Cardiac Vascular Nursing Exam Communication & Stakeholder Relations 3 — Questions and Answers
Question 1: A newly implanted pacemaker patient is being educated about activity restrictions. The patient nods at each instruction but cannot answer follow-up questions correctly. What should the nurse do?
- Pause, simplify the information into smaller segments, and use written materials or diagrams alongside verbal instruction (Correct answer)
- Document that education was provided and discharge the patient
- Ask a family member to re-teach the patient at home
- Increase the pace of instruction to cover all topics before discharge
Correct answer: Pause, simplify the information into smaller segments, and use written materials or diagrams alongside verbal instruction
When a patient cannot correctly answer follow-up questions, the nurse must modify the teaching approach using smaller chunks and multimodal materials.
Question 2: A cardiac nurse receives a verbal order over the phone to administer IV metoprolol. What is the correct process before administering?
- Repeat the order back to the physician verbatim, receive confirmation, document it as a verbal order, and administer only after confirmation (Correct answer)
- Administer immediately and document later
- Refuse all verbal orders for cardiac medications
- Ask another nurse to take the order and then administer
Correct answer: Repeat the order back to the physician verbatim, receive confirmation, document it as a verbal order, and administer only after confirmation
Read-back of verbal orders for high-alert medications like IV beta-blockers is mandatory to prevent life-threatening administration errors.
Question 3: A patient's family member insists on being present during all nursing assessments and frequently interrupts the nurse's questions to answer for the patient. How should the nurse address this?
- Politely explain that direct patient responses are needed for accurate assessment, and direct questions clearly to the patient (Correct answer)
- Allow the family member to answer to keep the peace
- Exclude the family member from all future interactions
- Document the behavior and take no further action
Correct answer: Politely explain that direct patient responses are needed for accurate assessment, and direct questions clearly to the patient
Nurses must obtain direct patient responses during assessment to ensure accuracy; politely redirecting family preserves patient voice without damaging the therapeutic relationship.
Question 4: During shift handoff on a cardiac telemetry unit, a nurse uses SBAR. Which element of SBAR addresses the nurse's most urgent patient concern?
- Recommendation — the nurse's specific request or suggested action for the oncoming nurse or provider (Correct answer)
- Situation — a brief statement of the current problem
- Background — relevant clinical history and context
- Assessment — the nurse's interpretation of the clinical data
Correct answer: Recommendation — the nurse's specific request or suggested action for the oncoming nurse or provider
The Recommendation element of SBAR is where the communicating nurse articulates the specific action needed, making it the most actionable component for urgent concerns.
Question 5: A patient with peripheral arterial disease from a non-English-speaking background requires education on wound care. The patient's adult child offers to interpret. What is the best practice?
- Use a trained medical interpreter rather than a family member to ensure accurate, unbiased translation of medical instructions (Correct answer)
- Accept the family member's offer as it is convenient and the patient seems comfortable
- Provide written English materials and rely on the family to translate at home
- Delay education until a family member with stronger English skills is available
Correct answer: Use a trained medical interpreter rather than a family member to ensure accurate, unbiased translation of medical instructions
Trained medical interpreters prevent mistranslation, protect confidentiality, and avoid placing family members in ethically difficult positions.
Question 6: A nurse notices that a colleague failed to document a medication error involving a cardiac patient but administered the correct antidote and the patient is currently stable. What is the nurse's responsibility?
- Encourage the colleague to complete an incident report and document the event, and report to the charge nurse if the colleague refuses (Correct answer)
- Ignore the situation since the patient is stable and no harm occurred
- Report the colleague to administration anonymously without first speaking to them
- Document the event in the patient chart under the colleague's name without their knowledge
Correct answer: Encourage the colleague to complete an incident report and document the event, and report to the charge nurse if the colleague refuses
Near-miss and medication error reporting is essential for patient safety culture; nurses are ethically and professionally obligated to ensure events are documented and reported.
Question 7: A palliative care consultation is ordered for a patient with end-stage heart failure. The patient's spouse says they do not want the patient to know 'how bad it is.' How should the nurse respond?
- Acknowledge the spouse's concern, but explain that the patient has the right to know their diagnosis and prognosis, and work with the team to facilitate an honest conversation (Correct answer)
- Honor the spouse's request and withhold all prognosis information from the patient
- Tell the patient everything immediately without informing the spouse
- Transfer care to a nurse more comfortable with end-of-life discussions
Correct answer: Acknowledge the spouse's concern, but explain that the patient has the right to know their diagnosis and prognosis, and work with the team to facilitate an honest conversation
Patient autonomy and truthful communication are ethical obligations; nurses must respect both the patient's right to information and the family's emotional concerns through facilitated dialogue.
Cardiac Vascular Nursing Exam Communication & Stakeholder Relations 3
A newly implanted pacemaker patient is being educated about activity restrictions.
The patient nods at each instruction but cannot answer follow-up questions correctly.
What should the nurse do?