Chapter 12: Effective Communication and Team Building Zerwekh 9th ED

10. Which action by the nurse shows a major characteristic of aggressive behavior? a. Achievement of personal goals at the expense of others b. Indirect expression of personal feelings c. Communication of personal needs d. Ability to restrict personal rights

ANS: A All of us have a style of communication that reflects our own personality and self-concept. Achievement of the nurse's goals at the expense of others shows an aggressive behavior. Indirect expression of one's feelings describes passive behavior. Being able to communicate one's own needs describes an assertive behavior. Restricting one's own rights does not describe an assertive style of communication. Aggression is not an indirect expression of one's feelings but a very direct expression. Aggressive communication is angry and dominating where the person attempts to humiliate or "put down" other people. PTS: 1 DIF: Cognitive Level: Application REF: p. 279 OBJ: Describe an assertive communication style. TOP: Effective communication MSC: NCLEX®: Not applicable

2. The clinical instructor interprets the development of mutual goals and guidelines as a. norming. c. storming. b. performing. d. informing.

ANS: A Norming begins with the development of guidelines and mutual goals. Successful task completion helps to redefine individual behavioral roles in the group. In the performing phase, everyone knows each other, and the group makes changes in a seamless way. The storming phase involves acting out roles normally portrayed in the presence of peers. Informing is not a phase in the group process. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 271 OBJ: Identify different types of groups and group process. TOP: Group process MSC: NCLEX®: Not applicable

7. How can the "grapevine" best be controlled? a. Providing factual information in anticipation of employees' questions b. Using an authoritarian communication style c. Putting everything in writing d. Having a strong union to represent employees

ANS: A Providing factual information in anticipation of employees' questions is an effective way to reduce the "grapevine." Most employees get secondhand information, and few employees get enough of the factual information that they need. Even if information is put in writing, it is important to communicate verbally to employees by answering their questions. A strong union does not necessarily reduce the grapevine. PTS: 1 DIF: Cognitive Level: Application REF: p. 261 OBJ: Identify effective ways of communication with other health care workers. TOP: Effective communication MSC: NCLEX®: Not applicable

4. Which term refers to the group member who watches others take the risks and responsibility for group input and agrees with everyone in the group? a. Mouse c. Self-server b. Motor mouth d. Know-it-all

ANS: A The mouse is less confident of his or her abilities and is therefore less aggressive in the group dynamics. The motor mouth often interrupts others to get his or her point across. The self-server does not serve as a functional part of the group unless there is a benefit to them. The know-it-all is not a term used to describe group members. PTS: 1 DIF: Cognitive Level: Application REF: p. 272 OBJ: Analyze group member roles. TOP: Team building MSC: NCLEX®: Not applicable

20. Which statement would be most appropriate for the nurse to make when practicing assertive behavior? a. "I feel upset when Dr. Smith yells at me in front of my patients." b. "I can't believe what a jerk Dr. Smith is; the doctor should be fired!" c. "Dr. Smith was right in her action." d. "I am reporting Dr. Smith to the medical director."

ANS: A The nurse practicing assertive behavior would state: "I feel upset when Dr. Smith yells at me in front of my patients." The statement is direct and uses "I" statements. When the nurse says, "I can't believe what a jerk Dr. Smith is; the doctor should be fired" and "I am reporting Dr. Smith to the medical director," the nurse is using aggressive behavior. Statements such as: "Dr. Smith was right in her action" indicate passive/avoidant behavior. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 279 OBJ: Describe an assertive communication style. TOP: Assertive styles of communication MSC: NCLEX®: Safe and effective care environment

19. A nurse manager is educating staff on how to give effective presentations. Which statement indicates an understanding of this? a. "To give an effective presentation, you should always maintain a positive attitude." b. "You should avoid planning and should create the presentation as you go." c. "Give the same presentation regardless of the audience." d. "To reduce anxiety, avoid making eye contact with the audience."

ANS: A To give an effective presentation the nurse should always maintain a positive attitude, plan the presentation ahead of time, spice up the presentation and make changes according to the audience, and make eye contact. PTS: 1 DIF: Cognitive Level: Application REF: pp. 264-265 OBJ: Apply effective communication skills in common nursing activities. TOP: Components of effective communication MSC: NCLEX®: Not applicable

2. A nurse manager is delegating a task to another nurse. Which of the following action(s) would help the manager effectively communication with the nurse? (Select all that apply.) a. Get the full attention of the nurse. b. Ask the nurse to repeat back what he or she heard. c. Give directions to the nurse as the nurse is walking away. d. Give clear, simple instructions. e. Give instructions while multitasking.

ANS: A, B, D The nurse manager should first get the full attention of the nurse before the nurse manager begins to communicate with the nurse. The nurse manager should give clear, simple instructions and ask the nurse to repeat back what he or she heard. PTS: 1 DIF: Cognitive Level: Application REF: p. 259 OBJ: Describe the basic components of communication. TOP: Communication in the workplace MSC: NCLEX®: Safe and effective care environment

1. Which of the following actions can the nurse take to communicate with the supervisor? (Select all that apply.) a. Keep the supervisor informed. b. Focus on problem solving. c. Use "you" statements. d. Calm down before speaking. e. Choose words wisely.

ANS: A, B, D, E To communicate openly and effectively with the nursing supervisor, the nurse should keep the supervisor informed, focus on problem solving, use "I" statements, calm down before speaking, and choose words wisely. PTS: 1 DIF: Cognitive Level: Application REF: pp. 257-258 OBJ: Describe the basic components of communication. TOP: Communication in the workplace MSC: NCLEX®: Safe and effective care environment

5. A nurse notices that a coworker has been taking longer lunch breaks. The nurse is frustrated by this and wants to use assertive communicate techniques to effectively handle the situation. Which statement(s) would be the most beneficial? (Select all that apply.) a. "I feel frustrated about the length of your breaks because I am really busy with my patient assignment today." b. "You need to stop taking such long lunch breaks while the rest of us pick up your slack!" c. "I am willing to compromise so that we can both get the breaks and help that we need." d. "I am having a hard time keeping up with both of our assignments today." e. "You are putting my nursing license in jeopardy."

ANS: A, C, D To effectively communicate, the nurse should use "I" statements and compromise with her coworker. Statements that would be the most beneficial include "I feel frustrated about the length of your breaks because I am really busy with my patient assignment today," "I am willing to compromise so that we can both get the breaks and help that we need," and "I am having a hard time keeping up with both of our assignments today." PTS: 1 DIF: Cognitive Level: Analysis REF: p. 279 OBJ: Describe an assertive communication style. TOP: Assertive styles of communication MSC: NCLEX®: Safe and effective care environment

1. Which action shows the cyclical phase of forming? a. A group dissolving b. Individuals coming together with a common bond c. Developing mutual goals d. A group completing tasks together

ANS: B Forming is the beginning development of a group with well-defined reasons and common directions. In the storming phase, the nurse begins to act out the roles they normally portrays in the presence of peers. Norming occurs during the development of mutual goals and guidelines that help to redefine the nurse's behavioral roles in the group. During the performing phase, everyone knows one another, is able to work together, and trusts one another. PTS: 1 DIF: Cognitive Level: Application REF: p. 269 OBJ: Identify different types of groups and group process. TOP: Group process MSC: NCLEX®: Not applicable

15. Staff nurse 1: "You're stomping around and glaring at me. I'm wondering what's going on." Staff nurse 2: "I'm sick of you always going to lunch first. You don't care about anyone but yourself." What assessment can best be made about this exchange? a. Staff nurse 1's remark is challenging and obstructive. b. Staff nurse 1's remark invites clarification of the meaning of the specific behaviors of staff nurse 2. c. Staff nurse 2's remark will facilitate effective problem solving. d. Staff nurse 2's remark will keep anger at a minimum and give incentive for meeting the other's needs.

ANS: B Nurse 1 was assertive in her approach by giving direct descriptive feedback reflecting nurse 2's actions with a question seeking information to explain nurse 2's actions. Asking about what is going on allows nurse 2 to make some comment about what is bothering her. Nurse 2's comment does not promote effective problem solving as it is judgmental (You don't care about anyone but yourself.). PTS: 1 DIF: Cognitive Level: Analysis REF: p. 279 OBJ: Apply effective communication skills in common nursing activities. TOP: Effective communication MSC: NCLEX®: Not applicable

18. A nurse is caring for a Latino patient. The nurse is aware of the importance of cultural competency and providing the patient with culturally competent care. What can be done to enhance communication with this patient? a. Use jargon or slang. b. Obtain an interpreter if needed. c. Give longer explanations to enhance understanding. d. Speak loudly to the patient.

ANS: B To communicate effectively with this patient, the nurse may need to obtain an interpreter. The nurse should also avoid jargon or slang, give shorter explanations, and speak in a normal volume and tone to the patient. PTS: 1 DIF: Cognitive Level: Application REF: p. 262 OBJ: Apply effective communication skills in common nursing activities. TOP: What does my image communicate to others? MSC: NCLEX®: Psychosocial integrity

4. Which of the following statements about listening indicate the nurse's adequate understanding? (Select all that apply.) a. "Listening is the hearing of words." b. "Listening requires most of our communication time." c. "We pay most attention to our listening skills." d. "People remember 1/3 of the messages that they have heard." e. "Listening requires a lot of energy."

ANS: B, D, E The nurse has an adequate understanding of listening when the nurse states: "Listening is not just the hearing of words," "Listening requires most of our communication time," "We pay least attention to our listening skills," "People remember 1/3 of the messages that they have heard" and "Listening requires a lot of energy." PTS: 1 DIF: Cognitive Level: Analysis REF: pp. 265-266 OBJ: Apply effective communication skills in common nursing activities. TOP: Components of effective communication MSC: NCLEX®: Safe and effective care environment

3. A member of a nursing committee frequently disregards the rules of the group and feels that the rules do not apply to the member personally. The president of the committee recognizes the term that best describe this person a. critical conservative. c. self-server. b. motor mouth. d. mouse.

ANS: C Self-servers are not willing to serve as a functioning part of the group, although they may appear to be group members when they perceive a personal benefit by the interaction. The critical conservatives typically have criticism for any suggestion other than their own. Motor mouths often interrupt others to get their points across. The mouse is known as a silent observer. PTS: 1 DIF: Cognitive Level: Application REF: p. 272 OBJ: Analyze group member roles. TOP: Team building MSC: NCLEX®: Not applicable

17. Which statement made the by the nurse indicates understanding of how to control the grapevine? a. "Grapevine rumors are generally true." b. "Avoid face-to-face communication." c. "Avoid spreading rumors." d. "Keep rumors circulating."

ANS: C To control the grapevine, the nurse should avoid spreading rumors. The nurse should also promote face-to-face communication, obtain information from the source, and stop the circulating of rumors by not engaging in gossip. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 261 OBJ: Identify effective ways of communication with other health care workers. TOP: What does my image communicate to others? MSC: NCLEX®: Safe and effective care environment

5. A graduate nurse is observing nurses on a busy surgical unit. The graduate nurse notices that the nurses work together as an interchangeable part of the team and have an appropriate level of skills. When questioned by the charge nurse, the graduate nurse identifies this type of team as a. potential. c. basic. b. pseudo. d. real.

ANS: D Each person on a real team has the skills and abilities to be goal and group oriented. Each member has the ability to work as an interchangeable part of the team and is accountable for the team's outcomes. The other options are not types of team. PTS: 1 DIF: Cognitive Level: Application REF: pp. 275-276 OBJ: Discuss team building. TOP: Team building MSC: NCLEX®: Not applicable

13. Dr. Jones asks you to give a medication to one of the patients, and you know the patient is allergic to it. When you point this out, Dr. Jones says, "Give the medication or I'll report this to your supervisor." What is the best assertive response? a. Agree to give the medication and hope no one finds out. b. Say, "I won't give the medication, and I don't care who you talk to about it." c. Walk away and ignore Dr. Jones. d. Say, "Perhaps you and I could talk this over with my supervisor together."

ANS: D Expressing to the physician that both of you should discuss the issue with the supervisor is an assertive response. As nurses gain experience, their judgment improves, and they are able to recognize ways to communicate needs and feelings with the goal of improving the processes and procedures used in the work setting. The patient's safety always comes first, so you would not go ahead and give the medication. When you walk away and ignore the comment, you are denying the feelings and not dealing assertively with the situation. Not giving the medication and stating that you don't care who the physician talks to about the issue is a threatening, aggressive response. PTS: 1 DIF: Cognitive Level: Application REF: p. 279 OBJ: Apply effective communication skills in common nursing activities. TOP: Effective communication MSC: NCLEX®: Not applicable

6. In considering the overall task of the team, what issues should be considered in the care of the patient? a. Nursing care plan, religious preference, and financial base b. Physician's orders, nursing actions, and religious preference c. Family needs, physician's orders, nursing diagnosis, and religious preference d. Physician's treatment plan, nursing plan of care, and needs of the patient and family

ANS: D Nurses as individuals and as team members are advocates of the patient with a focus on the best and safest delivery of quality health care. PTS: 1 DIF: Cognitive Level: Analysis REF: pp. 275-276 OBJ: Analyze group member roles. TOP: Group process MSC: NCLEX®: Not applicable

8. The graduate nurse has an adequate understanding of effective listening when stating which of the following? a. "Limited level of vocabulary often affects listening skills," b. "Underdeveloped attention span affects listening skills." c. "External noise distractions affect listening skills." d. "Emotional reactions interfere with the actual message."

ANS: D One of the most problematic reasons for ineffective listening is that people allow their emotions to dictate what they hear or do not hear. Limited vocabulary, underdeveloped attention span, and external noise distractions are not the most problematic reason for ineffective listening. PTS: 1 DIF: Cognitive Level: Application REF: pp. 265-266 OBJ: Identify effective ways of communication with other health care workers. | Define basic components of communication. TOP: Effective communication MSC: NCLEX®: Not applicable

16. A nurse is meeting with the nurse supervisor to discuss an issue with a coworker. Which of the following statements would help the nurse effectively communicate with the supervisor? a. "This is all my coworker's fault. I never do anything wrong." b. "My coworker always makes 100 excuses to get out of work." c. "I knew you would be on their side." d. "I feel upset that my coworker seems to have less work than I do."

ANS: D When communicating with a nurse supervisor, the nurse should avoid blaming others and exaggeration. The nurse should instead focus on using "I" statements to express themself. PTS: 1 DIF: Cognitive Level: Application REF: p. 279 OBJ: Describe the basic components of communication. TOP: Communication in the workplace MSC: NCLEX®: Safe and effective care environment

12. The nurse is using assertive communication skills to express self rights, when stating: a. "I shield others from my anger." c. "I am avoiding direct confrontation." b. "I do not compromise." d. "I am responsible for what I say."

ANS: D When you use an assertive communication style, you send the message that you will take responsibility for the consequences of both your words and your actions. Assertive individuals often compromise and may confront people directly about issues. Assertive individuals express anger appropriately rather than shielding others or repressing the feeling. The other statements do not express an assertive communication style. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 279 OBJ: Describe an assertive communication style. TOP: Effective communication MSC: NCLEX®: Not applicable

3. Which actions can the nurse take to improve personal credibility? (Select all that apply.) a. Wear well-fitting clothes. b. If female, wear a reasonable amount of make-up. c. Be as original as possible at work. d. Maintain a flattering, neat haircut. e. Maintain a reasonable weight.

ANS: A, B, D, E To improve the nurse's credibility, the nurse should wear well-fitting clothes and a reasonable amount of make-up (if female). The nurse should maintain a flattering, neat haircut and maintain a reasonable weight. The nurse should reserve individuality for outside of work. PTS: 1 DIF: Cognitive Level: Application REF: p. 259 OBJ: Identify effective ways of communication with other health care workers. TOP: What does my image communicate to others? MSC: NCLEX®: Not applicable

9. Which of the following actions by the nurse leader is most likely to lead to an effective meeting? a. Creating an atmosphere in which people say very little b. Sending out an agenda ahead of time c. Creating well-designed overhead transparencies d. Completing all the tasks of the group

ANS: B It is the leader's responsibility to send out an agenda ahead of time and to indicate any preparations members need to make or materials they need to bring. It is important to have a meeting atmosphere where people feel as though they can respond and ask questions in a cooperative and collaborative setting. It is not necessary to have well-designed handouts for the meeting or for the leader to complete all the tasks of the group because this would indicate a lack of participation from the group members. PTS: 1 DIF: Cognitive Level: Analysis REF: pp. 273-274 OBJ: Identify effective ways of communication with other health care workers. TOP: Effective communication MSC: NCLEX®: Not applicable

14. Your team leader reminds you that you have forgotten to complete an assigned task. What is an assertive response? a. "Not now; I'm busy." b. "You're right. I did forget. I'll do it now." c. "It's not my fault. You should have reminded me sooner." d. "I'm so sorry I've disappointed you. It won't happen again."

ANS: B When using assertive communication, a person would respond to criticism by acknowledging the issue and taking direct action to correct the problem. An apologetic response is not assertively taking responsibility for the forgotten task. Telling the person "you should have reminded you sooner" is placing the responsibility of the forgotten task onto another person. Telling the person you are busy is denying the issue. PTS: 1 DIF: Cognitive Level: Application REF: p. 279 OBJ: Apply effective communication skills in common nursing activities. TOP: Effective communication MSC: NCLEX®: Not applicable

11. The nurse interprets assertive behavior as a. apologetic. c. direct. b. coercive. d. self-denying.

ANS: C A person exhibiting assertive behavior would express his or her true feelings in an honest, direct manner. An assertive person's behavior respects others and is not coercive or self-denying or self-depreciating in any manner. Assertive persons accept compliments and criticism and are not excessively apologetic but have self-respect for their thoughts and actions. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 279 OBJ: Describe an assertive communication style. TOP: Effective communication MSC: NCLEX®: Not applicable