).
2. Downward communication involves direction given by management to the staff.
3. Diagonal communication involves dialogue among individuals at different hierarchical levels (e.g., staff nurses to chief executive officer of nursing).
4. Grapevine communication is an informal channel among individuals at all hierarchical levels and has the potential to generate misinformation.

Question 20

A nurse plans to seek employment in an acute-care setting after graduation. Which form of communication would be most effective in applying for a position?

Accepted Answer

1. This approach is too informal.
2. Applying for a job requires a high level of formality. A written cover letter and résumé are expected by most organizations offering employment opportunities. This submission would be done by email only if that is the organization's specific request.
3. This approach is too informal.
4. "Dropping in" to the manager's office is not professional. Any meetings generally occur at the request of the potential employer and would occur after the résumé and cover letter are sent.

Quiz 10: Communicating Effectively