Nursing Acceleration Challenge Exam I PN Communication and Documentation — Questions and Answers
Question 1: A patient says, 'I feel like no one really listens to me.' Which nurse response demonstrates the best therapeutic communication technique?
- 'Don't worry—all the nurses here care about you.'
- 'Tell me more about what you mean by that.' (Correct answer)
- 'I'm sure that's not true. Everyone tries their best.'
- 'You should speak with the charge nurse about your concerns.'
Correct answer: 'Tell me more about what you mean by that.'
Open-ended statements like 'Tell me more' encourage the patient to elaborate and show genuine interest. Reassuring ('don't worry') or minimizing responses block communication. Redirecting to another nurse dismisses the patient's concern.
Question 2: A nurse needs to hand off a patient to the oncoming nurse. Which communication framework is the standard for structured handoff reporting?
- ADPIE
- SBAR (Correct answer)
- SOAP
- RACE
Correct answer: SBAR
SBAR (Situation, Background, Assessment, Recommendation) is the standardized handoff communication tool used to provide concise, organized information during patient transfers and shift changes, reducing communication errors.
Question 3: A nurse discovers a medication error was made by a previous nurse. Which documentation action is correct?
- Document the error in the patient's chart and file an incident report (Correct answer)
- Correct the previous nurse's charting and add a note
- File only an incident report and omit it from the patient's chart
- Notify the supervisor verbally and make no written record until instructed
Correct answer: Document the error in the patient's chart and file an incident report
Medication errors must be documented in the patient's chart (objective facts only—what happened and patient's response) and reported via an incident/occurrence report. Altering another's documentation is falsification; omitting it from the chart is incomplete documentation.
Question 4: Which of the following is an example of a nonverbal communication barrier that a nurse should be aware of?
- Using medical jargon with a patient
- Speaking too quickly during patient education
- Standing over a seated patient while delivering bad news (Correct answer)
- Asking two questions at the same time
Correct answer: Standing over a seated patient while delivering bad news
Standing over a seated patient creates a power imbalance and communicates dominance rather than partnership—this is a nonverbal barrier. The other options are verbal communication issues. Sitting at eye level with a patient during sensitive conversations conveys respect and openness.
Question 5: A nurse is documenting assessment findings. Which entry is written correctly?
- 'Patient seemed uncomfortable and appeared to be in pain.'
- 'Patient appears anxious—probably worried about surgery.'
- 'Patient rates pain 7/10, diaphoretic, guarding abdomen, BP 152/94.' (Correct answer)
- 'Patient was uncooperative and difficult during morning care.'
Correct answer: 'Patient rates pain 7/10, diaphoretic, guarding abdomen, BP 152/94.'
Nursing documentation must be objective, specific, and measurable. Option C uses a numeric pain scale, observable signs (diaphoresis, guarding), and a vital sign—all objective data. The other options contain subjective interpretation ('seemed,' 'probably,' 'uncooperative') which are inappropriate in clinical documentation.
Question 6: A patient who speaks limited English is scheduled for surgery. The nurse needs to obtain informed consent. What is the most appropriate action?
- Ask the patient's adult family member to translate the consent form
- Use a hospital-approved professional medical interpreter (Correct answer)
- Speak slowly and use hand gestures to explain the procedure
- Have the patient sign the consent form after reading it independently
Correct answer: Use a hospital-approved professional medical interpreter
A professional medical interpreter (in person or via phone/video service) must be used for informed consent to ensure accurate communication and protect patient rights. Using family members is discouraged due to potential bias, omissions, or distortion. This is also a legal and accreditation requirement.
Nursing Acceleration Challenge Exam I PN Communication and Documentation
A patient says, 'I feel like no one really listens to me.' Which nurse response demonstrates the best therapeutic communication technique?