CELBAN - Canadian English Language Benchmark Assessment for Nurses Responding to Healthcare Issues Questions and Answers 1 — Questions and Answers
Question 1: A patient's son approaches the nurse's station and states loudly, "My mother has been waiting for her pain medication for over 30 minutes! Why is the service here so slow?" Which of the following is the most therapeutic initial response by the nurse?
- "I can see you're very concerned. Let me come with you to your mother's room and assess her pain right now." (Correct answer)
- "Sir, please lower your voice. There are other patients on the unit who are trying to rest."
- "We are doing our best. Her medication is scheduled to be given in another 15 minutes."
- "Who is your mother's assigned nurse? I will try to find them for you."
Correct answer: "I can see you're very concerned. Let me come with you to your mother's room and assess her pain right now."
This response is the most therapeutic because it first validates the family member's feelings ('I can see you're very concerned'), which helps to de-escalate the situation. It then proposes an immediate, action-oriented solution that prioritizes the patient's needs.
Question 2: A nurse is performing an initial assessment on an elderly patient who says, "I've just been feeling all topsy-turvy lately." Which of the following is the most appropriate clarifying question for the nurse to ask?
- "Are you saying you've been feeling dizzy or lightheaded?"
- "Can you tell me more about what 'topsy-turvy' feels like to you?" (Correct answer)
- "When did this 'topsy-turvy' feeling start?"
- "Have you taken anything to help with the 'topsy-turvy' feeling?"
Correct answer: "Can you tell me more about what 'topsy-turvy' feels like to you?"
This open-ended question encourages the patient to describe their symptoms in their own words without the nurse imposing their own interpretation. It is the best way to gather more specific and accurate assessment data about a vague complaint.
Question 3: A nurse on a busy medical unit is informed of four patient requests simultaneously. Which of the following situations requires the nurse's most immediate assessment?
- A post-operative patient rated their incisional pain as 7/10.
- A patient with a history of heart failure reports new-onset shortness of breath. (Correct answer)
- A patient who is NPO for a procedure is asking for a drink of water.
- A family member is asking for an update on a patient's lab results.
Correct answer: A patient with a history of heart failure reports new-onset shortness of breath.
According to the ABC (Airway, Breathing, Circulation) framework for prioritization, new-onset shortness of breath is a critical sign of a potentially life-threatening breathing problem that must be assessed immediately.
Question 4: A competent adult patient with a bacterial infection refuses their scheduled dose of intravenous antibiotics, stating, "I feel much better, and I don't want that needle in my arm anymore." What is the nurse's most appropriate initial action?
- Document the refusal in the chart and notify the physician immediately.
- Explain the potential health risks of not completing the full course of antibiotics. (Correct answer)
- Insist that the medication is necessary and that the doctor has ordered it.
- Ask a family member to try and convince the patient to take the medication.
Correct answer: Explain the potential health risks of not completing the full course of antibiotics.
A competent patient has the right to refuse treatment. However, the nurse has a professional responsibility to ensure the refusal is informed. The most appropriate initial action is to educate the patient on the risks and benefits, so they understand the potential consequences of their decision.
Question 5: When documenting telephone advice given to a patient, which of the following details is most essential for the nurse to include in the patient's record?
- The nurse's impression of the patient's mood.
- The specific instructions and recommendations provided to the patient. (Correct answer)
- The time the call ended.
- A note that the patient sounded satisfied with the advice.
Correct answer: The specific instructions and recommendations provided to the patient.
Clear and accurate documentation of the specific advice given is critical for legal protection and continuity of care. It provides a record of what the patient was told to do, such as self-care measures or seeking emergency services.
Question 6: A 16-year-old patient tells a nurse, "I've been feeling really down and I'm worried I might have depression, but please promise you won't tell my parents." In Canada, which response by the nurse is most ethically and legally appropriate?
- "I promise I won't tell them anything you don't want me to."
- "I am required by law to tell your parents everything about your health."
- "Let's talk more about how you're feeling. I will keep our conversation confidential, unless I'm worried you're at risk of harming yourself or others." (Correct answer)
- "It's best if you tell your parents yourself, so I'll wait until you're ready to do that."
Correct answer: "Let's talk more about how you're feeling. I will keep our conversation confidential, unless I'm worried you're at risk of harming yourself or others."
This response builds trust and respects the patient's confidentiality under the 'mature minor' doctrine, which is recognized in Canadian common law. It also clearly and honestly states the legal and ethical limits of that confidentiality, specifically regarding risk of harm.
CELBAN - Canadian English Language Benchmark Assessment for Nurses Responding to Healthcare Issues Questions and Answers 1
A patient's son approaches the nurse's station and states loudly, "My mother has been waiting for her pain medication for over 30 minutes! Why is the service here so slow?" Which of the following is the most therapeutic initial response by the nurse?