Mixed Deck — All CELBAN Topics Flashcards

Which statement BEST demonstrates active listening during a patient interview?

Answer: 'So what you're telling me is that the pain worsens after eating — is that correct?'

Paraphrasing and seeking confirmation shows the nurse has heard and understood the patient's specific message.

During a home care assessment, a nurse notices a patient whisper to their spouse: 'Don't tell her about the falls — she'll want to put me in a home.' What risk does this withholding behavior create?

Answer: Unreported falls prevent the nurse from implementing fall prevention strategies, increasing injury risk

Concealing fall history deprives the care team of information needed to assess fall risk and implement safety measures, putting the patient in danger.

Which phrase best demonstrates professional telephone closing etiquette for a nurse?

Answer: 'Thank you for calling. I'll follow up with the team right away. Goodbye.'

A professional closing summarizes the next action, thanks the caller, and ends courteously, reinforcing accountability and communication clarity.

A patient says, 'I understand' after medication instructions but cannot demonstrate the correct technique. What should the nurse do?

Answer: Re-teach using a different method and reassess

Verbal confirmation alone is insufficient; the nurse must re-teach and use return demonstration to verify understanding.

A patient's chart notes 'dyspnea on exertion.' What does this mean?

Answer: Shortness of breath during physical activity

Dyspnea refers to difficulty breathing or shortness of breath, and 'on exertion' means it occurs during physical activity.

A pharmacology reference passage states: 'Opioid analgesics act on mu, kappa, and delta receptors in the CNS. Common adverse effects include respiratory depression, constipation, urinary retention, nausea, and sedation. Tolerance develops to most effects except constipation.' A patient on long-term opioid therapy for cancer pain asks why they still need laxatives even though their pain control has stabilized. What is the BEST explanation?

Answer: Constipation is an opioid side effect that does not resolve with tolerance

Unlike most opioid side effects, tolerance to opioid-induced constipation does not develop, so bowel regimens remain necessary for the duration of opioid therapy.

During history taking, a patient says her pain is '8 out of 10' but she is smiling and chatting comfortably. How should the nurse document this finding?

Answer: Document pain as 8/10 as reported by the patient and note the observed discrepancy

The nurse must document the patient's self-report as it is the gold standard for pain assessment, while also noting any objective discrepancies for clinical context.

A nurse is teaching a postpartum patient about newborn feeding. Which statement indicates the need for further teaching?

Answer: 'I should give my baby water between feedings to prevent dehydration.'

Water should not be given to newborns as it can cause hyponatraemia and interfere with adequate breast milk or formula intake.

Which sentence correctly uses a semicolon?

Answer: The patient was stable; however, the nurse continued monitoring vital signs.

A semicolon correctly joins two independent clauses, and 'however' as a conjunctive adverb is properly preceded by a semicolon and followed by a comma.

During a telephone triage call, a patient reports crushing chest pain radiating to the left arm. The nurse should FIRST:

Answer: Instruct the patient to call 911 immediately and stay on the line with them

Symptoms of a possible cardiac event require immediate activation of emergency services; staying on the line ensures the patient is not alone.

A post-operative nursing note reads: 'Patient returned from OR at 1400 following laparoscopic appendectomy. SpO2 94% on 2L O2, BP 108/70, HR 102, RR 20. Patient is shivering and reports pain 7/10. Dressings dry and intact. Foley catheter draining clear yellow urine.' Which finding requires the MOST immediate nursing attention?

Answer: SpO2 of 94% on 2L O2

SpO2 of 94% on supplemental oxygen in a post-operative patient signals compromised oxygenation and warrants immediate assessment and intervention.

During a team huddle a physician says: 'We'll hold the metformin today — her creatinine came back at 180 and we're sending her for a contrast CT this afternoon.' What is the reason for withholding the medication?

Answer: Elevated creatinine and upcoming contrast imaging increase the risk of lactic acidosis with metformin

Metformin is held before contrast CT in patients with elevated creatinine to prevent contrast-induced nephropathy and metformin-associated lactic acidosis.

A patient refuses to take their prescribed medication. What is your best response?

Answer: "Can you tell me why you don’t want to take the medication?"

This response uses therapeutic communication by asking an open-ended question to understand the patient's concerns or reasons for refusal. It respects patient autonomy and allows the nurse to address specific barriers or provide necessary education, rather than being confrontational or dismissive.

When documenting an incident, which piece of information is considered 'subjective' data?

Answer: The patient stating, "I feel dizzy."

Subjective data is information reported by the patient that cannot be directly measured or observed by the healthcare provider. The patient's feeling of dizziness is their personal experience. The other options are objective data, which are measurable and observable facts.

A chart progress note reads: 'Crackles auscultated bilaterally at lung bases, O2 sat 91% on 2L NC.' What should the nurse do first?

Answer: Increase oxygen flow rate and reassess oxygen saturation

An O2 saturation of 91% is below the acceptable threshold of 95%; increasing the oxygen delivery and reassessing is the immediate nursing action.

This will provide the patient a realistic idea of how long the treatment, interview, etc. will take and let them know that you are working on the problem. (so they can make appropriate plans).

Answer: Level setting of expectations

Level setting of expectations means giving the patient a realistic sense of how long a process will take and confirming you are actively working on their issue. This is distinct from simply 'setting expectations' (which is more one-directional) and from probing or clarifying questions, which gather information rather than communicate timelines.

A nurse notices that a peer is consistently cutting corners in documentation. The MOST appropriate action is to:

Answer: Address the concern with the peer directly, then escalate to the charge nurse if it continues

Professional accountability involves addressing concerns collegially first, then escalating through proper channels if behavior does not change.

You are giving discharge instructions to an elderly patient who will be managing multiple medications at home. Which strategy is most likely to enhance their adherence to the medication schedule?

Answer: Creating a simple, large-print chart with the medication names, times, and doses.

Visual aids, especially those tailored to the patient's needs like a large-print chart, simplify complex information. This helps organize the schedule clearly, reducing the cognitive load on the patient and making it easier for them to follow the instructions correctly, thereby improving adherence.

A nurse hears a patient with a new colostomy tell a chaplain: 'I feel like I'm not a whole person anymore — I can't imagine my wife still finding me attractive.' What type of need does this statement primarily reflect?

Answer: Psychosocial and body image concerns requiring therapeutic communication and possible referral to a stoma nurse specialist or counselor

Body image disturbance after ostomy surgery is a psychosocial concern; nurses should offer therapeutic support and involve stoma care nurses and counselors as appropriate.

A nurse is asked by a patient to keep a conversation about substance use secret from other staff. What is the appropriate response?

Answer: Explain the limits of confidentiality and that information affecting care or safety must be shared with the team

Nurses must explain that confidentiality has limits when patient safety or care decisions are affected.