Chapter 3: Effective Communication multiple choice



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Chapter 3: Effective Communication
MULTIPLE CHOICE
1. A number of trends have been identified that impact communication, especially health care communication. Which of the following is not one of these identified trends?

a.

increasing diversity

b.

aging population

c.

more nurses

d.

technology

ANS: C


A variety of trends have been noted that can impact effective communication in society. These trends can also influence communication in health care environments and make it challenging for nurses and other health care professionals. Some of these identified trends are: 1) increasing diversity of the United States; 2) aging population; 3) technology; and 4) reliance on written communication using electronic data causing a shift from visual, auditory, and kinesthetic modes. Even with these changes in trends, nurses are still required to have keen writing skills in order to communicate effectively.

PTS: 1 DIF: Comprehension

TOP: Trends in Society that Affect Communication
2. A written assignment sheet provides a number of different functions that assist the nurse with delegation and patient care functions. Which of the following is not one of these expectations of a written assignment sheet?

a.

transmits information on what care is to be provided by whom per shift

b.

provides NAPs with a list of patients they are to care for per shift

c.

provides nurse with a list of patients they are responsible for per shift

d.

lets the nurse delegate care and responsibility to others

ANS: D


The written assignment sheet is one method in which nurses can organize and delegate patient care to members of the health care team. Some of the functions and expectations of a written assignment sheet include: 1) transmits information on what care is to be provided by whom per shift; 2) provides NAPs with a list of patients they are to care for per shift; and 3) provides nurses with a list of patients they are responsible for per shift. While the registered nurse does use the written assignment sheet to delegate and assign care, the responsibility for care ultimately remains with the nurse, as NAPs can provide care, but cannot assume full responsibility for patient care.

PTS: 1 DIF: Analysis TOP: Elements of the Communication Process


3. Three questions have been identified which can assist nurses seeking effective communication. Which of the following is not one of these three questions?

a.

Was the communication received and the message met with agreement?

b.

Was there a sender and receiver for the communication?

c.

Was the communication received?

d.

Did the communication change behavior and result in the intended outcome?

ANS: A


Three key questions have been noted to assist nurses in enhancing effective communication. These three questions are: 1) Was there a sender and receiver for the communication?; 2) Was the communication received? (not necessarily whether the message was agreed with or not); and 3) Did the communication change behavior and result in the intended outcome?

PTS: 1 DIF: Application TOP: Communication Skills and Delegation


4. A number of important skills pertaining to communication have been defined to assist nurses with effective communication. Which of the following is not one of these important identified skills?

a.

attending

b.

responding

c.

commenting

d.

clarifying

ANS: C


Four key communication skills have been noted to assist nurses with facilitating effective communication. These most important skills are: 1) attending; 2) responding; 3) clarifying; and 4) confronting.

PTS: 1 DIF: Comprehension TOP: Communication Skills


5. The communication skill that involves active listening is called __________.

a.

responding

b.

clarifying

c.

commenting

d.

attending

ANS: D


Four important skills that impact effective communication for nurses are attending, responding, clarifying, and confronting. The skill of attending requires active listening, and that the nurse pay close attention to what is being communicated verbally and nonverbally.

PTS: 1 DIF: Knowledge TOP: Attending


6. Which skill emphasizes that communication becomes clear through the use of techniques such as restating and questioning?

a.

clarifying

b.

confronting

c.

commenting

d.

attending

ANS: A


The communication skill of clarifying involves techniques to ensure that the communication message was clear and received correctly. Clarifying involves the use of restating and questioning which can be used in responding as well as clarifying the content of the message.

PTS: 1 DIF: Knowledge TOP: Clarifying


7. Verbal and nonverbal acknowledgments of the sender’s message pertain specifically to which of the following communication skills?

a.

attending

b.

responding

c.

commenting

d.

clarifying

ANS: B


The communication skill of responding pertains to the acknowledgment of the sender’s message. This acknowledgment may be done verbally, nonverbally, or through a combination of both such as nodding one’s head and stating a verbal affirmation that the message has been received.

PTS: 1 DIF: Comprehension TOP: Responding


8. Wiseman (2004) noted four principles pertaining to luck in his book The Luck Factor: The Four Essential Principles. Which of the following is not one of these factors?

a.

Lucky people create, manifest, and act on chance opportunities in their life.

b.

Lucky people make successful decisions by using their intuition and gut feeling.

c.

Lucky people’s expectations about the future help them fulfill their dreams and ambitions.

d.

Lucky people are able to transform their bad luck into good fortune.

ANS: A


Wiseman’s (2004) The Luck Factor: The Four Essential Principles noted four key elements that pertain to luck and some individual’s perception of how luck can influence their life and careers. These four principles are: 1) lucky people create, notice, and act on chance opportunities in their life (not manifest); 2) lucky people make successful decisions by using their intuition and gut feeling; 3) lucky people’s expectations about the future help them fulfill their dreams and ambitions; and 4) lucky people are able to transform their bad luck into good fortune.

PTS: 1 DIF: Comprehension

TOP: The Professional Role of the Nurse
9. An internal locus of control is __________.

a.

believing that luck or fate determines what will happen

b.

geared toward goal setting, taking control of one’s life, and not requiring assistance for decision making

c.

focusing mainly on day-to-day events

d.

focusing mainly on future events and preparing diligently for a potential problem

ANS: B


Locus of control pertains to one’s perception of environmental control or influence over the environment. An individual with an internal locus of control is geared toward goal setting, taking control of one’s life, and not requiring assistance for decision making. Individuals with an external locus of control may wait for others or believe that luck or fate determine what will happen. Time orientation also contributes to how an individual or group behaves in a given situation. Individuals with a present-oriented culture focus mainly on day-to-day events. Individuals with a future-oriented culture focus mainly on future events and prepare diligently for a potential problem, whereas past-oriented cultures focus primarily on their tradition and the maintenance of that tradition.

PTS: 1 DIF: Comprehension TOP: Environmental Control


10. Which of the following is not one of the values, behaviors, or attributes exhibited by a “professional” according to Flexner (1915)?

a.

intellectual activities

b.

activities based on knowledge

c.

techniques are new

d.

altruism motivates work

ANS: C


A number of authors have defined characteristics that describe a “professional.” Flexner (1915) identified seven characteristics of a professional which are: 1) intellectual activities; 2) activities based on knowledge; 3) techniques are teachable (not necessarily new); 4) altruism motivates the work; 5) activities can be learned; 6) activities must be practical; and 7) a strong organization exists.

PTS: 1 DIF: Application TOP: The Professional Role of the Nurse


11. Four essential dimensions of nursing have been described. When nurses provide focus on the response of the individual and family to a real or potential health problem, under which of these four dimensions are they practicing?

a.

nursing

b.

distinctive services

c.

benefits to consumers

d.

costs of nursing services

ANS: B


Four essential dimensions that pertain to nursing have been identified which influence nursing behaviors and decision making. These four dimensions are nursing, distinctive services, benefits to consumers, and costs of nursing services. When a nurse provides focus on the response of the individual and family to a real or potential health problem, he or she is acting under the dimension of distinctive services.

PTS: 1 DIF: Application TOP: The Professional Role of the Nurse


12. Some possible professional behaviors and attributes of a professional (Mitchell & Grippando, 1994) are listed below. Which is not necessarily correct regarding professional attributes and behaviors?

a.

time management skills

b.

caring

c.

initiative

d.

motivation

ANS: B


Mitchell & Grippando (1994) have listed some possible characteristics of a professional broken down into two categories: professional values, and professional behaviors and attributes. Characteristics that fall under professional behaviors and attributes include: 1) time management skills; 2) initiative; 3) motivation; 4) stress management; 5) creativity; and 6) self-discipline. Characteristics that fall under the category of professional values include: 1) caring; 2) altruism; 3) equality; 4) freedom; 5) ethics; and 6) truth.

PTS: 1 DIF: Comprehension

TOP: The Professional Role of the Nurse
13. Ellis (2002) identified four irrational ideas which can lead to anger which are important for nurses to understand and recognize. Which of the following is not one of these four irrational ideas?

a.

awfulizing

b.

can’t-stand-it-itis

c.

shoulding and musting

d.

blaming and damning others

ANS: D


Anger has been defined as a strong universal feeling of displeasure that may be precipitated by an event or situation which causes frustration or prevents an individual from reaching a goal. Ellis (2002) noted that anger tends to have four irrational responses that impact its influence over a given situation. These irrational responses are: 1) awfulizing; 2) can’t-stand-it-itis; 3) shoulding and musting; and 4) undeservingness and damnation (not blaming and damning others).

PTS: 1 DIF: Knowledge TOP: Anger


14. Three methods to deal with anger, but which may have potentially destructive drawbacks, are listed below. Which is not necessarily correct?

a.

aggression and confusion

b.

denying and repressing anger

c.

expressing anger

d.

turning the other cheek

ANS: A


Anger is an emotional response to a situation either real or perceived which nurses and other health care professionals may encounter on a fairly regular basis. Several methods for dealing with anger exist, but some of these may have unanticipated or potential drawbacks. Three of these methods are: 1) denying and repressing anger (may cause resentment); 2) expressing anger (may lead to defensiveness on the part of the respondent); and 3) turning the other cheek (may contribute to continued mistreatment and a lack of trust).

PTS: 1 DIF: Application TOP: Anger


15. Incongruent responses occur when the words or behaviors used in communications do not match or are inappropriate to the context of the message. Four types of congruent responses are listed below. Which is not necessarily correct?

a.

blaming

b.

placating

c.

threatening

d.

being super reasonable

ANS: C


The use of incongruent responses can contribute to miscommunication and lack of understanding. Some common forms of incongruent responses include: 1) blaming; 2) placating; 3) being super reasonable; and 4) using irrelevant information for decision making (not threatening).

PTS: 1 DIF: Application TOP: Incongruent Responses


16. Groupthink occurs when a need or desire for consensus and harmony override individual rational choice in a group or team environment. A number of symptoms of groupthink have been identified and are listed below. Which is not necessarily correct?

a.

illusion of invulnerability

b.

collective irrationalism

c.

self censorship

d.

illusion of unanimity

ANS: B


Groupthink can be destructive to the functioning of a group or team. Groupthink occurs when the need for maintaining a pleasant atmosphere supercedes the need to reach a good decision (Shortell & Kaluzny, 2006). Janis (1972) identified some characteristics or symptoms which may indicate the potential for groupthink behaviors and attitudes. These symptoms include: 1) the illusion of invulnerability; 2) collective rationalism (not collective irrationalism); 3) self censorship; 4) illusion of unanimity; 5) the use of mindguards; 6) pressures to conform; 7) belief in the inherent morality of the idea; and 8) stereotyping of others.

PTS: 1 DIF: Comprehension TOP: Avoiding Groupthink


17. The Myers-Briggs personality types are based on a psychological testing instrument which consists of four major pairs of categories of people. Which of the following is not one of these four pairs of categories?

a.

knowing or growing

b.

introvert or extrovert

c.

sensing or intuitive

d.

thinking or feeling

ANS: A


The Myers-Briggs Type Indicator (MBTI) is a psychological testing instrument which has been used to define personalities according to four pairs of categories which can then be divided into one of sixteen possible combinations of these original four category pairs. These category pairs are: 1) introvert or extrovert; 2) sensing or intuitive; 3) thinking or feeling; and 4) judging or perceiving (not knowing or growing).

PTS: 1 DIF: Comprehension

TOP: Myers-Briggs Personality Types
18. The SBARR tool is an effective method for communication between nurses and health care practitioners. Which of the following is not correct regarding SBARR?

a.

S= situation

b.

B=background

c.

R= recommendation

d.

A= advice

ANS: D


The SBARR tool has proven to be an effective means of enhancing communication between nurses and health care providers or practitioners. Miscommunication is one of the leading contributors to medical errors. The acronym SBARR means: 1) S= situation; 2) B=background; 3) A=assessment (not advice); 4) R= recommendation; and 5) R= response.

PTS: 1 DIF: Knowledge TOP: Communicating with Health Care Practitioners


19. Todd Bishop, a Crew Resource Management expert, developed a five-step assertive statement process that emphasizes inquiry and advocacy in effective communication. Which of the following is not one of this five-step process?

a.

State your concern.

b.

State the problem as you see it.

c.

State a solution.

d.

State the need for your solution.

ANS: D


Crew Resource Management (CRM) is a method for effective team management developed by aviation crews stressing safety concerns (Helmreich, 2000). CRM encourages an environment where the freedom to respectfully question is encouraged. Todd Bishop developed a five-step process of assertive statements that can be used in CRM to foster effective and appropriate communication. These five steps are: 1) opening or attention getter statement; 2) state your concern; 3) state the problem as you see it; 4) state a solution; and 5) obtain agreement (not state the need for your solution).

PTS: 1 DIF: Comprehension

TOP: Crew Resource Management
20. At times, nurses must work with difficult or destructive people. Some specific strategies for coping with difficult behaviors are listed below. Which is not necessarily correct?

a.

Criticizer: Don’t argue; ask for input and practice active listening.

b.

Detailer: Engage in communication, and ask direct questions.

c.

Controller: Keep focused on the task, and note any inconsistencies in the controller’s conversations.

d.

Pleaser: Let pleasers know that their comments are safe from attack and their opinions and input are valued.

ANS: B


Destructive or difficult behaviors can impair communication and effective quality patient care. Five key behaviors have been identified as being destructive or difficult to deal with. Some coping strategies that nurses can use when working with these types of behaviors are: 1) Criticizer: don’t argue, ask for input, and practice active listening; 2) Detailer: allow the detailer to give details at certain points in a group; 3) Controller: keep focused on the task, and note any inconsistencies in the controller’s conversations; 4) Pleaser: let pleasers know that their comments are safe from attack and their opinions and input are valued; and 5) Passive people: engage in communication and ask direct questions.

PTS: 1 DIF: Analysis TOP: Destructive or Difficult Behavior


MULTIPLE RESPONSE
1. Communication has been defined as an interactive process between the sender and receiver and can be influenced by a number of different processes. Which of the following are some of these processes that can influence communication?

a.

status

b.

emotions

c.

needs

d.

values

e.

ethnicity

f.

education

ANS: B, C, D, F

Communication is an interactive process where a verbal or nonverbal message is sent from one individual to another which involves feedback. Some processes that can impact communication are: 1) emotions; 2) needs; 3) values; 4) education; 5) perceptions; 6) culture; 7) goals; 8) literacy; 9) cognitive ability; and 10) communication mode.

PTS: 1 DIF: Analysis TOP: Elements of the Communication Process


2. What are the four “Cs” of communication?

a.

clear

b.

clinical

c.

concise

d.

correct

e.

compact

f.

complete

ANS: A, C, D, F

Zerwekh and Claborn (2009) identified four “Cs” for effective communication particularly in nursing and health care environments. They are: 1) clear (does the team member understand what is being said?); 2) concise (has the sender confused the direction by providing too much unnecessary information?); 3) correct (is the direction given in alignment with policies, procedures, job description, and the law?); and 4) complete (does the team member have all the information necessary to complete the task?).

PTS: 1 DIF: Knowledge TOP: Communication Skills and Delegation


3. Ruthman (2008) has identified a number of communication skills that may be used to enhance communication. Some of these have already been discussed such as confronting and clarifying. Which of the following are some of these additional communication skills?

a.

focusing

b.

commenting

c.

using silence

d.

using disagreement

e.

conveying acceptance

f.

asking nonrelated questions

ANS: A, C, E

Ruthman (2008) noted a number of skills that are important for communication. Some of these skills are: 1) focusing; 2) using silence; 3) conveying acceptance (not using disagreement); 4) asking related questions (not nonrelated questions); 5) reassuring; 6) supporting; and 7) open-ended questioning.

PTS: 1 DIF: Application TOP: Communication Skills


4. Six cultural phenomena have been defined by Giger and Davidhizar (2008) that should be considered when delegating patient care to staff members. Which of the following are not some of these six cultural phenomena?

a.

space

b.

social organization

c.

time

d.

environmental grounding

e.

biological variations

f.

age

ANS: D, F

Culture and cultural orientation can also play a significant role in how communication is given and received. Giger and Davidhizar (2008) have identified six key cultural phenomena which can impact communication. These six phenomena are: 1) space; 2) social organization; 3) time; 4) environmental control (not environmental grounding); 5) biological variations; and 6) communication (not age).

PTS: 1 DIF: Comprehension TOP: Culture and Delegation


5. Potential barriers to effective communication can impact how the message is delivered and if it is received. Which of the following are some of these barriers to communication?

a.

stereotyping

b.

internal locus of control

c.

inattention

d.

stress

e.

past-oriented culture

f.

giving advice

ANS: A, C, D, F



Barriers to communication are important for nurses to be aware of especially when they are encountered in practice. Nine potential barriers to communication have been noted by Ruthman (2008). These barriers are: 1) stereotyping; 2) inattention; 3) stress; 4) giving advice; 5) incongruent responses; 6) unclear expectations; 7) interrupting; 8) being defensive; and 9) offering false reassurance.

PTS: 1 DIF: Analysis TOP: Potential Barriers to Communication


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