Nursing Galen Fundamentals 155 Exam
1 Questions and Complete Rationales
Graded A+
Communication Process - Answer: A referent initiates communication between a sender and a receiver,
during which a message is sent through a channel and followed by feedback to ensure accuracy.
Non Verbal Communication - Answer: Nonverbal communication is wordless transmission of
information. According to seminal research by Mehrabian (1971), 93% of communication is nonverbal.
Body language constitutes 55% of all nonverbal communication, and voice inflection accounts for 38%.
Nonverbal communication is the more accurate mode of conveying information. Realizing the frequency
and value of nonverbal communication helps the nurse observe and assess patients more accurately.
Nurses who perceive the potential effect of their own nonverbal behavior will communicate more
professionally and consistently when interacting with others.
Body Language - Answer: Body language is conveyed in many ways. Posture, stance, gait, facial
expressions, eye movements, touch, gestures, and symbolic expressions influencing personal
appearance, such as jewelry and make-up, generally communicate a person's thoughts more accurately
than simple verbal interactions.
Facial Expresion and Eye Movement - Answer: Grimacing or rolling the eyes communicates significant
information. Some facial expressions may indicate fear or apprehension regarding impending diagnostic
testing or surgery.
Touch Gestures and Symobolic Expressions - Answer: Making physical contact in patient care situations
can communicate caring or can be perceived as restrictive, depending on the type of touch used. Gently
touching a blind patient's arm before providing care helps alert the patient to the nurse's presence (Fig.
3.2). Therapeutic touch, such as holding the patient's hand or touching the patient's shoulder, can
provide comfort and may alleviate pain. This is especially true when a patient is undergoing a painful or
stressful procedure. In most cases, it is important for the nurse to be aware of or verify a patient's
openness to touch before implementing it as a nursing intervention.
Proxemics - Answer: proxemics (i.e., study of the spatial requirements of humans and animals). He
identified four specific distances in which people interact: intimate space (0-1.5 feet), personal space
(1.5-4 feet), social space (4-12 feet), and public space (12 feet or more).
,Setting, Context, Content for Communication - Answer: Setting, Context, and Content
Spoken words may be communicated face to face, in a group setting, or through devices such as phones
or intercoms. The setting of communication greatly influences what is or what can be shared.
Written Communication - Answer: Written communication, although effective in providing details and
legal documentation, lacks the nuances that voice inflection and interactive conversation can provide.
Electronic Communication - Answer: Special care must be taken to maintain confidentiality while
communicating electronically. Electronic communication in the form of information referencing, e-mail,
social networking, and blogging can quickly contribute to a person's knowledge, providing patients and
health care professionals with vital information. However, the potential for miscommunication exists, in
part because nonverbal cues are not apparent. When communicating verbally by electronic media,
patients and nurses must take time to validate and verify shared information because
misunderstandings can occur if feedback is inadequate. Chapter 10 provides additional information on
the requirements of electronic documentation.
Intrapersonal Communication - Answer: Intrapersonal communication (i.e., occurring internally) focuses
on personal needs and can influence a person's well-being. Positive self-talk is internal conversation that
provides motivation and encouragement; it may be used to build self-esteem and self-confidence. By
encouraging positive self-talk, nurses empower patients to fight their diseases and persevere through
difficult situations.
Positive self-talk - Answer: internal conversation that provides motivation and encouragement; it may
be used to build self-esteem and self-confidence. By encouraging positive self-talk, nurses empower
patients to fight their diseases and persevere through difficult situations.
Negative self-talk - Answer: (i.e., harmful or destructive internal conversation) may damage the ability of
an individual to achieve one's greatest potential or to overcome adversity. Negative self-talk may
increase a patient's perception of pain, anxiety, or inability to meet the challenges of a poor prognosis.
Meditation - Answer: (i.e., mindful reflection or contemplation) is another form of intrapersonal
communication.
,prayer - Answer: (i.e., a form of meditation traditionally directed to a deity), meditation is a continuous
thought process that centers on one idea, with the goal of achieving inner peace and relaxation.
Interpersonal Communication - Answer: Interpersonal communication takes place between two or more
people. It may be formal or informal and conversational, and it may or may not have a stated goal or
purpose. In the context of an interview, it may vary from the strictly formal to very casual.
The CUS tool (Concern, Uncomfortable, Safety) - Answer: When using the CUS format, health care team
members can (1) state their Concern, (2) state why they are Uncomfortable, and (3) identify the Safety
issue and share what actions they think should be taken to prevent a negative patient outcome
SBAR - Answer: (situation, background, assessment, and recommendation) is a widely accepted method
of hand-off communication that involves interpersonal communication designed to enhance patient
safety and outcomes.
S>B>A>R what does SBAR stand for - Answer: • Situation: What is happening right now?
• Background: What led to the current situation?
• Assessment: What is the identified problem, concern, or need?
• Recommendation: What actions or interventions should be initiated to alleviate the problem?
Ethical Implications of communication - informaton (PHI) - Answer: Information shared during informal
and formal nurse-patient interaction is considered confidential. The nurse must maintain the patient's
right to privacy to ensure that the Health Insurance Portability and Accountability Act (HIPAA)
regulations are met.
Professional role boundaries - Answer: define the limits and responsibilities of individuals in a given
setting. When undertaken by nurses, actions such as sharing personal phone numbers with patients,
agreeing to meet patients outside the health care setting, and inappropriate touching violate these
boundaries. Ethical or legal action may be taken against nurses who ignore professional role boundaries.
Small-Group Communication - Answer: Communication in small groups focuses on meeting established
goals or the needs of group participants. Focus groups, support groups, and task forces are examples of
groups in which patients or nurses may be involved.
, Small-Group Dynamics - Answer: When asked to lead small groups, nurses need to be aware of the
phases of group development and group dynamics that may facilitate or hinder communication. In 1965,
psychologist Bruce Tuckman identified four phases of group development: forming, storming, norming,
and performing. He later added a fifth—adjourning—to denote the stage of closure in the small-group
setting
forming phase, - Answer: group members rely heavily on the leader to identify the mission and goals of
the group. Ground rules are identified, and trust is established through the development of
interpersonal relationships.
storming phase - Answer: small-group development may involve some personality conflicts among the
group participants. Group members with control issues may emerge. During the storming phase, the
group leader needs to work with members to resolve conflicts and build cohesion. It is the group
leader's responsibility to ensure that all members feel safe to share their thoughts and ideas freely,
without fear of ridicule.
norming phase, - Answer: Increased trust and openness emerge during the norming phase, resulting in
productivity and meaningful sharing of information. During this phase, it is essential that the group
leader encourage participation of all group members.
performing phase - Answer: Interdependence emerges during the performing phase of group
development. During this phase, problem solving takes place within the group. Group members are
typically highly committed during this time. Collaboration is effective in groups that perform at a high
level.
adjourning phase - Answer: The adjourning phase takes place as the small group disperses, having
achieved the group's goals. By recognizing the various phases of group development and using
strategies to encourage communication among all group members, nurses can be very effective small-
group facilitators.
Public Communication - Answer: Public communication requires education, preparation, openness to
diverse opinions, and communication skills that encourage acceptance and dialogue.
The Nurse-Patient Helping Relationship - Answer: Nurse-patient relationships focus on five areas: (1)
building trust, (2) demonstrating empathy, (3) establishing boundaries, (4) recognizing and respecting
cultural influences, and (5) developing a comprehensive plan of care.
