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WorksheetsNursing Communication & Assessment P2
Total questions: 30
Worksheet time: 15mins
A 72-year-old man with hearing loss arrives for a follow-up. He speaks softly and frequently asks you to repeat questions. Which communication approach is best?
Speak more loudly and slow your pace.
Face the patient, speak clearly at a normal volume, and reduce background noise.
Use family members to interpret to speed the interview.
Use complex medical words so the patient will take the visit seriously.
A nurse is taking a history from a patient who speaks limited English. Best practice is to:
Ask the patient’s family member to interpret.
Use a trained medical interpreter and speak directly to the patient.
Use simple English and hope the patient understands.
Rely on written instructions in English.
A patient states: “My chest pain got worse when I walked to the mailbox yesterday.” Which PQRSTU component does this illustrate?
Palliative
Quality
Provocative/precipitating (P) — setting/activity
Understanding
While performing a health history, you ask: “What brings you in today?” This is an example of:
A closed question
An authoritarian question
An open-ended question
A leading question
A patient with COPD becomes more dyspneic in the ED. You need to call the provider using SBAR. Which element belongs in the Recommendation?
Past medical history of COPD.
Current O2 saturation is 86% on room air.
Request immediate evaluation and consider increasing oxygen/ABG and chest x-ray.
Admitting diagnosis.
You are obtaining medication reconciliation. Patient lists “herbal drops for nerves.” Best action:
Document as “herbal remedy, unspecified.”
Ask for the name, dose, frequency and include it in the medication list.
Tell the patient herbs are unimportant and ignore them.
Remove all OTC and herbal agents from the med list.
A 4-year-old is anxious during immunization. Which technique is most appropriate?
Offer a complex explanation of the vaccine benefits.
Use short, simple directions and include the caregiver.
Leave the child alone to calm down.
Use medical jargon to assert authority.
During the review of systems the patient volunteers items already documented in the HPI. Best nursing action is to:
Re-ask every question in the ROS regardless.
Note that HPI addressed those items and avoid redundant questioning.
Ignore the ROS entirely.
Report that the patient is noncompliant.
A teen reveals suicidal ideation during HEEADSSS screening. Priority nursing action:
Encourage the teen to journal at home.
Assess for plan, intent, and means and initiate safety protocols.
Tell the teen to call a hotline later.
Refer to primary care in a week.
A patient says “I don’t want to tell you about my drinking.” You respond with:
“Why not? You need help.”
“I understand this is hard. Can you tell me more about your alcohol use?”
“If you don’t tell me, I’ll document refusal.”
“Other patients drink more than you.”
A patient with limited literacy brings a medication list. Best communication method:
Give them a typed summary in medical language.
Use simple, large-print materials, teach-back, and ask them to show how they’ll take meds.
Hand them a pamphlet and end the teaching.
Ask family to explain instructions later.
You notice a patient’s nonverbal cues (fidgeting, avoiding eye contact) contradict their verbal report of “I’m fine.” Best response:
Ignore nonverbal cues and accept the verbal statement.
Confront the patient: “You’re lying.”
Gently explore: “I notice you look upset — tell me about that.”
Immediately call social work.
During HPI you must document “severity” of pain. Which is best?
“Patient looks like they are in pain.”
Numeric pain scale (0–10) and effect on function.
“Moderate pain” without scale.
“Patient is in a lot of pain” (quote).
A patient’s cultural beliefs prevent blood transfusion. Nurse’s best action:
Ignore beliefs and proceed with transfusion.
Document patient’s preferences, discuss alternatives, and involve appropriate team members.
Refuse to provide care.
Ask family to override the patient.
When obtaining family history, which approach yields most useful data?
Ask only about parents’ cause of death.
Record age/health status or cause of death for first-degree relatives and chronic diseases present.
Skip genogram — it’s time consuming.
Only ask about genetic testing.
A patient reports “numbness in my left arm that started last night and wakes me from sleep.” Which HPI characteristic is this?
Timing — onset and frequency.
Quality.
Aggravating factors only.
Patient perception.
During an interprofessional handoff the nurse gives disorganized information causing a delay in treatment. The likely consequence is:
Improved continuity.
Medication errors, delayed treatment, and potential patient harm.
No effect — team will figure it out.
Better patient satisfaction.
A patient’s HPI states “right knee pain, sharp, 7/10 after twisting during soccer yesterday.” Which additional PQRSTU detail is missing?
Location and severity.
Associated factors (e.g., swelling) and what relieves/aggravates it.
The patient’s name.
Admission date.
Which question best assesses a patient’s perception of health?
“Do you have any allergies?”
“How do you define health for yourself?”
“What is your date of birth?”
“When was your last physical?”
A family member insists on being present for every interview despite the patient’s wish for privacy. Best nursing action:
Ask the family to leave without explanation.
Respect patient autonomy; offer private time and ask patient preference about family presence.
Always defer to family’s wishes.
Document family demand and continue with family present.
Which ROS item is considered subjective and should not include objective data?
“I have had a fever.”
“Temperature is 101°F.”
“Lung sounds: crackles present.”
“BP 150/90.”
You suspect intimate partner violence (IPV) during screening. Which step is appropriate?
Ask direct, nonjudgmental questions about safety and provide resources.
Ignore it unless the patient brings it up again.
Confront the partner in the room.
Tell the patient it’s their fault.
A toddler refuses to cooperate during a developmental screen. Best action:
Reschedule far in the future.
Use caregiver-assisted play, offer simple choices, and try a brief assessment.
Force the child to perform tasks.
Ignore developmental screening in toddlers.
A patient’s HPI includes “pain improves when I rest, worse with stairs.” Which PQRSTU factor does “worse with stairs” represent?
Severity
Aggravating factor
Region
Timing
Which communication technique is being used when the nurse employs silence to evoke further communication?
Confrontation
Facilitation (silence) to evoke further communication
Denial
False reassurance
You document a patient’s medication allergy as “aspirin — causes bad stomach.” Best follow-up documentation action:
Leave as is.
Clarify reaction type (e.g., GI upset vs. anaphylaxis) and document specifics.
Replace “aspirin” with “NSAID.”
Delete the allergy.
During interprofessional rounds, the nurse notices a discrepancy between the medication list and what the patient actually takes at home. Best immediate action:
Wait until the next clinic visit to reconcile.
Update the med list now and inform the team; perform medication reconciliation.
Remove suspected meds from the chart.
Document the discrepancy without action.
When asking about sexual health, which approach fosters disclosure and safety?
Use a nonjudgmental tone and standardize questions (ask matter-of-factly & use patient’s preferred language).
Avoid sexual health topics unless the patient brings them up.
Make jokes to lighten the mood.
Ask only the caregiver about the patient’s sexual history.
A patient with limited attention span keeps interrupting the interview. You should:
Finish the interview quickly without exploring concerns.
Use focused, closed questions when needed, but allow time for open narrative at the start.
Tell the patient to be quiet.
Ask unrelated questions to distract them.
Which element is essential when documenting the reason for seeking care?
A diagnostic label assigned by the nurse.
A brief spontaneous statement in the patient’s own words (symptom quoted when possible).
The nurse’s interpretation of the disease.
The last provider’s note only.
