Situational Nursing Interview Questions & Answers
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1.
Give an example of how you may connect and find common ground with a patient to gain understanding.
How to Answer
All patients are different and come from different backgrounds and life experiences. Sometimes, the patient will have biases and reject you as a competent individual. Learning how to connect and find common ground with a patient quickly can improve patient outcomes. There is always something that you can find in common with someone. It could be the weather, good or bad, a comment on a crossword they are completing, admiration for their turquoise necklace, anything that is authentic and sincere to start to build a bridge or connection. It doesn't have to be a colossal sharing of souls, but just looking quickly for similarities instead of differences can have real impact. Take the time to learn conversational techniques that can elicit conversation and build rapport.
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2.
How would you change your communication style if the patient's family was having trouble understanding what you were trying to tell them?
How to Answer
Nurses are teachers and instruct patients on difficult concepts and challenging instructions. The efficacy of their instructions is extremely important for optimal patient outcomes. For example, if a patient leaves the hospital or clinic setting without full comprehension of the plan of care then they may return to the hospital or have worsening symptoms or complications. Poor comprehension comes with a high burden of decreased patient outcomes, increased financial ramifications for patient and healthcare system, and decreased patient satisfaction. It is extremely important that the nurse learns to communicate with the patient and family in a way that they understand and can implement.
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3.
Your coworker forgot to sign off that she gave Tylenol as a PRN before she punched out and calls you from the car. She asks you to initial that it was given so nobody gives it again. What do you do?
How to Answer
It sounds like the right thing to do. After all, you don't want the patient to be given extra Tylenol, but you should never do this. It's illegal and forging the medical record. It's unethical and risks your nursing license. The correct thing to do is to write down the information about the dose and attach a sticky note to the MAR so that there is a visual reminder for the person administering medications. This information should be reported to the shift nurse manager and guidance received. Under no circumstances should the nurse sign off a medication that he or she did not administer.
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4.
In your inpatient unit, you are caring for a patient who is still weak from surgery. Upon reviewing physician orders, you see the patient is to get up and walk two laps in the hall. Tell me how you would proceed.
How to Answer
The interviewer is attempting to determine if the candidate would assess the patient's ability to participate in physical activity before getting her up to walk around the hall of the inpatient unit. Patient falls is one of the biggest patient safety concerns for hospitals, and it is the onus of the nursing staff to ensure they protect their patients from falls in all situations, even when there is a physician order stating otherwise. To effectively answer this question, the candidate should indicate that they would assess the patient's ability to participate in the physical activity, and if they, in fact, the patient was too weak, they would contact the physician for alternative orders. A more successful answer to this question would include a specific example from the candidate's nursing career where they prevented a patient fall by assessing their ability to participate in physical activity.
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3 Community Answers
Anonymous Answer"I would ensure that the patient is feeling strong enough to walk the laps by talking to them about it. Assess their ability prior to starting. I would then help them sit up and dangle their feet at the side of the bed to make sure and avoid any orthostatic hypotension. I would make sure that their non-slip socks are on and make sure that they aren't feeling dizzy. Once they are ready I would help them up and use any assistive devices as needed and walk with them."
Chad's AnswerYou make it clear that assessing the patient’s ability to participate in physical activity is the top priority. Good job! Be sure to also discuss the steps you would take if the patient was too weak to proceed. If possible, include a specific example of a time you prevented a patient fall by assessing a patient's ability to participate in physical activity and use the STAR method to frame your response.
Was this answer helpful? Yes (19) or No (0)Thank you, your vote helps us display the best answers!Anonymous Answer"Start slow and use mobility aids they normally use, ensure have non-slip socks or well-fitting shoes on, sit at the side of the bed for a few minutes ask if dizzy? Address pain prior to mobilizing but make sure meds won’t make them drowsy or uncoordinated. Even tho it’s ordered if it’s unsafe to walk them then don’t put myself or the patient at risk. Notify doc if failed walk test and next steps. Maybe need PT to mobilize the first time."
Cindy's AnswerGreat answer! It shows your knowledge and care. Good job.
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5.
You are caring for a patient on your inpatient unit, and after making a call to the physician hospitalist on staff for support, you learn that the patient's medication regimen needs to be changed. Tell me the first steps you take.
How to Answer
While many individuals may believe the first step a nurse should take in this situation would be to give the patient the new drugs that were verbally ordered by the physician, this is not the case. The first step the nurse should take after receiving the verbal order by the physician is to document the medication change in the patient's electronic medical record. Documentation errors are very common among nurses, and these errors include failing to document medications, procedures, and/or nursing actions. Because nurses are extremely busy and often distracted by multiple tasks and demands, it is important for this type of information to be immediately be documented in the patient record. To effectively answer this question, the candidate should indicate that they would document the changes in the patient's medication regimen before administering medications to the patient. A more successful answer to this question would include specific details from a similar situation from the candidate's nursing career where they ensured changes to the patient's care regimen were documented before administering care to the patient.
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Anonymous Answer"Once I learn that the patient's medication regimen needs to be changed, I would verify the orders with the doctor then immediately document them."
Chad's AnswerYou are definitely correct that the first step you need to take is to document the medication change. However, situational questions, such as this, are best answered by providing a story example from your past experience. For instance, tell the interviewer about a time where you ensured changes to the patient's care regimen were documented before administering care, and use the STAR (Situation, Task, Action, Result) formula as the framework for your response. This method will ensure that you provide the interviewer with a compelling answer that proves your ability to perform in this particular scenario. We have a guide that you may find helpful - https://www.mockquestions.com/articles/5 Behavioral Based Interview Questions You Should Prepare For/
Was this answer helpful? Yes (0) or No (0)Thank you, your vote helps us display the best answers!Anonymous Answer"I would call back the doctor let them know which medications need to be adjusted and why I felt they needed to be adjusted presenting BW, vitals, previous medication interactions, allergies changes in condition. Utilize SBAR and have the patient chart in front of me, as well as the online system open to view labs. My first step is to gather information prior to calling the doctor because they need to know how the patient originally presented how things have changed and recent data collected to aid in their decision process. I remember the first time as a new nurse calling the doctor when a patient was experiencing pain that was not controlled by their current pain medications and I had only didn't cycle a new set of vitals, I didn't have the MAR in front of me, I only had a brief history that I remembered off the top of my head. I felt very disorganized on that call and ever since I make sure to be prepared prior to calling the doctor. This way they get a clear picture of the patient and the patient's needs are met appropriately."
Cindy's AnswerGood use of example and explanation. By filling in the "whys" you are showing that you have a good grasp of the underlying reasons for your actions.
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6.
You are working phone triage for your physician practice when a patient calls asking for advice as he is having chest pains. Tell me what you direct the patient to do.
How to Answer
In this situation there are multiple directions the nurse could give the patient, but in a situation when a patient is having chest pains, the patient should be directed to go to the emergency department. While care can be given at a physician office or urgent care center, a patient with chest pains could be in the midst of a medical crisis which requires the service of an emergency department. The interviewer is asking this question to determine if the candidate understands the clinical significance of chest pains and the fact that the patient needs to be evaluated in the emergency department. To effectively answer this question, the candidate should indicate that they would direct the patient to hang up and immediately go to the emergency department. A more successful answer to this question would include a specific example from the nurse's career where they directed a patient with chest pains to the emergency department.
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Anonymous Answer"Ok, this patient might be having an MI so it is important for them to be seen right away to rule this out, get an ECG done, and a cardiac workup. Can ask if he has ever experienced this pain before? Does he have any cardiac history? Prescribed nitro for instance if so to take a spray of the nitro. Also should advise patient to take ASA if hasn't already done so. Patients having chest pain ask them to describe the pain LOTARP where is it, when did it start is it constant or intermittent what were you doing when it started, has it resolved gotten better or worse. Type is it sharp dull, tearing ripping, pressure, worse with deep inspiration or palpating, any associated symptoms SOB, diaphoretic, dizzy, does it radiate down their arm to their back up into the jaw. Any history of similar events did they see a doctor then. Any changes in medication, exercise, stress level. Advise going straight to emerg call EHS if no one to drive them do not drive yourself if you have chest pain."
Cindy's AnswerGood! Your answer reflects the urgency of the situation, but I'd recommend slowing down a bit and explaining the "why" behind your actions. This is a great opportunity to show that you understand the underlying reasons for the way you're handling the issue.
Was this answer helpful? Yes (0) or No (0)Thank you, your vote helps us display the best answers!Anonymous Answer"Immediately call 911."
Chad's AnswerGood start! It is clear you understand the clinical significance of chest pains and the fact that the patient needs to be evaluated in the emergency department. However, the interviewer will be anticipating a more complete answer with additional details. To strengthen your response, consider citing a specific example from your career where you directed a patient with chest pains to the emergency department.
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7.
You are talking with a patient during rounds, and the patient tells you she does not understand what the doctors tell her and she is unsure of what is going on with her health. Tell me how you respond to the patient.
How to Answer
Unfortunately, these types of situations are very common in the healthcare system, as patients are often confused or misinformed about their health. This is particularly true for elderly patients and/or patients without someone present to advocate for them. In this situation, the nurse should take time to help the patient understand what is going on with her health. The interviewer is asking this question to determine if the candidate would take initiative to help the patient; and to effectively answer this question, the candidate should indicate they would explain the medical situation to the patient in layman's terms. A more successful answer to this question would include a specific example from the nurse's career where they helped clarify a diagnosis, procedure, or other medical-related situation when a patient was confused.
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Anonymous Answer"Sadly this is not uncommon! I would take the time to review the diagnosis, tests done or to be done and why they were performed as well as results, blood work, plan, and along the way ask if she understands. Print out educational material about diagnosis or new meds. Ask if there is a language barrier can use a translator next time or provide educational materials in the native language or have a caregiver present when the doctor assesses."
Cindy's AnswerGood! If this is a common scenario, you may want to add an example from your experience. Have you had a similar situation? How did you respond? Did your response solve the problem?
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8.
You are alone in an elevator with two nurses from another floor who are talking about a patient. How would you respond?
How to Answer
Interviewers ask situational questions to test interviewees' people skills and their capacity to communicate and find optimal solutions. The answer here doesn't have to be work specific, unless it is apparent as in this question, but it's always a good idea to incorporate appropriate work behaviors in, when possible.
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9.
What kinds of review questions do you ask yourself after dealing with a difficult and challenging patient situation?
How to Answer
All nurses desire to have positive and impactful shifts every day, but this is not a reality. Things happen, situations go awry, and it's important to reflect as an individual or a team and extract the lesson to learn how to be better. It's human nature to rationalize or justify and not face the difficult feelings or emotions of a situation gone bad, but this reflection is extremely important so that it doesn't happen again.
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Anonymous Answer"What went well? What could I do better next time? What did I struggle with and how can I learn from my mistakes. For Example first time doing a sterile dressing change I went in and out of the room multiple times because I forgot supplies. Next time I made sure I gathered all my necessary supplies prior to entering the room helped with time management and the patient's confidence in my skill level."
Cindy's AnswerGood! This is a good answer format. Elaborate on why leaving the room was a problem in your example to give a fuller sense of why the change was necessary.
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10.
You are caring for a young patient who is being discharged with a prescription for an inhaler. Upon asking the patient if he knows how to use the inhaler, he says, "Yes, I do." Tell me how you proceed.
How to Answer
Although most medications are dispensed with administration instructions at the pharmacy, many patients do not understand how to administer to themselves which results in their misuse. For medications such as beta agonists or corticosteroids which are administered via inhaler, misusing the inhalant device could mean the patient is not getting enough medication to help manage their condition. This is common for all medications which is why it is important for nurses to ensure patients understand how to properly take their medications before discharge. The interviewer is asking this question to determine if the candidate would ensure the understands how to use the inhaler before discharging him, rather than simply taking the patient's word for it. To effectively answer this question, the candidate should describe, in detail, how they would verify that the patient understands how to use the inhaler. A more successful answer to this question would include a specific example from the candidate's nursing career where they helped educate a patient on their medication regimen before discharge or how they developed patient education protocols or materials for their unit or organization.
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Anonymous Answer"In this case, I would apply the teach-back method and ensure that the patient knows how to use it ."
Chad's AnswerThe teach-back method would be a great approach to take in this situation. However, the interviewer will be seeking a more detailed response describing how exactly you would verify that the patient understands how to use the inhaler. Are you able to describe the steps involved with implementing the teach-back method? If possible, cite a specific example from your nursing career of a time you helped educate a patient on their medication regimen before discharge.
Was this answer helpful? Yes (0) or No (0)Thank you, your vote helps us display the best answers!Anonymous Answer"Want the patient to demonstrate that they do in fact know how to use the inhalers correctly. Gather the supplies and have the patient demonstrate how to use the puffer. If not correct provide guidance and additional teaching. With younger patients, I like to print off instructions to go home with and involve a parent in teaching as well. Or better yet have the patient teach their parent how to do it. I like to do the teach-back method where you show them one step and they repeat back how to do it. Then you have them show you combining all the steps. Visual aids and hands-on teaching I find to be the most effective with patients. I also recommend if they are at home and have any concerns they can always call the 811 nurses line."
Cindy's AnswerGreat! The additional context works! It tells the interviewer why you are taking these steps. Good job.
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11.
How would you handle a patient who is trying to manipulate you in some way or talks about the other shift to you?
How to Answer
This answer appears easy ,but it's not. Being a new nurse sometimes makes people over eager to please and hearing great things about yourself rarely falls on unappreciative ears. You want to help and be sympathetic, but it's not helpful to engage in any conversation that downgrades your coworkers in any way. Sometimes these conversations are subtle and sometimes they are not. The easiest way to circumvent these situations is to enter each room prepared and with a plan for the visit or encounter and perform that task in a professional and kind manner. If the patient begins to complain about another individual, handle it by stating that you're sorry they had the experience and ask if they'd like for you to get the nursing manager to speak to.
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12.
How do you handle situations in which you disagree with a doctor's orders?
How to Answer
Nurses follow doctor's orders, but sometimes there are orders that a nurse feels are not in the patient's best interest. For example, if the doctor orders an antibiotic that the patient remembers she is allergic to, then it's easy for the nurse to tell the doctor that a different alternative is needed. But sometimes, the nurse disagrees with the validity of treatment that the doctor and patient agreed on. It's always helpful to say your dissension for the big stuff. You are more likely to be heard if you are known as a reasonable nurse who strives for excellence in their work ethic. If you have reasonable questions, ask the doctor if you could have several minutes of his time. Organize your thoughts, put your emotions in check, and outline your thoughts and rationales. The best outcome would be that the MD would do the same and it would be a learning moment. There is a chance that the doctor will not be as receptive as you would like and you will not impact the decision, but that should not stop you from advocating for your patient in a plain and reasonable manner.
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13.
How would you handle a situation in which nursing leadership were to reject an idea you pitched to streamline your job?
How to Answer
It's difficult to be rejected in any way, and it's really difficult when you excitedly share something that you feel will be helpful and it is not received well. If you pitch an idea to a supervisor or leadership team, ask for good feedback and learn their perspective. While it's easy to become defeated and not want to contribute, nursing needs you on the leading edge of thought. Review your idea and your presentation. Revise your pitch, if necessary, and ask for another opportunity to present your idea after further considerations. Consider the real possibility that you may have not presented your idea in a way that resonated with the recipient.
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14.
During your shift in the ER, a patient presents with bruising from a fall. Her male companion answers questions for her, and she barely gives eye contact. What do you do in this situation to get the patient to answer independently?
How to Answer
Sometimes a domestic abuse victim's only connection to help might be a trip to the ER or urgent care. All patients should be screened for abuse whether man, woman, or child. A nurse needs to know the warning signs and learn how to assess and ask effective questions. The nurse needs to learn how to optimize the interview and assessment so that the patient (man, woman, or child) can express themselves in a safe space. In the above scenario, the nurse needs to separate the woman safely from the man, so that she can ask if the woman feels safe and assess her for abuse.
It may be difficult to separate the individual from the companion, but it's best they be separated, as the potential abuse victim may not speak openly in front of the abuser.
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Anonymous Answer"I would separate the patient from the boyfriend. If the boyfriend is tough to separate often I’d be like let me take you to the women’s bathroom we need a sample. Ask if she feels safe at home, we had these SMART cards we could give women that were super non-descript looked like a gift card but had a helpline phone number. Let her know we are here to help her and it’s a safe space."
Cindy's AnswerGood. Again, context would help. What is your theory about the situation that makes your actions understandable?
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15.
You are currently in a patient's room during hourly rounds and although she is not due for another dose of pain medication for two more hours, she is complaining of increased pain. Tell me how you proceed.
How to Answer
The interviewer is asking this question for two reasons - first, to ensure the candidate will not give the patient a dose of pain medication before it is due; and second, to see if the candidate will attempt to lower the patient's pain using other comfort measures. While the administration of pain medication will relieve a patient's pain, it is important that pain medication is administered as directed by the physician, in order to avoid patient overdose or other negative side effects. Although patients may ask for pain medication in advance of their scheduled dose, nurses can help reduce their pain using other comfort measures, such as repositioning, offering heated blankets or warm compresses, helping them stretch, or getting them up for a walk. To effectively answer this question, the candidate should indicate that they would avoid giving the patient their pain medication early and instead use alternative comfort measures to help reduce the patient's pain. A more successful answer to this question would include an example from the candidate's nursing career where they helped a patient manage their pain using comfort measures rather than pain medication.
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Anonymous Answer"I would not give additional pain medication if it was not due yet, don’t want to overdose the patient. I would provide other comfort measures, pillows for support, warm or cool compresses, distraction, let the patient know when the next dose can be given and that they can use their call bell if I’m not back by that time. If they’re constantly requesting pain meds prior to the next dose I would call the doctor and see if pain management could be adjusted as the patient may require additional doses or higher strength. Perhaps changing the route from IV or PO to SQ butterfly for longer-lasting effects. Also, advise the patient to let me know when pain increases, don’t want to play catch up harder to control pain that way."
Cindy's AnswerGreat. I like that you assume facts and then answer the hypothetical. It shows that you're able to think ahead and have a plan if the original one doesn't work.
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16.
What tools or techniques do you use to remember difficult information or instructions given verbally only?
How to Answer
Situational interview questions are designed to assess candidate competencies in more depth and to avoid rote, standardized answers. The interviewer is looking to observe how you would triage a problem and figure out how to handle it in an optimal way. Situational questions allow the interviewer to showcase unique talents and competencies. Situational interview questions challenge the interviewee to think about situations that they may have never experienced before.
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Anonymous Answer"Listen attentively and repeat back what I heard and ask for clarification if unsure what was said or the order to do things in was confusing. Repeat it to myself multiple times, acronyms,"
Cindy's AnswerGood! Add a bit of context at the beginning of your response. I've included an example below.
"I use a number of techniques that help me remember important information. First, I listen attentively and repeat information back to the speaker to invite corrections in case I misheard. I also use repetition and acronyms. I recently used a technique during a [here, use an example of applying one of the techniques to remember complex information]."
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17.
You are caring for a patient who is three-years-old and the physician has ordered a weight-based medication. When you look at the patient's records, you find the weight is documented in pounds. Explain how you proceed.
How to Answer
Many pediatric medications are weight-based, which means the dosage that the patient will receive depends on their weight. However, for most of these medications, the dosing guidance is listed in kilograms and not pounds, the common unit of weight in the United States. Because of this difference in weight units, medication dosing errors in pediatric patients is very common. The interviewer is asking this question to determine if the candidate is aware of the common issues regarding pediatric weight and medication dosing errors and to determine how they would respond in this situation. To effectively answer this question, the candidate should indicate that they would convert the patient's weight to kilograms in order to determine the correct dosage of the medication for the child. A more successful answer to this question would include an example of when the candidate successfully mitigated such a situation during their nursing career.
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Anonymous Answer"When giving weight-based medications, it is important to convert pounds to kilograms because medications are ordered in kilograms. Therefore, I would convert the three-year-olds weight from pounds to kilograms to obtain an accurate dosage for the child's medication. This prevents med errors and any possible overdose or inadequate dosage."
Cindy's AnswerGood! The question is testing this very important aspect of your knowledge.
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18.
You are rounding on your patients on your inpatient unit, and as you enter an elderly woman's room, you find her sitting up and alert. Tell me what steps you take to prevent her from falling between now and the next time you round.
How to Answer
Falls are a common risk for patients who are receiving inpatient care, particularly among the elderly or patients with decreased mobility. Because of this, falls prevention is a common initiative at most hospitals and care facilities. Most nurses are expected to round on their patients hourly, at a minimum, and during these rounds, they are expected to ask their patients about the four P's - Pain, Potty, Positioning, and Possessions. By ensuring the four P's are covered, the nurse is ensuring the patient is comfortable and has everything they need, which will likely prevent them from attempting to get up on their own, hence preventing falls. The interviewer is asking this question to determine if the candidate has an understanding of falls prevention and the four P's of nursing. To effectively answer this question, the candidate should describe how they would check on the patient using the four P's. A more successful answer to this question can include a situation of how the candidate has used the four P's to prevent a patient from falling in their nursing career, how they trained a colleague on the four P's, or even how they implemented a falls prevention program at their facility using the four P's.
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Anonymous Answer"I believe that this depends on the condition of the patient and their specific fall risk assessment. If the patient is a fall risk it is important to go over a few things with them. I would go over the use of the call light, ensure that they are wearing their nonslip socks, ensure that the bed is lowered and that there are no items on the floor that they could potentially slip-on. Based on the institution's policies, the use of a bed alarm could be considered and discussed with the patient. While the nurse is in the room they can discuss the need for the patient to get out of bed whether they are in pain, need to go to the restroom, need any belongings that aren't near them and whether they are comfortable in their current position or need help repositioning for maximum comfort."
Chad's AnswerGreat answer! It sounds like you take great care to ensure the risk of falls is minimized for your patients. Consider referencing the four P’s (pain, potty, positioning, possessions) explicitly, to ensure it is evident to the interviewer you understand falls prevention and the four P's of nursing. Also, in the last sentence of your response, you move away from “I” language. Try to stick to first-person pronouns (I, me, my) so your answer remains personalized to you. I have offered a slight rewording of this sentence below:
"“While in the room, I always ask the patient if there is any need for them to get out of bed - whether they are in pain, need to go to the restroom, need any belongings that aren't near them, and whether they are comfortable in their current position or need help repositioning for maximum comfort."
Was this answer helpful? Yes (0) or No (0)Thank you, your vote helps us display the best answers!Anonymous Answer"I would proceed by making sure to inquire about the 4 P's. I would do a thorough pain assessment. I would assist the patient to the bathroom because a full bladder can encourage the need to get out of bed. I would turn and reposition the patient in bed and make sure they are comfortable by offering a warm blanket. Lastly, I would ask if they needed anything before the next comfort round."
Cindy's AnswerGood answer. This is a very specific answer that reflects your knowledge of protocols.
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19.
How would you explain a complex task to someone using verbal instructions?
How to Answer
Teaching patients in a way they can understand is an integral part of nursing. Healthcare is increasingly complex, so it makes sense that the instructions can be, as well. This question provides a chance to showcase your talent to take a complicated idea and explain it without losing the integrity of dumbing it down.
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Anonymous Answer"See what their baseline is and then fill in knowledge gaps from there. Break it down into smaller or simpler steps and frequently check in with the person to see if they understood. If I can use props or visuals I do. Teach back method is very effective and asking how they learn best so you can help make it easier for them to retain the info."
Cindy's AnswerGood start. This question is well suited to using an example that shows your approach in action. Can you think of a recent example to share?
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20.
How do you handle being asked to do a nursing task you've never completed before?
How to Answer
Most situational interview questions are best answered using the STAR method which involves thinking about the situation, task, action and result and providing solid and thorough answers. This is not the time to say that you would jump in with both feet. The interviewer is not looking for someone who just jumps when someone says jump, but someone willing to jump with confidence and competence. Your job is to provide an answer that illustrates this difference.
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21.
We are work with difficult and uncooperative coworkers, at times. How do you handle uncooperative coworkers?
How to Answer
Nursing is challenging and stressful sometimes. People get cranky, machines break, trays are late, and families are needy. Nurses are human beings and have off days. However, the goal for excellent patient outcomes must take precedence over bad days and bad moods, and the interviewer is looking for a candidate who can weather the storm, hold their own, and get the job done for the patient, without adding stress or chaos to the situation.
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22.
How would you handle a coworker who is habitually late, which causes you to leave work late?
How to Answer
This is a management and leadership issue which impacts other staff members' lives and team morale. However, it's worth taking the opportunity to address it with the coworker individually before elevating it to leadership. There is something happening if leadership is not addressing it, as they would be alerted if they were chronically punching or signing in late. It may be that the time clock is a distance walk to the unit, or they stop at the cafeteria on the way for coffee and the result is they are late for their shift. It is not helpful to be passive-aggressive and complain to other staff members. Learn to have the uncomfortable conversation directly, kindly, and professionally with the person or people that need to hear it.
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23.
How do you handle ethical or philosophical differences with a patient?
How to Answer
Nurses care for all patients, so they must have emotional mastery and cultural competence. It's difficult sometimes to separate our personal preferences and philosophies from our patients and not superimpose our cultural grid on their choices and feel disapproval. It is unprofessional and not optimal patient care to do so. Nurses must remind themselves when they enter the door to a patient's room that they do not need to know the whole story, and they can never know all the nuances that led to the belief or decision they disagree with. They must lead themselves to treat the individual in front of them as a human being who they are there to help, serve, and not to judge.
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24.
How would you handle someone asking you for medical advice or diagnosis validation outside the workplace?
How to Answer
This is a difficult challenge for nurses who know things and also have a compelling need to serve others. It's easy and ego-boosting to become the resident 'expert', but that can backfire. There is a reason why when people call the ER for advice, the standard answer is to present for an evaluation and advice isn't given over the phone. We live in a litigious society, and you worked hard for your license. Protect it just as hard. What may seem to be benign advice to your neighbor may result in catastrophic consequences. Also, it is best to give advice that points people in the direction of great care, such as writing down all symptoms.
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25.
How would you handle a patient that assumes a 'helpless' role, does not do what is necessary for their treatment, and asks you to do certain tasks that they could and should perform for themselves?
How to Answer
A nurse cares about patients, so it's difficult sometimes to recognize when we over function for patients and do not encourage them to be their best. Doing too much for patients is as damaging as doing too little. Nurses need to learn the subtle dance between empathy and advocacy for patients helping themselves. You want to encourage without being demeaning or too harsh, but also push them to do what they can for themselves in every situation possible. A weight lifter doesn't bench press 200 pounds over night but adds weight little by little. Each time a patient swings his own leg out of the bed, or shuffles to the bathroom with the assist of two, wonderful things are building incrementally in his or her body. Sometimes, nurses do things for patients because they are busy and don't have time for the slower patient to do it. Occasionally, on a booming floor this may be necessary, but should be the exception, not the rule.
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26.
How do you handle difficult family members who disagree with the care that the patient agreed to?
How to Answer
Patient families can be challenging, and they do not always agree with the patient's decision. Sometimes they will pull you aside and tell you their opinion. As long as the patient is competent to make their own decisions, the best way to deal with these situations is to tell the family that they really need to talk with the patient. You should not be talking about the patient's condition when they are not present, anyway. Remember your license and advocate for your patient's rights.
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27.
Describe a situation where it may be appropriate to use humor in the workplace.
How to Answer
Being sick is not funny business, and someone coming in cracking jokes under dire circumstances may find their humor is rejected. There is a time for humor in healthcare, but it must be mindful. What people think is funny can vary wildly. If humor is used, it should be very mild and universal. It's a good policy to be kind, tolerant, professional, and compassionate with your patients. Certainly, laugh at a child's joke, if appropriate, and acknowledge a patient's attempt to be cheerful, but follow rather than lead with humor and only support, chuckle or smile at anything that would be universally accepted as OK. Some people poke fun at themselves, but sometimes, it's a self-esteem issue so it's best to avoid playing along.
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28.
What are some action steps you could take to alleviate stress in patients in an ER waiting room?
How to Answer
Emergency room waiting rooms are stressful places. After all, everyone in that waiting area is experiencing some kind of emergency and many of them feel their need is just important as anyone else's. Time slows down when someone is frightened, sick, or in pain, so even the shortest wait can get tempers flaring. People who are sick do not have an expansive world view but naturally are narrowly focused on their situation. They may have no ideas of the car crash victims arriving via ambulances through the back but only know that they are waiting. There are a limited number of things that you can do to shorten the wait, but you can humanize the experience by letting them know that they are seen and valued. When they come in, explain the wait time because knowledge is power. Check in with them every so often. Remind the individuals who accompany them where the cafeteria is. There really is nothing you can do to lessen their wait, but you can reduce their frustration by acknowledging their wait time and providing information in a friendly and respectful manner.
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29.
A coworker left her computer open with sensitive information on the screen. You are the only one in the nurses' station. How would you address this with her?
How to Answer
Patient confidentiality must be honored, and leaving a computer open even to run to the bathroom for a minute risks a serious breach of patient confidentiality. Even though you are the only person in the room, you should not have access to patient information that you have no need to know. Even if you wouldn't say a word to anyone and you are a professional nurse with integrity, you should not be able to see possible protected information on a patient that you are not personally taking care of. Leaving a computer wide open is a serious risk to confidentiality.
If you see this, you could gently close the computer so that the screen is not visible and discuss the seriousness of this when your coworker returns. You must protect your license and you should report to supervision. It's uncomfortable to do so, but a nurse always takes the action that protects and advocates for the patient.
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30.
If you have too many things on your to-do list, how to you decide which to do first and which to postpone?
How to Answer
A nurse shift is usually a very busy one, with few unimportant tasks. Taking the time to organize and frontload your day by doing the most important patient tasks first helps free up time later. Sometimes, it is helpful to delegate to others when possible, but it's never an acceptable answer if anything patient-care related is not done because there wasn't time. Future pace your day and sketch out a timeline for each activity. When you follow your plan and you realize at 10 AM that you are still dealing with some problems with your 8 AM task, then the best time to ask for support or help is at 10 AM. At 2 PM, it's too late to gather support and finish the shift completely and correctly.
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Anonymous Answer"Prioritize based on ABCS see most unstable patients first, give critical meds first, ask for help/delegate easier faster tasks. For instance, if a patient is hypertensive and symptomatic I want to give their antihypertensive meds before giving a bed bath to my other patient."
Cindy's AnswerYes! Prioritization is key to handling the important issues first. Can you add to your answer by discussing what ABCs are and why that method is important here?
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31.
You are preparing medication in your unit's med room when you are paged to the nurse's station. You plan to immediately return to the med room, which you can see from the nurse's station. Do you lock the door upon leaving the med room?
How to Answer
While most medication rooms in hospitals and clinical facilities automatically lock when closed with current technology, some do not, and in these cases, it is important that nurses and other clinical professionals keep the medication room secured at all times. Not only does leaving medications unsecured place the facility at significant financial risk, it also places patients and the public at risk as well. If an unauthorized individual enters an unlocked medication room and takes medications, these drugs will not be available to patients who need them and may end up being misused by those who end up receiving them. The interviewer is asking this question to ensure the candidate understands the importance of securing the unit's medications. To effectively answer this question, the candidate should indicate that they would ensure the medication room was secured. A more successful answer to this question would include a specific example from the candidate's nursing career where they were in a similar situation or when they helped develop or implement a new policy for securing medications for their unit.
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Anonymous Answer"For patient safety and as per hospital policies medication carts cannot be left open unsupervised. I would secure the meds before leaving especially narcotics for patient safety, hospital policy, and protect your license. Meds could get stolen, misplaced, patients sneak in and take meds could overdose. The last one in the med room needs to ensure you leave everything secured and locked prior to leaving. Safe medication handling."
Cindy's AnswerAgain, you sound very knowledgeable about protocols, so good job. I'd enhance the answer by adding context in the beginning. Answer the question ("Yes, I am careful to lock the door,") and then explain why, ("because hospital policy requires I do so to protect patient safety").
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32.
You are assisting a physician to perform a procedure when you are asked to retrieve a bottle of acetic acid that can be used on the patient. After retrieving the bottle from its normal location, what do you do before passing it to the physician?
How to Answer
The interviewer is asking this question to determine if the candidate would verify that they retrieved the correct chemical before passing it to the physician. This confirmation is important, as the nurse may have accidentally retrieved the incorrect bottle or a bottle containing a different chemical may have been in the place where the requested chemical was typically kept. If either of these were the case, and the incorrect chemical was passed to the physician and used on the patient, significant consequences could occur. Simply verifying that the correct chemical is being passed to the physician could help avoid a serious medical error. To effectively answer this question, the candidate should indicate that they would verify that they have the correct chemical by checking the label on the bottle. A more successful answer to this question would include a specific example from the candidate's nursing career where they avoided a medical error by verifying the name of a chemical or drug that was to be administered to a patient.
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Anonymous Answer"I do closed-loop communication if they verbally order a medication I repeat the order back to them, for example, acetic acid correct? what is the strength and any other supplies you want me to bring back as well? So I’d return and be like Dr blah blah here is the acetic acid per your request what dose would you like and what route. Show them the bottle to confirm the correct medication is in hand."
Cindy's AnswerGood start. Spend a little time on what and why. Define closed-loop communication and why you would use it in this instance. What's the purpose of using it? Why is it appropriate or critical under these circumstances?
Was this answer helpful? Yes (0) or No (0)Thank you, your vote helps us display the best answers!Anonymous Answer"You visually look at the medication, strength, and expiration date before handing it to the physician to ensure it is the correct medication."
Chad's AnswerGreat answer! The interviewer will be pleased that your first step in this situation would be to verify that the correct chemical was retrieved, before passing it to the physician. This simple step is integral in avoiding potentially serious medical errors. To improve your response, I would suggest using first-person pronouns (I, me, my), rather than second-person. I have offered a revision below:
"I would visually look at the bottle’s label to confirm the medication, strength, and expiration date before handing it to the physician. I always verify that I retrieved the correct chemical, to avoid any potential medical errors."
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33.
Everyone on your unit is busy and you requested that your unit's nursing assistants bathe one of your patients earlier today. The patient has yet to be bathed and she is upset about it. Tell me how you proceed.
How to Answer
Inpatient nursing is very much a team effort, and while nursing assistants and care partners are typically available to assist with tasks such as bathing patients, they are sometimes at capacity and are unable to take on all the requests. In these situations, it is a requirement of all members of the care team, including nurses, to care for the patient, and this includes changing, bathing, or otherwise cleaning them. To effectively answer this question, the candidate should indicate that they would take initiative and bathe the patient rather than allowing the patient to wait even longer and become even more upset. A more successful answer to this question would include a specific example from the candidate's nursing career where they provided similar care for a patient when nursing assistants were unavailable.
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Anonymous Answer"I would be polite, approach the patient, apologize and let her know it’s been a busy day. Sorry for the delay, some really sick patients today required more hands-on, less time for baths. Apologize give her a basin and some warm clothes in the meantime for comfort."
Cindy's AnswerGood! Your approach demonstrates both empathy and good problem solving when you have to make difficult choices.
Was this answer helpful? Yes (0) or No (0)Thank you, your vote helps us display the best answers!Anonymous Answer"You would apologize to this patient and either offer to bathe her yourself or go find the assistant and get a definite time she will be back to bathe this patient."
Chad's AnswerExcellent! Apologizing to the patient is a great first step and a great indication of your bedside manner. It is also clear from your response that you recognize inpatient nursing is a team effort, and are more than willing to step up and complete unfinished tasks. Rather than indicating you would seek out the nursing assistant, which may result in the patient waiting even longer and becoming even more upset, consider focusing your answer on taking the initiative to bathe the patient yourself.
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34.
A patient on your unit you are caring for has had his peripheral venous catheter in place for approximately 100 hours. The catheter looks normal and the vein is open. Tell me how you proceed with administering more IV medications.
How to Answer
In order to help prevent nosocomial infection, which is an infection a patient acquires while receiving care in a hospital, peripheral catheters should be replaced every 72-96 hours. If not changed, the IV catheter may become infected and cause the patient's hospital length of stay to increase or could even cause death in extreme cases. Although a peripheral catheter may look normal and the vein may be open, it is imperative the catheter be changed. The interviewer is asking this question to determine if the candidate understands the importance of changing peripheral catheters on time in order to prevent infections. To successfully answer this question, the candidate should indicate they would change the catheter, specifically noting that the catheter should have been changed at a maximum of 96 hours.
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Anonymous Answer"So IVs should be changed every 72-96hs regardless of the patent to help prevent nosocomial infections as an iv is an entry point for bacteria. I would therefore remove and resite the iv prior to giving intravenous medication. The longer it remains insitu the higher the risk. If the patient is requiring long-term Iv meds I would speak with the doctor to see if. a PICC line might be a better option."
Cindy's AnswerGreat! This answer has the right combination of what and why to demonstrate a deep knowledge of the subject.
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35.
You are caring for a patient on your unit who is now resting well but has tried to get up and fallen multiple times over the past couple of days. As you prepare to leave the patient's room, do you restrain her to prevent her from falling again?
How to Answer
While it may seem like the most rationale step to take in this situation would be to restrain the patient, only current behavior should determine whether a patient should be restrained. The use of restraints can have physical and psychological consequences for the patient, so it is important that nurses and other medical professionals be very careful with their use. In this situation, since the patient is resting well and not agitated, the nurse should avoid using restraints. The interviewer is asking this question to determine if the candidate understands that restraints should be used judiciously, and to effectively answer this question, the candidate should indicate they would not restrain the patient in this situation. A more successful answer this question would include an example from the candidate's nursing career where they chose not to restrain a patient based on current behavior, despite previous history of falls, violence, and/or intentional or unintentional self-harm.
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Anonymous Answer"No, I would not restrain her. You need an order to restrain someone and restraints are a last resort option for patients that need them. I would implement other methods to prevent the patient from falling."
Chad's AnswerThis is a good response! You make it clear that you would not restrain the patient in this situation. Again, sharing a story example from your nursing career of a time where you chose not to restrain a patient, despite a previous history of falls, will strengthen your response.
Was this answer helpful? Yes (0) or No (0)Thank you, your vote helps us display the best answers!Anonymous Answer"Always use the least restraint to prevent additional stressors for the patient. I would not restrain this patient even tho they are a falls risk. They are resting well not agitated. I would Put on bed alarm, open curtains so visible from the nursing station, bed rails up, tuck them in with blankets, ensure they’ve been toileted given water and lights at the appropriate level, all necessities within reach so all basic needs have been met if possible prior to leaving the room. I would have a 1:1 sitter if possible. Restraints can be very stressful and traumatic best to try other measures prior to restraining and always have chemical restraints on Baird if physically restraining."
Cindy's AnswerGood! So, the risk is low and outweighs the stress of restraints? I would dwell a bit longer on the reasons for your choice and make them explicit in your answer.
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36.
You are nearing the end of your 12-hour shift on your inpatient unit and you are exhausted from caring for eight high-acuity patients. As your colleague arrives to relieve you, tell me how you proceed.
How to Answer
When inter-shift information is involved, nurses must ensure that they properly handover information to their colleagues properly, even if this means they stay late to complete handover paperwork on each of their patients. Failing to properly handover information to the next nurse could have dire consequences to patients, making handovers a vital element of a nurse's set of responsibilities. Many facilities have standardized handover templates for nurses to complete before the end of their shifts, and these templates include elements such as: background, assessments, vitals, and recommendations. While many electronic health record systems pre-populate much of this information, it is imperative the remaining information is completed. The interviewer is asking this question to determine if the candidate understands the importance of completing handovers. To effectively answer this question, the candidate should indicate they would ensure handover information for all patients was completed before departing for the day. A more successful answer to this question would include an example from the candidate's nursing career where they ensured their handovers were completed despite being exhausted or dealing with other confounding factors.
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Anonymous Answer"Even though I'm exhausted it is still very important to give a thorough nursing report. Need to give a good report to not only help my colleague have a better shift but also less risk for patients as well as having the oncoming nurse informed about their current presentation and plan. I usually do cheat sheets for each patient. Name, room, when they came in what they presented with, diagnosis, pertinent medical history, interventions done (IV, foley, fluids, meds), diagnostics imaging results, blood work, let them know abnormal values and what’s been done about them. Vitals and frequency. Plan follow up with GP, discharge, awaiting cath lab repeat imaging, IV and, specialist to see, etc."
Cindy's AnswerGreat, in describing your process.
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37.
You are caring for a patient and the physician has ordered an IV medication for them. You have collected the medication and the supplies needed to administer the IV. Tell me how you will proceed from this point.
How to Answer
Before starting an IV and administering the medication, in this situation, the nurse should look in the patient's electronic health record and review the physician's medication order to verify they have the correct medication, dosage, and administration duration. This is a safety protocol that is standard in nursing practice to prevent medical errors, as administering the incorrect medication, incorrect dosage, and/or incorrect duration can have dire consequences to the patient. The interviewer is asking this question to assess the candidate's understanding and regular practice for such precautions. To effectively answer this question, the candidate should indicate that they would verify the medication, dosage, and administration duration by reviewing the order in the electronic health record. A more successful answer to this question could include examples of how the candidate prevented a colleague from committing a medical error by reminding them to review this information, helped develop training materials on the matter for their unit, or even helped change protocols to improve compliance and patient outcomes.
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38.
You are conducting intake on a patient who was just seen at your facility earlier in the week. After you enter the patient's vital signs, you see their medication list, which was updated earlier in the week. Tell me how you proceed.
How to Answer
Because patient medications can change very quickly, even over a few days, it is important that nurses verify current medications for every patient at the beginning of every patient visit. If a patient's medication list is not verified and accurately updated, they are at risk of being prescribed a new medication that could interfere with one they are taking. If the nurse does not verify and update the patient medication list, the prescribing provider will not be aware of undocumented medications and will not be able to avoid prescribing errors. The interviewer is asking this question to assess whether or not the candidate understands that medication must be reviewed and verified with the patient or a caregiver during each encounter. To effectively answer this question, the candidate should indicate that they would review and verify the medications with the patient. A more successful answer to this question could include an example of how the candidate has dealt with a similar situation in the past, learned from a mistake that was made because they did not verify the medication, or spearheaded a policy change at their facility to ensure medications are verified during each patient visit.
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39.
You are caring for a patient on your inpatient unit who is bedridden and unconscious. When the patient came to you, they already had a bedsore. How do you prevent this from happening again?
How to Answer
For patients who are bedridden, bedsores can be a common, but avoidable, problem. If these sores become infected, the consequences for the patients can be severe, especially if they are in a weakened medical state. To prevent bedsores for their patients who are bedridden, nurses should ensure their patients are repositioned at least once every two hours. This repositioning may be completed by a care partner or nursing assistant, but it is ultimately the responsibility of the nurse to ensure their patients are properly cared for. The interviewer is asking this question to ensure the candidate understands it is their responsibility to protect their patients from hazards such as bedsores. To effectively answer this question, the candidate should indicate that they would ensure the patient was repositioned at least every two hours. A more successful answer to this question could include examples of how the candidate has worked with physicians and the physical therapy department to ensure the patient was properly moved, trained care partners or nursing assistants on proper patient repositioning, or helped their colleagues prevent bedsores in similar situations with their patients.
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Anonymous Answer"Do a daily skin assessment and document your findings. Reposition the patient every 2hrs and provide skincare every shift and after each incontinent episode. Apply barrier cream as needed."
Chad's AnswerGood. You have identified all of the proper steps needed to prevent the patient from developing bedsores again. Consider adding a statement that demonstrates you know what the potential consequences of bedsores on the patient can be, and that you recognize it is ultimately the nurse’s responsibility to ensure their patients are being properly cared for. Also, use full sentences in your response, to guarantee there is no confusion with the interviewer.
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40.
You are caring for a patient on your inpatient unit who is taking a turn for the worse. You decide you need to call the hospitalist physician. Tell me how you will proceed.
How to Answer
Before calling for the assistance of a physician, therapist, or nursing colleague, unless it is a dire emergency, nurses should gather as much pertinent information on the patient as they can so they can effectively and succinctly explain the situation and the needs of the patient. If the nurse does not collect this information in advance of making the call to the physician, the call will likely take additional time as they will have to look the information up and take more of the physician's time. While patients are not typically put at risk in these situations, having the information ready to report during the call assists nurses with building professional relationships with the many professionals the must consult with on a daily basis. The interviewer is asking this question to determine how important the candidate feels it is to collect information before calling the physician. To effectively answer this question, the candidate should indicate that they would collect all pertinent information on the patient, including diagnosis, condition, impression, test results, and vital signs. A more successful answer to this question can include experience from the candidate's nursing career, information the candidate typically relays during such a call, or how the candidate assisted a colleague with such a call.
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Anonymous Answer"Before calling the physician it is important to ensure that I have all the information necessary for any questions the physician might ask. Details about the patient's condition throughout the shift and any changes that occurred should be documented. Vital signs and assessment should also be documented and available in case the physician asks."
Chad's AnswerGood answer! The interviewer will be pleased to hear you recognize the importance of collecting pertinent information before calling the physician. To strengthen this response, be more specific on the types of information you would collect. Consider also including an example from your career when you have made a call in this situation, and what the outcome was, to demonstrate your experience level.
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41.
You just finished preparing IV medications for a patient, and you thoroughly washed your hands before doing so. As you enter the patient's room with the medication, describe the first thing you do to prevent patient infection.
How to Answer
While hospitalized or receiving outpatient medical treatment, patients are at significant risk of picking up an infection as a consequence of the care they are receiving. Although infection prevention measures in the healthcare industry have greatly improved over the years, the risk still exists and healthcare professionals must be vigilant in order to prevent healthcare-acquired infections. Although it may seem obvious, the simple task of handwashing is the first step in infection prevention. The interviewer is asking this question to determine if the candidate understands the importance of handwashing and is in the habit of washing their hands upon entering a patient's room and/or before administering IV medication. To effectively answer this question, the candidate should explain that the first step they would take to prevent infection would be to wash their hands thoroughly. A more successful answer to this question would include an example of how the candidate has helped train colleagues on handwashing in such situations and/or assisted in the development and implementation of handwashing policies for their nursing unit.
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Anonymous Answer"As soon as I walk into the patient's room I will wash my hands again and put gloves on. I will then continue to administer the medications. I will ensure that the patient's IV is intact, wipe the hub with an alcohol pad, flush the line and check for blood return then administer the medication."
Chad's AnswerGood answer! I suggest a slight rewording of your opening sentence to demonstrate to the interviewer you understand why handwashing is so important. I have offered a revision below.
"“As soon as I walk into the patient's room, the first thing I would do to prevent the patient from getting an infection is to thoroughly wash my hands again before putting gloves on. I would then proceed to administer the medications. To do so, I would ensure that the patient's IV is intact, wipe the hub with an alcohol pad, flush the line and check for blood return, then administer the medication.”"
Was this answer helpful? Yes (0) or No (0)Thank you, your vote helps us display the best answers!Anonymous Answer"Wash hands again or alcohol rub, break the chain of infection!"
Cindy's AnswerGood! To enhance your answer, can you explain why thoroughly washing your hands before preparing the IV medications isn't enough? This seems like a deliberate detail to lead you to address why another hand-wash is necessary despite a recent one.
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42.
Your patient, who has just returned from surgery, now has multiple tubes and lines that you did not insert. You need to administer a drug into her central line, but are having a hard time finding this tube. As you are in a rush, tell me how you proceed.
How to Answer
When returning from the operating room, intensive care unit, or other units of the hospital, a patient may have many more tubes and lines inserted into their body than normal, and at times, it may be difficult for a nurse to differentiate the lines. This is especially the case if the nurse is in a rush. In this scenario, the nurse, in order to administer medication into the patient's central line, they should take time to ensure they have the correct tube. Administering the medication into the incorrect line or into a drain is a medical error that could have negative consequences for the patient. The interviewer is asking this question to determine if the candidate would take the time to confirm that they are using the correct tube to administer the medication in the patient's central line. To effectively answer this question, the patient should indicate that they would carefully ensure that they had the correct tube for the central line before administering the medication. A more successful answer to this question would include a specific example from the candidate's nursing career where they were in a similar situation, and they took time to ensure they were administering a medication in the appropriate line.
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Anonymous Answer"No matter how much of a rush I am in, I will take the time to ensure I am flushing the right line. I would ask another nurse for help identifying the line and then proceeding with administering the medication."
Chad's AnswerExcellent! Administering medication into the incorrect line or into a drain could have negative consequences for the patient. Your response shows you are mindful of this and would take the time to carefully ensure you had the correct tube for the central line before administering the medication.
Was this answer helpful? Yes (0) or No (0)Thank you, your vote helps us display the best answers!Anonymous Answer"Even if I am in a rush I make sure that I am practicing safely. In this case, if I am unsure of which line to administer a medication through I will start at the patient and work my way down. I work with central lines so I am familiar with where this is located. Also, lines are usually labeled or color-coded. For instance, the red cap is for blood and the other lumens can be for medication administration. I’d review the PDTM to ensure the medication I need to give is done appropriately and if I am unable to determine which tubes lines or drains are for what often in the patient chart these are documented. When in doubt I will grab another nurse to assist me."
Cindy's AnswerGreat content! The ER example is very effective. You may want to reorganize the information so it's easier for the interviewer to get the point you are trying to make.
"Patient safety is a primary concern. Regardless of the time crunch, I would place safety first to avoid making a mistake that could compromise the patient. Also, I don't administer medications unless I am fully knowledgeable. In the ER, for example, I did not have the opportunity to work with J tubes or feeding tubes, so when I was required to work with a patient requiring feeds, I relied on colleagues to help me out. In this case, I know that central lines are labeled to help prevent a mistake. I'd review the PDTM and patient chart to review all documentation before proceeding."
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