A licensed practical nurse (LPN) has been practicing for 25 years on a unit where a newly graduated RN with a bachelor’s degree is hired. Before the RN arrives on the unit, the LPN is heard saying, “She’ll try to tell everyone what to do because she makes more money. She’ll sit at the desk and let us do all the work.” This is an example of a(n):

1. interpretation.
2. context.
3. precipitating event.
4. preconceived idea.

D

A new mother is experiencing pain after delivering an infant with Down syndrome. The staff nurse states, “I don’t think she is really hurting. Let the next shift give the pain medication.” The team leader notices the staff nurse looks agitated and anxious and asks about any concerns in providing care to this new mom. The staff nurse admits having a stillborn infant with Down syndrome. This is an example of which component of communication?

1. Personal perception
2. Past experiences
3. Filtration
4. Preconceived idea

B

A nurse gives Dilantin intravenously with lactated Ringer’s solution containing multivitamins. The drug precipitates and obstructs the only existing line. When the team leader informs the nurse that these drugs cannot be mixed, the nurse states, “Everyone just pushes the medicine slowly. No one checks for compatibility. There isn’t even a compatibility chart on the unit.” Which type of logical fallacy has influenced the nurse?

1. Ad hominem abusive
2. Appeal to common practice
3. Appeal to emotion
4. Appeal to tradition

B

An RN is consistently late to work, causing reassignment of patient care and the need for repeated shift reports. The nurse, who receives a warning for repeated tardiness, states, “My husband left me, I have no car, no family close by, and the bus is always late, which makes me late. The nurse manager doesn’t care how hard I try to get here, and I am raising a child by myself.” The nurse is using which type of logical fallacy?

1. Appeal to emotion
2. Appeal to tradition
3. Hasty generalization
4. Confusing cause and effect

A

The new director of nurses has instituted “walking rounds” on all nursing units, rather than the usual taped shift reports. A veteran nurse exclaims, “She doesn’t know how we do things here!” The nurse is demonstrating:

1. appeal to emotion.
2. appeal to tradition.
3. red herring.
4. straw man.

B

A male nurse hired to work in the emergency department is observed throwing a contaminated needle into the trash can. The team leader reprimands the nurse for not appropriately disposing of sharps. The nurse states, “You don’t care that I threw the needle in the trash. You just want an all-female staff,” putting the team leader in a defensive position. This communication technique is known as:

1. straw man.
2. red herring.
3. slippery slope.
4. confusing cause and effect.

B

A nurse who was recently certified in chemotherapy administration fails to check compatibility of phenytoin (Dilantin) before injecting into a continuous infusion of D5W leading to occlusion of the line. Which statement by the nurse demonstrates a red herring?

1. The nurse is upset and states, “I am sure I have injected this before without a problem” and the supervisor interprets this to mean the nurse often take shortcuts.
2. The nurse states, “You are just upset because I am certified in chemotherapy administration and you are not.”
3. “The nurse who started the IV didn’t get a blood return but determined the IV was the patient’s—that is the problem.”
4. “This drug always occludes the line because it is so viscous.”

B

During a health history interview, the nurse listens to a patient relating the precipitating events that led to the onset of chest pain. She focuses her attention on the patient, makes eye contact, and acknowledges what the patient has to say. The nurse is exhibiting:

1. assertive communication.
2. active listening.
3. empathy.
4. passive communication.

B

The nurse is demonstrating active listening when:

1. while assessing the patient’s vital signs, the nurse records the data and states, “You are improving, your vital signs are normal.”
2. eye contact is maintained while focusing on the patient as the patient describes the current pain level and location.
3. he or she states, “I know how you feel, I recently lost my father and I am still hurting.”
4. cultural values are in opposition to the patient but shares that “I agree with your decision to use herbs rather than the prescribed medications.”

B

An older adult is unable to reach the telephone and is found dead at home several hours later. The son of the deceased person arrives at the hospital and asks, “Can I just please stay and hold my dad’s hand? He was so afraid of dying alone.” Which response by the nurse shows empathy?

1. “You are just too late for that. Where were you when he needed you?”
2. “Did you ever consider purchasing a cell phone for your dad to prevent this from happening?”
3. “I’ll close the door so you can spend time with your dad. I will check back in a few minutes.”
4. “I lost my dad last year. He died alone. He was a policeman. I am just like you. Let me stay here and console you.”

C

A nurse is preparing an exercise program as part of a health promotion program for older adults with osteoporosis. Which question would retrieve the most valuable information about health practices?

1. “Do you exercise?”
2. “Do you like to exercise?”
3. “When do you exercise?”
4. “What exercise practices do you participate in?”

D

Which component of an e-mail shown below would be both effective and concise?

1. Subject: A short concise subject line: Meeting.
2. Body: I would like you to answer these questions before the next meeting: Where would you like to meet? Do you want all the staff to attend? Can we serve refreshments? What is one goal for our unit?
3. Body: Dear Staff, As you know, each department must reduce staff by 2%. We will need to discuss how to inform unlicensed staff about the downsizing efforts of the hospital.
4. Body: The next staff meeting is scheduled for Tuesday, January 19, at 5 PM in the first floor auditorium. Please send items for the agenda. Sally Smith, MSN, RN, smith@hospital.org or ext. 5582.

D

During height and weight assessments at a school’s health fair, a child admits to drinking a cup of coffee with his mother every morning, and another child reports enjoying a morning cup of coffee on the commute to school. These two children are both below average on the height chart, and the nurse states, “Drinking coffee stunts a child’s growth.” This logical fallacy is referred to as:

1. appeal to common practice.
2. confusing cause and effect.
3. ad hominem abusive.
4. red herring.

B

A patient’s spouse was just diagnosed with lung cancer although there was no history of tobacco use. The spouse states, “I am so mad. How can you get cancer without smoking?” Which statement by the nurse represents empathy?

1. “Research is identifying many risk factors for cancer besides smoking.”
2. “I understand how you could feel angry about the diagnosis.”
3. “He is still a good husband.”
4. “Why do you think he got cancer?”

B

A nurse wants to apply open communication to obtain a thorough history and to determine cognitive function. Which question represents the use of open communication?

1. Is today Wednesday?
2. Do you know what day it is?
3. Tell me what day of the week today is.
4. Do you know what the first day of the week is?

C

The nurse caring for a patient states, “Your blood pressure is dangerously high. Are you taking antihypertensive medicine?” The patient states, “I can’t afford my medicine. I have no insurance.” The nurse states “I feel really sorry for that patient. I wish it wasn’t against policy to give her money.” The nurse wants to help and places a note on Facebook that any donations would be appreciated to help a waitress who works at the cafeteria next door to the hospital buy her medications. The nurse posts that “She was so sick last evening when she came to the ED. I can’t believe they don’t provide insurance. I can’t give her money but you all can help.” This nurse:

1. is showing empathy and as long as she lets the patient know the money is not from her, she is not violating any social media guidelines.
2. is at risk for HIPAA violations.
3. has properly followed policy and protected the patient by not using her name.
4. is demonstrating the logical fallacy of slippery slope.

B

A group of nurses are meeting to decide how to staff the upcoming holidays. Each of the four members freely expresses thoughts about fair staffing but is willing to listen to other thoughts and reconsider their first recommendations. The nurses are avoiding conflict and supporting professional communication through:

a. empathy.
b. positiveness.
c. supportiveness.

d. accommodation.

C

A nurse is asked to “float” to another area where the patients require total care. The nurse smiles, picks up her stethoscope, and says, “I’ll come back and eat lunch with everyone here.” When she enters the elevator she hits the wall and mutters, “Always me. Don’t I have any rights”? The nurse is demonstrating which communication style?

a. Assertive
b. Aggressive
c. Passive
d. Passive-aggressive

D

A nurse is overhead saying, “I don’t mind working during the election and holiday. My parents are divorced, money is tight, and honestly I don’t trust any politicians anyway. I plan to take a few weeks off next month.” She works independently to research strategies to improve patient-centered care for the large number of immigrants that arrived in the area and then works with the team to share ideas. She recommends, “Let’s think the suggestions over and come back together next week.” This nurse’s communication style is consistent with which generation?
a. Baby Boomers
b. Traditionalist
c. Generation X
d. Millenniums

C