Test bank for nursing leadership and management for patient safety and quality care 1st edition

Test Bank for Nursing Leadership and Management for Patient Safety and Quality Care 1st Edit

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Chapter 6: Effective Communication Multiple Choice Identify the choice that best completes the statement or answers the question. ____

1. The nurse leader has just observed a nurse whose behaviors indicate a possible substance abuse problem and knows that staff nurses have not reported these behaviors because of what most common reason?

1. The staff nurse believed that reporting a colleague required more skill than the nurse possessed.

2. The staff nurse did not believe it was his or her responsibility.

3. The staff nurse believed the compromised nurse was not hurting any patients.

4. The staff nurse thought that speaking up would not change anything.

____

2. The nurse leader believes that there may be a nurse on a medical-surgical unit who is redirecting a patient’s pain medication for individual use. The nurse knows that this can lead to what situation on the nursing unit?

1.

2.

3.

4.

____

3. The director of nursing (DON) has planned a meeting with unit managers and placed notices with the date, time, and place on the unit bulletin boards. When the time came for the meeting only one-third of the managers were present. The DON knows that what element of the communication process was overlooked in announcing this meeting?

1.

2.

3.

4.

____

Decreased nursing turnover Increased staff morale Increased productivity Increased patient safety issues

Message Decoding Sender Feedback

4. A staff nurse has made an appointment with the nurse leader to discuss a confidential issue. In what way can the nurse leader display active listening to the staff nurse?

1. Ask the staff nurse to be seated and sit on the desk in front of the nurse.

2. Avoid any head movement to avoid distracting the staff nurse.

3. Make sure that the nurse leader’s body language is seen as positive, or inviting, to the staff nurse.

4. The nurse leader should gaze at a spot slightly above the staff nurse’s head.

____

5. The nurse leader utilizes active listening with nursing staff to what most important end?

1.

2.

3.

4.

____

To encourage empowerment of staff To help the staff do things the way the nurse leader wants it to go To appear nicer and warmer to the nursing staff To cause all unit conflicts to disappear

6. The DON knows that which type of communication is most effective when discussing possible policy changes with a nurse manager who is 62 years of age?

Copyright © 2017 F. A. Davis Company

1.

2.

3.

4. ____

7. The nurse manager needs to have a discussion with a staff nurse concerning a statement from a family member of a patient who was discharged 3 weeks ago. Where would be the best place for the nurse manager to have this discussion with the staff nurse?

1.

2.

3.

4.

____

In the medication room In a corner of the nurse’s station In an empty patient room In the nurse manager’s office

8. The DON has informed all nurse managers that all staff must have a doctor’s excuse for all work absences that are caused by illness. What form of communication would be the most common way for the nurse manager to convey this information to the staff?

1.

2.

3.

4.

____

The DON should post a message to the nurse manager page on social media.

The DON should drop by the nurse manager’s office to discuss the matter.

The DON should send the nurse manager an e-mail.

The DON should send a group e-mail to all nurse managers with the policy attached.

A message posted on the unit bulletin board An e-mail directed to all staff A face-to-face meeting with each staff personally An announcement at the monthly staff meeting

9. The nurse manager will be using formal language in a presentation to the staff nurses about current evidence-based procedures. What elements of this form of language will be best for this nurse manager to use?

1.

2.

3.

4.

Provide the staff with a thorough history of the procedure.

Make the presentation and dismiss the staff.

Provide staff with a step-by-step direction of the new way to conduct the procedure.

Make sure to include all known medical terms related to this procedure.

____ 10. The nurse leader knows to do what to prevent grapevine communication on the nursing unit?

1.

2.

3.

4.

Ignore the information that is moving through the grapevine.

Share minimal information with staff to avoid promoting confusion.

Allow information that is in the grapevine to continue until it fades away.

Provide regular communication to the staff of the nursing unit.

____ 11. The nurse manager of an orthopedic unit has noticed that there are two nurses who do not appear to get along with each other. When these two nurses work the same shift, productivity is substantially lowered. The nurse manager contacts the nurse manager of the neurology unit for input in solving this issue and uses what type of organizational communication?

1.

2.

3.

4.

Downward communication Upward communication Lateral communication Diagonal communication

Copyright © 2017 F. A. Davis Company

____ 12. A new nurse manager will be leading an interprofessional team in developing evidence-based care paths for patients who require surgery but also have dementia. This manager will need assistance with communication during these meetings if the manager states that what is a general competency of interprofessional communication?

1. Obtain the ideas and opinions of the other team members.

2. Refrain from sharing the manager’s own knowledge about the discussion topics and allow team members to determine relevant information.

3. Make sure that all language used in the meetings is respectful.

4. Recognize that this new manager has unique skills that bring a positive contribution to the group.

Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 13. The nurse leader is using active listening skills during an important meeting with nursing staff concerning the budget for the next fiscal year. The leader realizes that what stages are necessary to be an effective active listener? Select all that apply.

1.

2.

3.

4.

5.

Attending Remembering Defending Reacting Understanding

____ 14. The nurse leader wants to ensure that all communication to nurse staff is received and understood and will use what characteristics to ensure that this occurs? Select all that apply.

1.

2.

3.

4.

5.

Be respectful of what others say.

Be sympathetic.

Use a commanding tone of voice.

Utilize sarcastic humor.

Encourage input from others in the meeting.

____ 15. The nurse leader has noticed some miscommunication between staff members in the recent past and plans to model what characteristics of effective communication? Select all that apply.

1.

2.

3.

4.

5.

Occurs in a timely manner Gives information that is accurate Brings resolution to all conflicts Is eagerly accepted Promotes quality patient care

Copyright © 2017 F. A. Davis Company

Chapter 6: Effective Communication Answer Section MULTIPLE CHOICE 1. ANS: 2 Chapter number and title: 6, Effective Communication Chapter learning objective: Discuss the importance of effective communication to safe and quality nursing care.

Chapter page reference: 119 Heading: Why Effective Communication Is Critical Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate Feedback 1 2 3 4

While a person’s lack of ability is one of the reasons a nurse does not speak up, the majority of nurses do not speak up because they believe it is not their responsibility.

The majority of nurses do not believe it is their responsibility to report other colleagues.

Most nurses are concerned that patients are at risk when cared for by the impaired nurse but do not feel it is their responsibility to report the situation.

Many nurses feel that speaking up would not change the situation, but the majority will not speak up because they feel it is not their responsibility.

PTS: 1 CON: Communication 2. ANS: 4 Chapter number and title: 6, Effective Communication Chapter learning objective: Discuss the importance of effective communication to safe and quality nursing care.

Chapter page reference: 119 Heading: Why Effective Communication Is Critical Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate Feedback 1 2 3 4

When nurses do not speak up and express concern over a possible impaired nurse, there is an increase in nurse turnover.

Decreased morale results when nurses do not report the behaviors of a possible impaired nurse.

When nurses do not speak up, the unit experiences decreased productivity.

When nurses do not report the behaviors of a possibly impaired nurse, there can be an increase in safety issues.

Copyright © 2017 F. A. Davis Company

PTS: 1 CON: Communication 3. ANS: 2 Chapter number and title: 6, Effective Communication Chapter learning objective: Describe the communication process.

Chapter page reference: 120 Heading: Basics of Communication Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate Feedback 1

2

3

4

The message is the content or information the sender is transferring and can be transmitted verbally, nonverbally, and in writing. The DON provided this information.

The most common issue is feedback or lack of it.

Decoding is the process of interpreting the message. The message was clear with time, date, and place of the meeting, but there is no evidence that feedback (determination that the message was received) occurred.

The sender is the person who begins the transfer of information or in this case the DON. The problem was most likely the feedback or that the message was not received adequately.

The most common problem in the communication process is feedback that determines if the message was received as intended. The sender put the message on bulletin boards because the sender assumed that it was a place where the nurse managers would look for such an announcement. Because only a few people attended the meeting, it may be assumed that there was inadequate feedback.

PTS: 1 CON: Communication 4. ANS: 3 Chapter number and title: 6, Effective Communication Chapter learning objective: Explain the importance of practicing active listening.

Chapter page reference: 123 Heading: Active Listening Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate Feedback 1 2 3

To promote active listening, the nurse leader should be seated squarely in front of the staff nurse. In this case, the nurse leader is sitting on a desk that is higher than a chair.

The nurse leader should not keep the head still but should employ head gestures, such as nodding, to let the staff nurse know that the nurse leader is listening.

The nurse leader should focus on adopting positive body language such as keeping the arms and legs uncrossed and leaning slightly forward to demonstrate active listening.

Copyright © 2017 F. A. Davis Company

4

The nurse leader should be on eye level with the staff nurse, not gazing slightly above the nurse’s head, to demonstrate active listening.

PTS: 1 CON: Communication 5. ANS: 1 Chapter number and title: 6, Effective Communication Chapter learning objective: Explain the importance of practicing active listening.

Chapter page reference: 123 Heading: Active Listening Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate Feedback 1

2 3 4

Benefits of active listening by a leader to staff include empowerment of staff and provision of information that facilitates work and quality improvement and speeds up problem solving and decision making.

It facilitates quality improvement, but it does not cause the staff to believe all the nurse leader tells them.

While showing interest in the staff, the nurse leader may appear friendlier, but that is not one of the benefits that the nurse leader is trying to attain.

While active listening by the nurse leader may lead to improved problem solving and decision making, it does not eliminate unit conflicts.

PTS: 1 CON: Communication 6. ANS: 2 Chapter number and title: 6, Effective Communication Chapter learning objective: Define factors that impact communication.

Chapter page reference: 124 Heading: Generation Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate Feedback 1

2 3 4

Staff who are baby boomers (born between 1947 and 1964) prefer personal forms of communication, so a message posted to a social media page would not meet the manager’s needs.

Baby boomers respond best to personal forms of communication, so dropping by the nurse manager’s office would be the preferred form of communication from the DON. Baby boomers prefer personal forms of communication, so an e-mail would not meet the nurse manager’s needs.

A group e-mail with an attachment would be the preferred communication of Gen X

Copyright © 2017 F. A. Davis Company

and Y, but baby boomers prefer personal forms of communication.

PTS: 1 CON: Communication 7. ANS: 4 Chapter number and title: 6, Effective Communication Chapter learning objective: Define factors that impact communication.

Chapter page reference: 125 Heading: Environment Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate Feedback 1

2 3 4

Although the medication room is often a closed area to the side of the nursing station, it is not private and the nurse manager should find a place where the staff nurse has the freedom to speak without being overheard.

There is no privacy in the nurse’s station, so this would not be an appropriate place for the nurse manager to discuss a serious situation with the staff nurse.

Although an empty patient room may be quiet and empty, there is no expectation of privacy in this situation.

The nurse manager’s office is the best place to minimize distractions and will be comfortable enough for the staff nurse to share confidential information.

PTS: 1 CON: Communication 8. ANS: 2 Chapter number and title: 6, Effective Communication Chapter learning objective: Define factors that impact communication.

Chapter page reference: 125 Heading: Roles and Relationships Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate Feedback 1 2 3 4

The most common way for nurse managers to communicate policy changes is by e-mail. A note on the bulletin board is not the most common way.

The most common way for the nurse manager to communicate policy change is by e-mail.

Personal face-to-face meetings are a way to communicate sensitive information. Policy changes are usually communicated by e-mail.

The most common method for a manager to communicate policy is by e-mail. Sensitive information is usually communicated in a face-to-face manner.

Copyright © 2017 F. A. Davis Company

PTS: 1 CON: Communication 9. ANS: 3 Chapter number and title: 6, Effective Communication Chapter learning objective: Compare and contrast informal and formal communication, and identify appropriate use of each.

Chapter page reference: 126 Heading: Formal and Informal Communication Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate Feedback 1 2

3 4

The nurse should provide clear, concise direction or instruction. A thorough history of the procedure would not be clear or concise.

The nurse manager who uses formal communication should seek frequent feedback.

Dismissing the meeting without any feedback is not an example of formal communication.

Providing the staff with a step-by-step paper procedure would be providing clear, concise directions or instructions.

In formal communication, all slang and jargon should be avoided, not including all possible terms possible.

PTS: 1 CON: Communication 10. ANS: 4 Chapter number and title: 6, Effective Communication Chapter learning objective: Compare and contrast informal and formal communication, and identify appropriate use of each.

Chapter page reference: 126 Heading: Formal and Informal Communication Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate Feedback 1 2 3 4

The nurse manager should monitor the grapevine and intervene quickly to provide accurate information.

The nurse manager should share as much information as possible with staff, not minimal information.

The nurse manager should attempt to stop the grapevine information to avert unrest and job dissatisfaction among employees. It should not be allowed to continue.

Staff members would rather hear information from the manager than through the grapevine, so the nurse manager should endeavor to have regular communication with the staff.

Copyright © 2017 F. A. Davis Company

PTS: 1 CON: Communication 11. ANS: 4 Chapter number and title: 6, Effective Communication Chapter learning objective: Delineate among organizational communication, interprofessional communication, and intraprofessional communication.

Chapter page reference: 127 Heading: Organizational Communication Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate Feedback 1 2 3 4

Downward communication is the sending of information from a nurse leader to the staff.

Upward communication is the sending of information from a staff nurse to the nurse leader.

Lateral communication is the sending of communication to someone at the same level, for example, nurse leader to nurse leader.

Diagonal communication is where a nurse leader communicates with someone at a different level of administrative hierarchy.

PTS: 1 CON: Communication 12. ANS: 2 Chapter number and title: 6, Effective Communication Chapter learning objective: Delineate among organizational communication, interprofessional communication, and intraprofessional communication.

Chapter page reference: 128 Heading: Interprofessional Communication Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate Feedback 1 2

3 4

Using active listening and encouraging ideas and opinions of other team members is an interprofessional competency statement.

The manager should express one’s knowledge and opinions to team members to ensure common understanding of information and treatment and care decisions, not refrain from expression of that knowledge.

Using respectful language is an interprofessional competency statement.

The recognition of one’s own uniqueness is an interprofessional competency statement.

PTS: 1

CON: Communication

Copyright © 2017 F. A. Davis Company

MULTIPLE RESPONSE 13. ANS: 1, 2, 5 Chapter number and title: 6, Effective Communication Chapter learning objective: Explain the importance of active listening.

Chapter page reference: 123 Heading: Active Listening Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate

1.

2.

3.

4.

5.

Feedback Attending is the second stage of active listening and involves engaging in the conversation by adopting positive body language, facial expressions, and gestures.

Remembering is the fifth stage of active listening and involves recalling previous conversations to establish a starting point when re-engaging.

Defending is not a stage in active listening and actually often defeats communication from being received at all.

Reacting is not a stage in active listening. The active listener should be alert to the information but refrain from reacting to the message at that time.

Understanding is the third stage of active listening and involves gaining an understanding of what is being said and what may not be said.

PTS: 1 CON: Communication 14. ANS: 1, 5 Chapter number and title: 6, Effective Communication Chapter learning objective: Explain the importance of active listening.

Chapter page reference: 123 Heading: Active Listening Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate

1.

2.

3.

4.

5.

Feedback The effective communicator is respecting of what others have to say.

The effective communicator has empathy, not sympathy.

The effective communicator asks, not commands.

The effective communicator avoids all use of sarcasm, including sarcastic humor.

The effective communicator encourages the input from others.

PTS: 1 CON: Communication 15. ANS: 1, 2, 5 Chapter number and title: 6, Effective Communication Chapter learning objective: Discuss the importance of effective communication to safe and quality patient care.

Copyright © 2017 F. A. Davis Company

Test Bank for Nursing Leadership and Management for Patient Safety and Quality Care 1st Edit

Chapter page reference: 128 Heading: Interprofessional Communication Integrated Processes: Communication and Documentation Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Communication Difficulty: Moderate

1.

2.

3.

4.

5.

Feedback One characteristic of effective communication is timeliness.

One characteristic of effective communication is accuracy.

Effective communication can assist with conflict resolution, but it does not resolve all conflicts.

Communication that is effective is understood but not necessarily accepted.

One characteristic of effective communication is that it fosters quality patient care.

PTS: 1

CON: Communication

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