An example of an environmental factor that would cause a nurse to modify a planned critical interaction occurs when the:
a. Patient expresses a personal dislike for the nurse
b. Patient is in total denial about her condition
c. Nurse lacks the degree of knowledge required for the interaction
d. Nurse learns that the patient's mother has been hospitalized with a stroke
ANS: D
Environmental factors include timing. Timing of critical interventions is important. It should occur when the individual can give full attention to the topic. It would be inappropriate to continue with the plan in the face of the patient's distress related to her mother's illness. The remaining options reflect other types of factors that influence communication such as atti-tudes, knowledge, and relationships.
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