Models of Communication

Every question here, with the answer

1. A nurse is giving discharge diet instructions to a patient after a myocardial infarction. The patient says they eat “snowballs” every day, and the nurse realizes the word may not mean what the nurse first thought. What should the nurse do next to support safe and effective teaching?

   1. Document that the patient’s diet cannot be assessed because the message is unclear.
   2. Continue the teaching using the nurse’s original understanding of the word.
   3. Ask the patient additional questions to clarify the meaning before changing the teaching plan.
   4. Switch to written instructions only and avoid discussing the diet further.

   Answer: Ask the patient additional questions to clarify the meaning before changing the teaching plan.

   The section describes semantic noise as a barrier when words are understood differently. In the example, the nurse asked additional questions, clarified what the patient meant, and then changed the plan of care and teaching information.

2. A nurse is planning communication with members of the healthcare team using the interactional model. Which nursing actions or considerations fit this model? Select all that apply.

   1. Limit the communication to verbal messages only.
   2. Be aware that a noisy, busy room may prevent feedback and cause the message to be lost.
   3. Allow time for feedback so the message can be clarified.
   4. Recognize that the sender and receiver may alternate roles during the communication.
   5. Use a one-way message because feedback is not part of this model.

   Answer: Be aware that a noisy, busy room may prevent feedback and cause the message to be lost., Allow time for feedback so the message can be clarified., Recognize that the sender and receiver may alternate roles during the communication.

   The interactional model is a two-way process that includes feedback, and the sender and receiver can change roles. The section also notes that physical context, such as a noisy and busy room, can interfere with feedback and cause the message to be lost; it is not limited to verbal communication.

3. A nurse asks a patient to rate pain using a pain rating scale. While listening to the patient’s verbal response, what should the nurse also do when using the transactional model?

   1. Observe the patient’s nonverbal communication for congruence with the verbal response.
   2. Stop the assessment until the patient can provide the answer in writing.
   3. Focus only on the number the patient gives because verbal communication is the main channel.
   4. Avoid interpreting visible signs because feedback is not part of the transactional model.

   Answer: Observe the patient’s nonverbal communication for congruence with the verbal response.

   In the transactional model, sending and receiving can occur simultaneously, and multiple communication modes may be used at the same time. The section specifically describes monitoring visible signs of pain while observing the patient use the pain rating scale.

4. A postpartum patient’s partner explains that the family returned the thermostat to 80°F because warmth is part of the patient’s cultural postpartum practice. Which nurse responses are appropriate when applying the transactional model? Select all that apply.

   1. Ask whether there are other cultural practices the nurse should know about after the birth.
   2. State that the patient’s wishes will be respected and shared with future caregivers.
   3. Lower the thermostat again because the nurse finds the room uncomfortable.
   4. Apologize and acknowledge that the nurse did not realize the warm room was part of the patient’s culture.
   5. Tell the patient that cultural preferences cannot affect the care environment.

   Answer: Ask whether there are other cultural practices the nurse should know about after the birth., State that the patient’s wishes will be respected and shared with future caregivers., Apologize and acknowledge that the nurse did not realize the warm room was part of the patient’s culture.

   The transactional model is influenced by social, relational, and cultural context, so the nurse should respect the patient’s context and preferences. In the scenario, the nurse apologizes, agrees to respect the preference, informs future caregivers, and asks about other cultural practices.

5. A patient is unable to speak, and the nurse needs to assess the patient’s pain. Which communication approach is most appropriate based on the section?

   1. Wait to assess pain until the patient can speak verbally.
   2. Use medical jargon because it provides the most precise meaning.
   3. Communicate only through written words because pictures are not appropriate in patient care.
   4. Use referent communication, such as a faces-based pain rating scale.

   Answer: Use referent communication, such as a faces-based pain rating scale.

   The section explains that referent communication can use faces or objects in place of words. It specifically identifies checking pain in a patient who is unable to speak as a helpful use of referent communication.

6. A nurse manager emails an employee about an important department meeting. Which statements reflect the transmission model of communication in this situation? Select all that apply.

   1. The nurse manager should strive to make the message clear and concise.
   2. The communication is a linear, one-way process between sender and receiver.
   3. The defining feature is that sender and receiver send and receive messages simultaneously.
   4. The sender has the burden to make sure the message was received and understood.
   5. Noise may make interpretation of the message difficult.

   Answer: The nurse manager should strive to make the message clear and concise., The communication is a linear, one-way process between sender and receiver., The sender has the burden to make sure the message was received and understood., Noise may make interpretation of the message difficult.

   The transmission model is linear and one-way, with the sender initiating the message and needing to be clear and concise. The section also states that the burden is on the sender to ensure the message was received and understood, and that environmental or semantic noise can interfere with interpretation; simultaneous sending and receiving describes the transactional model.