Effective Communication and Teamwork in Nursing: Exam Questions and Answers for 2024, Exams of Nursing

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NUR 219 Exam Questions With 100%

Correct Answers 2024

Communication - Correct Answer-- Written

• In person Team building/ collaboration - Correct Answer-- Discuss the communication for a successful team
• ID how to evaluate performance and give feedback Conflict - Correct Answer-- ID types
• Recognize methods to resolve/ combat lateral violence Lateral violence - Correct Answer-- Examples
• Discuss methods to resolve/ combat lateral violence Process of communication - Correct Answer-- It is a complex, ongoing process between participants who create a shared meaning in an interaction

• It has content and value, the content regards to what was said, while the value pertains to how it was said.
• Nursing is composed of knowledge, clinical work and interpersonal communication Communicating effectively- written communication - Correct Answer-- SBAR tool
• Event information
• Assessment/ orders Communicating effectively- in person communication - Correct Answer-- verbal
• non verbal What is essential for written communication - Correct Answer-- Clarity: objective/ subjective info fm the pt and fam
• Components of an assessment: clear understanding of normal values chart by exception
• Event writing: objective info and facts chronological

Verbal communication - Correct Answer-- Accurate

• Straightforward
• Professional without bias
• Speak slowly and clearly
• reflect Examples of verbal communication techniques of acceptance - Correct Answer-- Pt- I have done something terrible
• RN- I would like to hear about it, it is okay to discuss it with me Examples of verbal communication techniques of restatement
• Correct Answer-- Pt- I hate this place. I dont belong here
• RN- you dont want to be here? Acceptance - Correct Answer-- receive info in a nonjudgmental manner

Restatement - Correct Answer-- repeating the main idea expressed; lets pt know what was heard Example of verbal comm tech- validation - Correct Answer-- pt- my doctor didnt explain my dx to me

• RN- let me see if i understand Validation - Correct Answer-- clarifying the nurses understanding of the situation Non- verbal communication - Correct Answer-- May be more powerful than words we speak
• includes direct eye contact, tone of voice, gestures of hands
• be aware of timing and environment
• be careful of distractions Therapeutic communication - Correct Answer-- Pt centered approach where nurses est effective interactions with their pt to deliver holistic and quality care

Therapeutic communication - Correct Answer-- With each pt interaction, you are building an interpersonal relationship. -As senior students, there should be a deeper understanding of the real meaning of the message in interacting with the pt. Therapeutic communication - Correct Answer-- You can confidently discuss pt's needs and preferences to improve pt safety and satisfaction and provide a quicker healing process. Why is therapeutic communication so important? - Correct Answer-- It eliminates fear, anxiety, and stress in your pt. The nurse recognizes their own beliefs, thoughts, biases, and limitations.

• They avoid projecting their own emotional issues to the pt and foster a nonjudgmental attitude and effective engagement techniques Information exchange strategies in healthcare - Correct Answer-- SBAR
• call out
• handoff
• CUS- concerned, uncomfortable, safety

What does SBAR provide - Correct Answer-- A tool for team members to effectively communicate info to one another Situation- what is going on with the pt Background- what is the clinical background or contex Assessment- what do i think the problem is Recommendation- what would i recommend Call- out/ read back and verified - Correct Answer-- A strategy used to communicate important or critical info

• informs all team members simultaneously during emergency situations -helps a team member anticipate next steps

Ex of call-out/read back and verified - Correct Answer-- Ex: you have called a code on your pt. you have to be certain all info is spoken out loud and correct

• all responders have a role. MD., nurse, respiratory, supervisor Handoff description - Correct Answer-- A transfer of info (along with authority and responsibility) during transition of care across the continuum; to include the opportunity to ask questions, clarify and confirm info Handoff components - Correct Answer-- increases accountability
• decreases uncertainty
• communicate verbally
• opportunity for questions CUS (concerned, uncomfortable, safety) - Correct Answer-- getting the physcians attentions when you really need it

CUS EX - Correct Answer-- "im concerned that ms. c is not her usual self. Im uncomfortable that she is behaving so oddly. I believe she is not safe; she may have something going on we are missing" 4 Cs of teamwork - Correct Answer-- communication

• coordination
• collaboration
• consenus Managing team communication - Correct Answer-- active listening
• assertive behavior
• providing feedback
• saying no
• confrontation Active listening in team comm - Correct Answer--telling others that you value both what they have to say and their participation in team activities

Assertive behavior in team comm - Correct Answer-- asking for what one wants and needs and doing it in a respectful way Providing feedback in team comm - Correct Answer-- provides reassurance and support. can be postive or negative Saying no in team comm - Correct Answer-- est professional/ personal boundaries with those around you Confrontation in team comm - Correct Answer-- process of directly expressing ones view of a prob situation with the person involved Group process - Correct Answer-- coming together for a specific purpose or objective

• each group will have a leader that motivates and moves the group towards decisions and details. There may even be a co- leader. That role can be formal or informal Group roles - Correct Answer-- monopolizer
• silent member
• energizer

• follower
• recorder Group role- monopolizer - Correct Answer-- they constantly talk or interrupt others. They want to be heard and can be aggresive at times. they may be anxious and talking a lot subsides their fear. or they may be passionate about the topic of choice Group role- silent member - Correct Answer-- they function by being quiet. they may still be productive part of the group by doing other tasks. in general may be comfortable speaking in front of others Group role- energizer - Correct Answer-- they attempt to stimulate the group to make decisions or provide motivation to accomplish tasks Group role- follower - Correct Answer-- just goes along with the movement of the group Group role- recorder - Correct Answer-- writes ideas, types up data into comp. and serves as group memory

Stakeholder - Correct Answer-- A person or group of people that have direct interest in something you are trying to do or achieve Conflict - Correct Answer-- two or more individuals with different values, perspectives, goals or needs view things differently

• can happen in any environment
• intrapersonal- occurs within an individual
• interprofessional- occurs bw 2 or more indiv. within an organization Ex of conflict; interaction with physicians - Correct Answer-- A plastic surgeon came in to suture up a patient with a pretty bad facial wound. He asked for certain instruments and dressings to have at bedside. After we got started, the hemostat wouldn't click closed. He tried numerous attempts and got so frustrated, he threw the entire tray across the room. Later, he apologized for his behavior.

Ex of conflict; interaction of patients - Correct Answer-- A patient admitted with a small bowel obstruction was due for an AM abd. X-ray. By 11, the patient was pacing and anxious. After calling radiology, they were absolutely slammed with ER priorities. By 1, still NPO, the patient called our VP of Nursing to say how incompetent we were. Finally, he got his x-ray around 3, was discharged home and had a bad experience/review of his hospital stay because of one department. Conflict resolution- key pnts - Correct Answer-- consider the source - an ill pt, scared fam member, an overworkdr colleague

• acknowledge their pain and feelings (listening is crucial in nursing)
• reason with them/ explain the rationale
• give them time to consider if appropriate
• evaluate and re- visit the source of the conflict Approaches to conflict resolution - Correct Answer-- compromise
• accommodation
• competition

• collaborating Compromise - Correct Answer-- This method involves handling the conflict by reaching a resolution that involves a "win" on both sides of the table. Both parties are happy and find that middle ground! Accommodation - Correct Answer--The person suppresses and smooths over differences because they dread conflict. They want to do whatever it takes to maintain harmony. Competition - Correct Answer-- These folks always want to be the winner. That gives them a sense of pride and achievement. Losing makes them appear as a weak, inadequate and failing individual.
• They can attack, overpower, overwhelm and intimidate. Collaborating - Correct Answer-- This style maximizes both assertiveness and cooperation. The attempt is made to fully satisfy the interest of both parties. It works best when the conflict in not intense and when each party has information that is useful to the other.

Conflict resolving methods DESC - Correct Answer-- Describe the specific situation or behavior; provide concrete data

• Express how the situation makes you feel (ex- uncomfortable) and what your concerns are
• Suggest other alternatives and seek agreement
• Consequences should be stated in terms of impact on established goals; strive for consensus Workplace violence - Correct Answer--Any violent act, including physical assaults and threats of assault, directed towards persons at work or on duty. People working in healthcare are particularly vulnerable to these attacks because of the intense environment we work in. -Can range from physical injuries, psychological trauma or death. -Violence from patients or family members is more likely to occur in Emergency departments, psychiatric settings, waiting rooms and geriatric units.

Recognize the signs that an issue may be escalating into a potential violent scene. Nurses are front-line in reducing aggression in patients, visitors and co-workers. - Correct Answer-* Family member is upset about the care given to their loved one. Listen to them and their frustrations - Correct Answer-* Know your resources!!! If you need back-up, you need to know who to call for help. (Code Yellow-need security and a supervisor STAT!!!) Don't be a hero! - Correct Answer-* Always keep yourself and the patient safe!! If it's a visitor or family member that is violent, get yourself to a safe place to prevent them from harming you. If the patient is exhibiting signs of violence, make sure their environment and their well-being is protected. (Using bed alarm and restraints, decreasing stimuli, remove objects that could be harmful) - Correct Answer-

Horizontal (lateral) violence in the workplace - Correct Answer-- When co-workers commit acts of aggression against their co-workers. -These are the people you work with on a daily basis, some are like family. But when tensions run high or you have a real difference of opinion. It can get ugly. -The acts can range from mild to severe..... Horizontal (lateral) violence in the workplace ex - Correct Answer--Ignoring the person or giving the silent treatment -Making ugly remarks purposely within hearing -Ridiculing the individual or gossiping around others -Direct verbal abuse -Sexual harassment -Physical attack Cognitive rehearsal - Correct Answer--Way in which nurses can mentally prepare yourself to address threats from incivility or bullying.

What can be done about workplace bullying - Correct Answer-- Most organizations/facilities have created policies addressing the code of conduct addressing bullying. There is a zero tolerance in most healthcare environments. -They are hosting regular training sessions to empower employees when to recognize it and be coached on the proper way to communicate what is going on. -SPEAK UP!!! No one knows until you say something if incidents keep occurring between yourself and a co-worker. There is always ways to resolve situations, you must be your own advocate when you know a relationship is unhealthy.

• most are caused bc of personality diff or completion wihtin workplace -The nurse is caring for a client who had an open cholecystectomy 24 hours ago. The client's vital signs have been stable for the last 24 hours, but the client now has a temperature of 101.1F (38.4 C), a heart rate of 116 beats/min, and a respiratory rate of 26 breaths/min. Using SBAR communication, which of the following recommendations should the nurse make when calling the physician? Select all that apply. - Correct Answer--Draw stat Blood cultures X2, CBC and BMP.
• Start broad-spectrum IV antibiotics after blood cultures are drawn.

• Obtain UA with culture and sensitivity if indicated. A client is brought to the Emergency Department dead on arrival (DOA) from a gunshot wound. The client's family arrives and is escorted to a private area. A multidisciplinary team composed of a physician, nurse and social worker interacts with the family. All members work together to complete the following tasks. Which are the priority nursing responsibilities? Select all that apply. - Correct Answer-- Providing therapeutic touch and support as needed -Caring for body organs which are appropriate for transplantation. -Escorting the client's family for viewing of the body. The charge nurse finds the mother of the child with a chronic bladder condition requiring clean intermittent catheterization (CIC) visibly upset. The mother states, "That other nurse said parents are not allowed to perform CIC in the hospital because of increased infection risk." The charge nurse should tell the parent: - Correct Answer--"You can use CIC on your child. I will talk with your nurse to clarify the policy." The nurse is monitoring a client, who is six hours post- embolectomy, for an acute arterial occlusion of the left leg.

When a Doppler ultrasound fails to detect a pedal pulse, the nurse notifies the surgeon who requests that the client be prepared for immediate surgery. The client refuses to consider additional surgery. What is the nurse's initial intervention? - Correct Answer-Notify the provider immediately A nurse answering the phone at the nurse's station receives a bomb threat. What should the nurse say? - Correct Answer-- Where is the bomb and when is it set to explode? A nurse is observing a newly licensed nurse and a UAP pull a patient up in bed. Which of the following statements indicates appropriate feedback by the observing nurse? - Correct Answer--"You used your body weight appropriately to counter the patient's weight when pulling the patient up." A nurse on a telemetry unit is caring for a patient who was admitted with chest pain. The patient becomes angry, stating that there is nothing wrong with him and that he is leaving. What statement should the nurse use when talking with the patient? - Correct Answer--You came in here with chest pain and until the doctor finds out the reason for that, it is a good idea to stay here so we can treat you immediately.

A nurse who has just assumed a position as unit manager is examining her skills fostering interprofessional collaboration on the unit. Which action supports interprofessional collaboration? - Correct Answer--Encourage team member's referral requests. A nurse is hired to replace a staff member who resigned. After working on the unit for several weeks, the nurse notices that the unit manager does not intervene when there is conflict between team members, even when it escalates. Which of the following strategies is the manager demonstrating? - Correct Answer--Avoidance Nurses can create a healthier workplace by: - Correct Answer-- Modeling healthy workplace interactions Types of laws - Correct Answer-- criminal laws

• statutory laws
• civil laws Statutory laws - Correct Answer--Federal laws: Patient self- determination act, HIPAA, ADA, EMTALA, reporting statutes

• state laws: nurse practice acts, good samaritan laws, nurse pt ratios, reporting statutes Civil law - Correct Answer-- involve the violation of ones persons rights by another person -contract law, intentional torts, unintentional torts
• consequence of a guilty verdict: monetary damages Intentional torts - Correct Answer-- Invasion of privacy
• assault and battery
• defamation of character
  • libel
  • slander
• false imprisonment
• intentional infliction of emotional distress Unintentional torts - Correct Answer-- Negligence: failure of an individual to perform an act that a reasonable person in similar circumstances would

• Malpractice: failure of a professional person to act as other prudent professionals with the same knowledge and education would act under similar circumstances Malpractice can include failure to - Correct Answer-- Assess and monitor
• Follow standards of care
• Use equipment in responsible manner
• Communicate
• Document
• Act as patient advocate Malpractice- minimize your risk - Correct Answer-- Know and follow NPA
• Assess patients frequently (use your nursing judgment!)
• Report abnormals promptly
• Follow up on care delegated to others- Communicate openly
• DOCUMENT!
• Report and file incident reports promptly

Standards of care - Correct Answer--The care a patient should expect to receive under similar circumstances; a constant. -Based on professional literature, journals, protocols, & expert opinions Patient rights - Correct Answer-- Privacy

• Confidentiality
• Informed Consent
• Advance Directives
• Freedom from Restraint Legal requirements of nurses - Correct Answer-- Report abuse of children and elders
• Preserve HIPAA
• Preserve Patient Self- Determination Act
• Be cautious of social media use
• Preserve the NPA
• Maintain standards of care RN - Correct Answer-- Assessing

• Analyzing
• Delegating
• Teaching
• Evaluating
• Supervising LPN - Correct Answer-- Collecting
• Basic teaching
• Assisting in evaluating
• Delegating UAP - Correct Answer-- Recording and reporting
• Hygiene
• Elimination
• Nutrition
• Ambulation Principles of delegation - Correct Answer-- Nursing profession determines scope & standards of practice
• RN takes responsibility & accountability for provision of nursing practice

• RN directs care and determines appropriate utilization of resources when providing care
• RN may delegate tasks or elements of care but does not delegate nursing process itself
• RN considers facility/agency policies & procedures and the knowledge, skills, training, and experience of any individual to whom the RN delegates elements of care
• Decision to delegate is based on RN's judgement of complexity of the patient, availability & competence of the individual accepting delegation, and the type & intensity of supervision required
• Organization is accountable for ensuring the RN has access to documented competency information for staff to whom the RN is delegating tasks
• RN uses critical thinking and professional judgement when following the 5 Rights of Delegation Tasks that can be delegated - Correct Answer-- maintaining asepsis
• personal hygiene
• nutrition
• ambulation
• vital signs