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Presenting Yourself to the Workplace

1. What is a good substitute for handwashing? A. Wearing gloves. B. Using hand sanitizer. C. Using antibacterial wipes. D. There is no substitute for handwashing. Rationale: There is no substitute for handwashing. Always follow correct handwashing procedures. Gloves do not replace handwashing. Wash hands every time you change your gloves and understand how to use, remove, and dispose of gloves correctly. Hand sanitizer does not replace handwashing. Even when using hand sanitizer, follow correct handwashing procedures. Antibacterial wipes do not replace handwashing. Always follow correct handwashing procedures. 2. When is it appropriate to use a patient’s name? A. When you are at home talking to your spouse. B. When you are at work, in a public area, chatting with a colleague about your day. C. When you are at work, in a private area, discussing patient care. D. When you have a funny picture of the patient you want to post to social media and you want to make sure it is tagged correctly. Rationale: It is appropriate to use a patient’s name at work, in a private area, while discussing patient care. It is never appropriate to use a patient’s name at home. You have a legal and ethical obligation to protect patient privacy. Always keep patient information confidential. It is never appropriate to use a patient’s name in a public area. You have a legal and ethical obligation to protect patient privacy. Always keep patient information confidential. It is never appropriate to name or post a photo of a patient anywhere on the internet. You have a legal and ethical obligation to protect patient privacy. Always keep patient information confidential. 3. You are introducing a colleague to a young female patient. Which personal title is most appropriate? A. Miss B. Mrs. C. Ms. D. Leave out the title since you don’t know how she would prefer to be addressed. Rationale: Ms. is always appropriate for a female patient. Miss and Mrs are considered outdated. However, if a patient requests that you address her by one or the other, you should defer to her preference. Ms. is always appropriate for a female patient. Miss and Mrs are considered outdated. However, if a patient requests that you address her by one or the other, you should defer to her preference. Ms. is always appropriate for a female patient. Miss and Mrs

are considered outdated. However, if a patient requests that you address her by one or the other, you should defer to her preference. Do not leave off the personal title. Ms. is always appropriate for a female patient. Miss and Mrs are considered outdated. However, if a patient requests that you address her by one or the other, you should defer to her preference. 4. You are introducing a male patient to a surgeon and an anesthetist. What would be the most appropriate introduction? A. “Dr. Blake, I would like to introduce you to Terrance Smith. Mr. Smith, this is Dr. Stephen Blake, our chief of surgery. And that sweetheart over there is Ms. Reynolds, one of our anesthetists.” B. “Dr. Blake, Ms. Reynolds, this is Terrance Smith, the patient I was telling you about. Mr. Smith, this is Dr. Blake, our chief of surgery, and Ms. Reynolds, one of our anesthetists.” C. “Mr. Smith, I would like you to meet Dr. Blake, our chief of surgery, and Ms. Reynolds, one of our anesthetists. Dr. Blake, Ms. Reynolds, this is Terrance Smith.” D. “Mr. Smith, this is Ms. Reynolds, the anesthetist who will be with you during your procedure, and Dr. Blake, our chief of surgery. Dr. Blake, this is Terrance Smith.” Rationale: The correct order is to introduce the most important person first. When a patient, or customer, is present, he or she is the most important person, followed traditionally by medical doctors and surgeons, others with doctorates of any kind, and then persons without doctorates, usually arranged by rank, education, and seniority. In this example, it is correct to lead with Mr. Smith (the patient), then Dr. Blake and Ms. Reynolds: “Mr. Smith, I would like you to meet Dr. Blake, our chief of surgery, and Ms. Reynolds, one of our anesthetists. Dr. Blake, Ms. Reynolds, this is Terrance Smith.” Additionally, do not introduce doctors by their first names or refer to colleagues by pet names. 5. You are performing a routine computer task for which you are responsible, when you are interrupted by a client. Which response would be the most appropriate? A. Ask someone else to deal with the client while you finish the task. B. Be grateful for the interruption so you won’t have to finish the task. C. Greet the client promptly, then perform the task. D. Ignore the client while you finish the task. Rationale: Be courteous, and greet the client promptly. Be courteous, and greet the client promptly, even if you are not the correct person to assist him or her. Be courteous, and greet the client promptly. When you have seen to the client’s needs, finish all tasks you have been assigned. Be courteous, and greet the client promptly. Do not ignore the client while you work.

Active Listening 1. A communication technique where the listener gives the speaker her full attention in order to understand, respond, and remember what was said is called? A. Active listening B. Listening C. Reflective listening D. Nonverbal communication Rationale: Active listening is a communication technique where the listener gives the speaker her full attention in order to understand, respond and remember what was said. Listening is the passive process of hearing someone speak. Active listening is a communication technique where the listener gives the speaker her full attention in order to understand, respond and remember what was said. Reflective listening is a communication technique where the listener repeats back what the speaker says to verify understanding. Nonverbal communication encompasses the non spoken elements of communication, including body language and facial expressions. 2. How does active listening result in better patient care? A. Active listening causes patients to be more compliant with their treatments. B. Active listening demonstrates respect. C. Health care professionals with good listening skills are able to uncover valuable information that can be used to provide better care. D. Patients value providers who are good listeners. Rationale: While active listening does demonstrate respect, and can foster a good providerpatient relationship, the benefit of active listening is in the valuable information that can be uncovered. Health care professionals with good listening skills are able to uncover valuable information that can be used to provide better care. While patients do value providers who are good listeners, the benefit of active listening is in the valuable information that can be uncovered. 3. What type of question promotes more complete answers? A. Closed-ended B. Open-ended C. Reflective D. Leading Rationale: Open-ended questions prompt the most complete answers; they encourage the patient to explain something fully. Closed-ended questions elicit short answers. This type of question is useful when you need a concise, concrete result. Open-ended questions prompt the most complete answers. Reflective questions confirm or clarify something the speaker has already said. Open-ended questions prompt the most complete answers. Leading questions

direct the speaker to answer in a specific way. Open-ended questions prompt the most complete answers. 4. Which of these people is displaying the most attentive body language? A. Lia flips through the medical record and takes notes while the Mrs. Rush explains her medical history. B. John makes eye contact with Mr. Smith frequently as he types at his workstation and nods at one of his comments to show he is paying attention. C. Elaine puts her papers down and sits down across from Mr. Klein, hands in her lap, and makes eye contact with him while he explains his situation. D. Thomas listens to Ms. Brown while he works at making her comfortable, occasionally smiling or glancing her way. Rationale: Elaine is displaying the most attentive body language. She has put away her papers and given Mr. Klein her complete attention. Lia isn’t as attentive as Elaine. Lia is trying to read and listen at the same time and isn’t giving Mrs. Rush her full attention. John isn’t as attentive as Elaine, but he is giving the patient his attention as he takes notes. Thomas is more focused on his task of making Ms. Brown comfortable than he is on listening to her. Elaine the person displaying the most attentive body language. 5. Keri is listening to Mrs. Ellison. They have found a quiet place for their conversation and Keri leans toward Mrs. Ellison and makes eye contact as they talk. By doing this, Keri is performing which part of active listening? A. Giving her full attention B. Encouraging Mrs. Ellison to elaborate on her statement C. Communicating her understanding D. Waiting for Mrs. Ellison to stop talking so she can speak Rationale: Keri is giving Mrs. Ellison her full attention, as shown by her eye contact and body language. Keri is giving Mrs. Ellison her full attention, as shown by her eye contact and body language. Her next step might be to encourage Mrs. Ellison to elaborate on her statement. Keri is giving Mrs. Ellison her full attention, as shown by her eye contact and body language. When Mrs. Ellison stops speaking, Keri would paraphrase Mrs. Ellison’s words to communicate her understanding. Although Keri will not interrupt Mrs. Ellison while she’s speaking, she is not just waiting for her turn to speak. Instead, Keri is giving Mrs. Ellison her full attention, as shown by her eye contact and body language.

Empathy 1. What is the part of the brain that most closely associated with empathy? A. Limbic system B. Neocortex C. Medulla D. Cerebellum Rationale: The limbic system controls emotion and memory, which aids our ability to empathize with others. The neocortex involves thinking, language, motor commands, and sensory perception, which contribute to empathy, but is not as closely associated with empathy as the limbic system. The medulla controls autonomic functions such as respiration, heart function, and digestion. This part of the brain is not closely associated with empathy. The cerebellum is mainly concerned with movement and equilibrium. This part of the brain is not closely associated with empathy. 2. What is empathy? A. Sharing the feelings of others B. The ability to understand the feelings of others C. The total impression you make on people through your behavior, body language, and charisma. D. Knowing how to appropriately behave in a particular situation. Rationale: Empathy is the ability to understand the feelings of others. Sympathy is sharing the feelings of others. Compassion is sympathy, coupled with the desire to alleviate the suffering of others. Situational awareness is the ability to appropriately behave in a particular situation. 3. Focusing your attention on the present, observing your environment, and accepting without judgement are aspects of which empathy-building practice? A. Active listening B. Loving-Kindness meditation C. Mindfulness meditation D. Primordial sound meditation Rationale: Mindfulness meditation is an empathy-building practice that involves focusing your attention on the present, observing your environment, and accepting reality without judgement. Active listening is the practice of paying close attention to person’s verbal and nonverbal language. It is essential to effective communication. Loving-kindness meditation is an empathybuilding practice that involves positivity, acceptance and kindness directed to yourself and others. Primordial sound meditation is a mantra-based technique used to still the mind. 4. Why is empathy important for health care professionals? A. It enables faster patient care.

B. It promotes friendship. C. It promotes more successful patient care. D. It causes stress reduction in the patient and healthcare provider. Rationale: Empathy promotes more successful patient care, which can speed recovery and lead to better patient outcomes, but it does not make patient care faster. Empathy is important to healthcare professionals because it promotes more successful patient care though understanding, rather than friendship. In a health care environment, empathy is used to relate to coworkers as well as patients. By understanding your colleagues’ feelings, you foster cooperation and teamwork. By understanding your patients’ feelings, you can provide more successful patient care through increased patient compliance, better pain management, overcoming bias, and reducing the impact of health disparities. Empathy is important to healthcare professionals because it promotes more successful patient care though understanding, which can, in turn, reduce stress. 5. What is the primary step in forming an empathic relationship? A. Showing interest B. Displaying authenticity C. Withholding judgement D. Active listening Rationale: The primary step in forming an empathic relationship is showing interest in a person. Authenticity, or being true to your own nature or beliefs, aids in trust; showing interest is the primary step in forming an empathic relationship. Withholding judgement aids in understanding; showing interest is the primary step in forming an empathic relationship. Active listening aids in understand; however, showing interest is the primary step in forming an empathic relationship.

Assessing Apical Pulse 1. What is the primary purpose of initially assessing an apical pulse? A. Assessment of the patient’s cardiac function B. Establishment of a baseline as part of the patient’s vital signs C. Assessment of the patient’s risk for cardiovascular disease D. Determination of oxygen saturation Rationale: The primary purpose for initially assessing an apical pulse is establishing a baseline for the patient against which future assessments of apical pulse rate can be compared. The apical pulse rate provides some information about the patient’s cardiac function; however, obtaining such information is not the primary goal of conducting this assessment at this time. Measuring the apical pulse rate does not adequately assess the patient’s risk for cardiovascular disease. Other factors (such as age, smoking, dietary patterns, and exercise habits) contribute to the risk for cardiovascular disease. Pulse oximetry is the measurement of arterial blood oxygen saturation, not an apical pulse. 2. What instruction should the nurse give nursing assistive personnel (NAP) regarding the appropriate technique when measuring the adult patient’s apical pulse? A. Document the patient’s pulse rate and rhythm. B. Place the patient in the right lateral position before measuring the apical pulse. C. Review the patient’s previous apical pulse measurements. D. Place your stethoscope at the fifth intercostal space over the left midclavicular line. Rationale: These anatomical landmarks allow correct placement of the stethoscope over the apex of the heart. Documenting the patient’s pulse rate and rhythm pertains to documentation, not technique. The patient may assume a sitting or supine position before measuring the apical pulse. The heart is located to the left of the sternum. If unable to locate the point of maximal impulse (PMI), reposition the patient on the left side to hear the sounds more clearly. Reviewing the patient’s previous apical pulse measurements does not pertain specifically to the technique or procedure itself. 3. Which action would take priority if a patient’s apical pulse has an irregular rhythm? A. Reassess the pulse for 1 full minute. B. Assess the patient’s peripheral pulses. C. Wait 5 minutes, and then reassess the apical pulse. D. Review documentation regarding an irregular rhythm. Rationale: A second measurement confirms the initial findings of an irregular heart rate. Irregular rate is more accurately assessed when measured over a longer interval. Peripheral pulse assessment is not a priority. Apical pulse is the most accurate pulse site. An irregular apical pulse already indicates an alteration in cardiac output. Waiting 5 minutes to reassess the apical pulse is not a priority action and could be dangerous in some unstable cardiac conditions.

Reviewing documentation regarding an irregular rhythm is not the priority action, because establishing a history of irregular heartbeat is not essential. 4. Which statement demonstrates an understanding of the importance of communicating changes in the patient’s apical pulse rate? A. “The patient’s apical pulse is recorded as you asked.” B. “The apical pulse is more difficult to hear when the patient is sitting up.” C. “The apical pulse is usually slower in the morning than it is in the afternoon.” D. “The apical pulse increased from 78 to 110, but the patient had just returned from the bathroom.” Rationale: This statement identifies a significant change in the patient’s apical pulse rate and the reason for the deviation in the rate. Recording the patient’s apical pulse pertains to documentation, not to changes in apical pulse rate. While sitting up may make it more difficult to hear the apical pulse this may be true for an individual patient, it does not pertain to changes in the patient’s apical pulse rate. The general statement that the apical pulse is usually slower in the morning than it is in the afternoon may or may not be accurate; it does not pertain to a significant change in the patient’s apical pulse rate. 5. The nurse can best determine the effect of crying on a patient’s apical pulse by doing what? A. Measuring the patient’s apical pulse before and after crying B. Assessing the patient’s apical pulse 30 minutes after crying C. Measuring the patient’s pulse deficit after crying D. Comparing the patient’s post-crying apical pulse rate with her baseline or previous rate Rationale: The comparison of apical pulse rates at these times is the best means of evaluating the effect of crying on the patient’s apical pulse rate. These values would be available data to compare. It is unlikely that the nurse will have the opportunity to measure the patient’s apical pulse before and after crying. The time interval of 30 minutes is too long to effectively assess the effect of the crying on the apical pulse. Pulse deficit indicates alterations in cardiac output, not the effect of the emotional reaction.

Assessing Apical-radial Pulse 1. What is the major health problem resulting from a pulse deficit? A. Bradycardia B. Activity intolerance C. Decreased cardiac output D. Impaired tissue perfusion Rationale: Decreased cardiac output is the major problem indicated by a pulse deficit. Decreased cardiac output may lead to other problems, such as activity intolerance. Bradycardia is a pulse rate less than 60 beats/minute. This can occur without a pulse deficit. Activity intolerance may or may not occur with a pulse deficit. Impaired tissue perfusion may or may not occur with a pulse deficit. Decreased cardiac output may lead to impaired tissue perfusion. A cardiac dysrhythmia may lead to impaired tissue perfusion, but the impaired perfusion itself is not the most important possible result of the dysrhythmia. 2. What should the nurse do when a pulse deficit is suspected? A. Measure the radial pulse for 1 minute, and then measure the apical pulse for 1 minute. B. Measure the radial pulse for 30 seconds, and then measure the apical pulse for 30 seconds. C. Measure the radial pulse for 1 minute, wait 5 minutes, and then measure the apical pulse for 1 minute. D. Ask another health care provider to count the radial pulse while the nurse counts the apical pulse. Rationale: The nurse counts the apical pulse while another health care provider counts the radial pulse. To identify pulse deficit, the apical and radial pulses must be measured at the same time. A more accurate measurement is obtained when apical pulse rate is assessed over a longer interval (count 1 full minute). 3. Which action should the nurse perform after identifying a pulse deficit? A. Reassess the apical-radial pulse in 5 minutes. B. Assess the patient for signs of decreased cardiac output. C. Notify the primary health care provider of the pulse deficit. D. Initiate interventions directed toward managing t...