Orthopaedic Nurse Test Communication & Stakeholder Relations 4 — Questions and Answers
Question 1: A patient's adult children disagree with each other about whether their parent should have surgery for a hip fracture. The patient is cognitively intact. What is the priority?
- Hold a family meeting and let the family decide
- Clarify the patient's own informed decision, since a competent patient has autonomy (Correct answer)
- Ask the surgeon to make the final decision
- Defer to the eldest child as next of kin
Correct answer: Clarify the patient's own informed decision, since a competent patient has autonomy
A cognitively intact adult patient has the legal and ethical right to make their own healthcare decisions regardless of family disagreement.
Question 2: Which action by an orthopaedic nurse best demonstrates culturally competent communication?
- Treating all patients the same regardless of background
- Asking patients about their cultural beliefs regarding pain and treatment, and incorporating these into the care plan (Correct answer)
- Using medical terminology consistently to maintain professionalism
- Relying on visual aids to eliminate the need for verbal communication
Correct answer: Asking patients about their cultural beliefs regarding pain and treatment, and incorporating these into the care plan
Asking patients directly about their beliefs and incorporating responses into care planning is the hallmark of culturally competent, individualized care.
Question 3: A post-operative ACL repair patient tells the nurse they saw conflicting information online about their recovery protocol. The best response is to:
- Advise the patient to stop using the internet for medical information
- Acknowledge the confusion, clarify the prescribed protocol, and offer verified educational resources (Correct answer)
- Tell the patient to bring the websites to the physician's attention
- Explain that online sources are always unreliable
Correct answer: Acknowledge the confusion, clarify the prescribed protocol, and offer verified educational resources
Acknowledging patient research, clarifying evidence-based protocols, and providing reputable resources builds trust and reduces health misinformation harm.
Question 4: A nurse overhears a colleague making a negative comment about a patient's weight in front of other staff. The most appropriate response is to:
- Ignore it to avoid conflict with the colleague
- Address the colleague privately, explain the impact, and report if behavior continues (Correct answer)
- Report the colleague to administration without speaking to them first
- Confront the colleague loudly in front of staff to deter future behavior
Correct answer: Address the colleague privately, explain the impact, and report if behavior continues
A private, direct conversation is the first step in addressing unprofessional behavior; escalation through proper channels follows if the behavior continues.
Question 5: A hospital case manager requests an update on a patient's post-operative progress. The nurse's best approach is to:
- Refer the case manager directly to the physician
- Provide a concise, focused update on functional status, pain control, and discharge readiness (Correct answer)
- Share the complete medical record for the case manager to review independently
- Ask the charge nurse to handle all case manager communications
Correct answer: Provide a concise, focused update on functional status, pain control, and discharge readiness
A concise, relevant clinical update on function, pain, and discharge status enables the case manager to coordinate post-acute care effectively.
Question 6: A patient scheduled for knee arthroplasty is visibly anxious and asks repetitive questions about the surgery. The nurse's most therapeutic response is to:
- Limit responses to avoid reinforcing anxiety
- Respond calmly to each question, identify the source of anxiety, and offer pre-operative education tools (Correct answer)
- Encourage the patient to wait and ask the surgeon in the OR
- Document the anxiety and request a sedative order
Correct answer: Respond calmly to each question, identify the source of anxiety, and offer pre-operative education tools
Calm, consistent responses and targeted education address the cognitive and emotional components of pre-operative anxiety effectively.
Question 7: When a patient's advance directive conflicts with the family's wishes for aggressive post-surgical intervention, the nurse should:
- Follow the family's wishes to avoid conflict
- Honor the advance directive, notify the physician and ethics committee if needed, and support the family through the process (Correct answer)
- Ask the surgeon to make the final call
- Defer the decision until the patient regains consciousness
Correct answer: Honor the advance directive, notify the physician and ethics committee if needed, and support the family through the process
Advance directives legally represent the patient's expressed wishes; the nurse must honor them and involve ethics resources when family conflict arises.
Orthopaedic Nurse Test Communication & Stakeholder Relations 4
A patient's adult children disagree with each other about whether their parent should have surgery for a hip fracture.
The patient is cognitively intact.
What is the priority?