Marquis Leadership 8e Ch 19 Organizational, interpersonal, and Group Communication

Ans: C
Feedback:
The combination that best characterizes the communication process is sender message receiver. The other options would result in the likelihood of miscommunication.

1. What is the best combination that characterizes the communication process?
A) Sender receiver message
B) Receiver message sender
C) Sender message receiver
D) Message sender receiver

Ans: A
Feedback:
Using various communication methods in combination increases the likelihood that everyone in the organization who needs to hear the message actually will hear it. The other options are single methods.

2. When does communication have the greatest likelihood of being accurately interpreted?
A) More than one mode is used
B) Face-to-face communication is used
C) Written communication is used
D) The sender repeats the message using the same mode

Ans: B
Feedback:
Because nonverbal communication indicates the emotional component of the message, it is generally considered more reliable than verbal communication. None of the remaining options present true statements regarding nonverbal communication.

3. Which statement concerning nonverbal communication is true?
A) It is consistent across cultures
B) It is given more credence than verbal communication when the two are incongruent
C) It should be minimized because it confuses the receiver regarding the true intent of the message
D) It is a significant part of the communication exchange only when it is not congruent with the verbal exchange

Ans: C
Feedback:
The role of the leader is to encourage communication that is appropriate and discourage communication that is inappropriate among staff. The other options fail to convey that responsibility.

4. An RN is a team leader for a small module of patients. While listening to a tape- recorded report on Mr. Smith, one of your team members remarks, My mother lives near him and she says his wife is a terrible housekeeper. As the leader of the team, what will the RN do?
A) Ask the informant to be quiet
B) Include the information in report for the next shift
C) Ask the team member what the purpose was in sharing the information
D) Ignore the comment

Ans: B
Feedback:
Nurse-leaders should intervene appropriately when communication problems (in this case, rumors) arise. The remaining options fail to fulfill that responsibility as effectively as the correct option does.

5. The hospital is facing low census and downsizing. However, the RNs have been assured that everyone on the unit will keep their jobs and downsizing will occur through normal attrition and voluntary absences without pay. Today, the evening charge nurse reported that last evening the staff was discussing various rumors about mass layoffs. What is the best approach to take?
A) Tell an informal leader on the evening shift the truth and let the leader spread the news informally
B) Hold a meeting for all staff members and tell them that the rumor is not true
C) Ignore the rumor because it will soon pass
D) Find out who started the rumor and correct the information

Ans: B
Feedback:
In the norming stage, consensus evolves as group cohesion develops. This is the only option that describes a behavior associated with a group's norming stage.

6. Which behaviors would be associated with a group in the ìnormingî stage?
A) Group members actively attempt to impress each other with their credentials
B) Group members establish short- and long-term goals for the group to accomplish
C) Group members achieve stated goals
D) The group terminates and celebrates its accomplishments

Ans: C
Feedback:
Assertive communication allows people to express themselves in direct, honest, and appropriate ways that do not infringe on another's rights. The remaining statements do not correctly describe assertive communication.

7. Which statement describes assertive communication?
A) It makes you respect yourself and allows you to get what you want
B) Although it is unfeminine, it is a necessary communication skill for female managers
C) It involves rights and responsibilities for all parties in the communication
D) Assertive communication will never offend anyone

Ans: A
Feedback:
Assertive communication is not rude or insensitive, nor is it passive aggressive.

8. An RN is orienting a new graduate nurse to the unit and has found this individual's charting to be inadequate. What is the most appropriate statement to initiate a discussion with the new RN?
A) Tell me in your own words what you intend your charting to convey.
B) Your charting is non-descriptive.
C) Do you think a refresher course in charting would help you?
D) Are you having difficulty assessing your patient?

Ans: C
Feedback:
Assertive communication effectively identifies and addresses an issue without being rude, insensitive, or passive aggressive. None of the remaining options actually identifies the communication problem.

9. The RN overhears the nurses' aide speaking in a harsh tone to Mrs. Smith, who has some early Alzheimer's memory loss. Which statement will the RN make to begin addressing this issue?
A) You must remember to watch your tone of voice with patients. Someone might overhear.
B) Do you think it would be a good idea to have an in-service on dealing with Alzheimer's patients?
C) I am concerned about your conversation with Mrs. Smith. It seemed short and impatient.
D) I have decided to reassign Mrs. Smith to another aide.

Ans: A
Feedback:
Informal communication through the grapevine occurs when most personnel are involved in the unofficial exchange of information. This process is not accurately described by any of the other options.

10. Which statement describes the informal communication referred to as ìthe grapevine?
A) Most personnel engaging in the unofficial exchange of information.
B) Information exchange is initiated by subordinates and directed upward
C) Information is conveyed unofficially by administration through department heads
D) The exchange of information initiated by someone in a staff position to someone in a line position

Ans: D
Feedback:
Only essential information is included in a memo since extraneous information will detract from the message. None of the other options presents correct information concerning a memo.

11. Which statement regarding a memo is true?
A) A memo makes it main point at least twice
B) A memo is written using an authoritative format
C) Headings are not used in a memo to avoid confusing the reader
D) Only essential information is included in a memo

Ans: C
Feedback:
The gatekeeper makes sure all voices in the group are heard in order to facilitate and promote open communication. The role of gatekeeper is not accurately described by any of the other options.

12. Regarding group building, what is the responsibility of the gatekeeper?
A) Mediating, harmonizing, and resolving conflict
B) Accepting and praising the contributions and viewpoints of group members
C) Facilitating and promoting open communication of all group members
D) Recording the group's process and providing feedback to the group

Ans: D
Feedback:
Confidentiality of patients must be upheld, unless there is a legitimate professional need to know, such as when a provider must share information about a patient with another provider so that the other provider can assume care. None of the other options is an accurate statement regarding confidentiality.

13. What statement about the maintenance of confidentiality is true?
A) It must never be breached
B) It is made easier with electronic technology
C) It is primarily the duty of the medical records staff
D) It can be breached when necessary for legitimate professional need

Ans: C
Feedback:
Men are usually more competitive and less collaborative than women in their communication patterns, and differences often impact the quality of organization communication.

14. What is important to remember about gender differences in communication?
A) Men are more collaborative communicators
B) It rarely impacts nursing care
C) It affects the quality of organization communication
D) Women are more competitive communicators

Ans: C
Feedback:
Assessment is where the nurse states the patient's problem. The problem is not documented in any of the other SBAR locations.

15. What location of the SBAR charting tool states the patient's problem?
A) Situation
B) Background
C) Assessment
D) Recommendation

Ans: B Feedback:
In downward communication, the manager relays information to subordinates. This is a traditional form of communication in organizations and helps to coordinate activities in various levels of the hierarchy. The other forms are not as effective as the various levels of an organization's hierarchy.

16. What is the traditional form of communication in organizations that helps to coordinate activities in various levels of the hierarchy?
A) Upward
B) Downward
C) Horizontal
D) Diagonal

Ans: C
Feedback:
Review occurs when the speaker summarizes the information he/she has conveyed to make sure the message was understood correctly. Once the speaker is finished conveying this summary and the other party has validated or clarified it, the listener has enough information to recommend or request more information. This does not occur in any of the other portions of the model.

17. What portion of GRRRR (greeting, respectful listening, review, recommend or request more information, and reward) is being used when the speaker summarizes the information conveyed to make sure the message was understood correctly?
A) Greeting
B) Respectful listening
C) Review
D) Recommend or request more information

Ans: C Feedback:
Nonverbal communication is considered more reliable because it conveys the emotional part of the message. The other modes are not as effective with conveying emotion.

18. What communication mode is considered most reliable in conveying the emotional component of the message?
A) Written
B) Verbal
C) Nonverbal
D) Telephone

Ans: A
Feedback:
The incongruence between verbal and nonverbal messages is the most significant barrier to effective interpersonal communication.

19. What is the most significant barrier to effective interpersonal communication?
A) Incongruence between verbal and nonverbal messages
B) Incongruence between telephone and written messages
C) Incongruence between verbal and written messages
D) Incongruence between telephone and nonverbal messages

Ans: B
Feedback:
SBAR provides a structured, orderly approach to provide accurate, relevant information, in emergent patient situations as well as routine handoffs. The other options are not as focused on providing information in all the described situations.

20. Which method best provides a structured orderly approach to communicating accurate, relevant information, in emergent patient situations as well as routine handoffs?
A) GRRRR listening model
B) SBAR tool
C) Hospital information system
D) Wireless, local area networking

Ans: A
Feedback:
As an information source, the Internet allows nurses to access the latest research and best practice information so that their care can be evidence based. The remaining options are not focused on personal nursing practice.

21. How can the Internet be best used as a means of improving one's personal nursing practice?
A) Accessing the latest research and best practice information
B) Communicating with other health-care team members
C) Minimizing the need for paper documentation
D) Securing patient information for confidentially

Ans: B
Feedback:
The playboy remains uninvolved and demonstrates cynicism, nonchalance, or horseplay. The blocker persists in expressing negative points of view and resurrecting dead issues. The dominator attempts to control and manipulate the group while the recognition seeker works to focus positive attention on himself.

22. Which behavior by a team member is demonstrated through cynicism and a nonchalance attitude about the group's work?
A) Blocker
B) Playboy
C) Dominator
D) Recognition seeker

Ans: B
Feedback:
The ANA has developed principles for social networking that include participation in policy development, nurse patient boundaries, separating personal and professional online information, and reporting to authorities when patient welfare has been potentially harmed.

23. Which nursing action demonstrates compliance with the American Nurses Association (ANA) principles for social networking by nurses?
A) Strictly avoiding the use of social networking in a professional setting
B) Participating in the development of institutional policies governing online conduct
C) Ignoring any information that appears to have the potential to harm a patient's welfare
D) Realizing that social networking is not related to a nurse's professional boundaries

Ans: C
Feedback:
Vocal clues such as tone, volume, and inflection add to the message being transmitted. Tentative statements sound more like questions than statements, leading listeners to think that you are unsure of yourself, and speaking quickly may be interpreted as being nervous. Loud and slurred speech can be barriers to communication.

24. Which vocal delivery suggests that a person is asking a question rather than making a statement?
A) Loudness
B) Slurred words
C) Tentativeness
D) Rapid delivery

Ans: D
Feedback:
The study of how space and territory affect communication is called proxemics. In the United States, between 0 and 18 inches of space is typically considered appropriate only for intimate relationships; between 18 inches and 4 feet is appropriate for personal interactions; between 4 and 12 feet is common for social exchanges; and more than 12 feet is a public distance (Loo). Most Americans claim a territorial personal space of about 4 feet.

25. A nurse sits at the foot of a patient's bed during an admission interview. This positioning supports the proxemics concept of which psychological comfort zone?
A) Intimate relationships
B) Personal interactions
C) Social exchange
D) Public distance

ANS: C
Feedback: EHRs must meet meaningful use requirements, which involve capturing the right data that can improve client outcomes. This characteristic of EHRs does not specify their accessibility or require that they mean the same thing to all users

Electronic health records (EHRs) have recently been introduced in a health-care organization, and the steering committee is ensuring that the system meets the criteria for
meaningful use. This characteristic of the EHR ensures that the system:
a. is readily accessible in any care setting, nationwide.
b. uses language that is accessible to and understandable by clients.
c. contains data that has the potential to improve client outcomes.
d. means the same thing to every user.

ANS: B, C
Feedback: Many of the challenges faced during the adoption of EHRs involve inadequate technology and training. Communication between managers has not been identified as a major hurdle. Evidence-based practice enhances client care but does not directly address challenges around EHRs. Similarly, engaging clients and families greatly benefits the care that nurses provide but not the adoption of EHRs.

A large health-care organization has struggled to meet mandated electronic health record (EHR) standards. What actions address the likely challenge that this organization is facing?
Select all that apply.
a. Improving communication between managers at the organization's various sites
b. Increasing the organization's budget for technology
c. Investing more in employee training
d. Engaging clients and families with the process
e. Increasing the use of evidence-based practice

ANS: B
Feedback: The "A" in the SBAR or ISBAR model denotes "assessment," in which the nurse summarizes the client's condition and states what the problem likely is.

The nurse is caring for a postoperative client whose pain is not being relieved by the current analgesia regimen. When using the SBAR model for communicating with the client's
health-care provider, how should the nurse best address the "A" component of the model?
a. "The client is postoperative day 2 following total hip arthroplasty."
b. "The client's pain control might be inadequate because she's been rating it at 9 out of 10 for the past hour."
c. "The client also has type 2 diabetes and atrial fibrillation."
d. "An increase in her hydromorphone dose is probably a good idea."

ANS: B, C
Feedback: When dealing with an emotional employee, the manager should allow the employee time to express what he or she wants and to make statements that reflect back the employee's message. The manager should not terminate the interaction unless there is a plausible safety risk. Telling the employee how her tone is hindering communication and asking whether the employee is accusing the manager are likely to escalate the situation, further harming communication.

The nurse-manager has been approached by an angry employee whose vacation request was denied. What should the manager do when communicating with this employee? Select all that apply.
a. Tell the employee that anger will not be tolerated and then leave the situation.
b. State, "I understand that you are angry that your vacation request wasn't approved."
c. Allow the employee sufficient opportunity to express what she wants from the manager.
d. Tell the employee how her mode of communication is hindering the message.
e. Ask the employee, "Are you accusing me of bullying you by turning down your request?"

ANS: C, D
Feedback: The manager should take care on aspects of appearance and should avoid crossed arms, which communicate defensiveness or aggression. There are many communications that are inappropriate to have in a public place and space of 12 to 18 inches is considered unusually close. Even though some individuals and cultures perceive eye contract as provocative or aggressive, it is still valued in most circumstances.

A manager is careful to address nonverbal aspects of communication when communicating with employees. What practices should the manager adopt? Select all that apply.
a. Have communications in public places as much as possible to reduce intimidation.
b. Stand between 12 and 18 inches from an employee when having an important conversation.
c. Be thoughtful about aspects of appearance that can be controlled by the manager.
d. Avoid crossing arms across the chest.
e. Limit eye contact with employees to avoid being perceived as aggressive.