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Communication Skills Behavioral Sciences — Step 1 practice questions
127 questions in this area, with an explanation for every answer choice.
Three samples below, free and without an account.
How this shows up on Step 1
Behavioral Sciences questions in this section combine two things the exam tests separately elsewhere. Covers psychiatry, ethics, communication and the social determinants of health. These questions ask what you would say next, and the answer is usually the option that acknowledges the patient before acting.
Sample questions
Sample question 1
A physician must tell a patient that imaging shows metastatic cancer. Which of the following best describes the recommended approach?
Explanations
A. Deliver the news and immediately outline the complete treatment protocol in detail
Retention after bad news is minimal, so detailed planning should follow later.
B. Avoid using the word "cancer" to reduce distress
Euphemism causes confusion and impairs informed decisions.
C. Arrange a private setting, ask what the patient already understands and how much they want to know, give a brief warning, deliver the news in plain language, respond to emotion, and then discuss next steps · correct
Structured protocols such as SPIKES organize this task: arrange the SETTING privately with adequate time, assess the patient's PERCEPTION of their situation, obtain an INVITATION regarding how much detail they want, deliver KNOWLEDGE with a brief warning shot in plain language and small chunks, respond to EMOTIONS with empathic statements, and close with STRATEGY and summary. Two common errors are burying the news in technical preamble and moving immediately to treatment details — after hearing "cancer," retention collapses, so plans are better deferred to a follow-up visit with written information.
D. Begin with an extensive technical explanation before stating the diagnosis
Technical preamble delays and obscures the essential message.
E. Prognosis should be given as a precise number in all cases
Prognostic detail should match what the patient wants to know, often given as ranges.
Sample question 2
A patient suffers a serious complication after surgery that resulted in part from a system failure. Which of the following communication approaches is most consistent with evidence and professional standards?
Explanations
A. Provide information only through the hospital attorney
Routing all communication through counsel damages the relationship.
B. Wait until the investigation is fully complete before saying anything to the patient
Initial disclosure should be prompt, with updates as facts emerge.
C. Promptly disclose what happened, express genuine empathy and apology, explain what will be done to investigate and prevent recurrence, and provide ongoing support · correct
Communication-and-resolution programs — prompt disclosure, sincere apology, explanation, and support — improve patient trust and are associated with FEWER claims and lower costs, contradicting the traditional "deny and defend" assumption. Many states also have apology laws protecting expressions of sympathy. Patients consistently report wanting acknowledgment, an explanation, and assurance that others will be protected.
D. Explain that complications are expected and no discussion is warranted
Dismissing the event as expected disrespects the patient and forgoes learning.
E. Avoid apologizing, since any expression of regret constitutes an admission of liability that increases lawsuits
Evidence does not support the belief that apology increases litigation; silence does.
Sample question 3
A nurse calls a physician to report a change in patient status using a structured format: Situation, Background, Assessment, Recommendation. Which of the following best describes the purpose of this framework?
Explanations
A. To replace all documentation requirements
SBAR supplements but does not replace formal documentation requirements.
B. To make the conversation longer and more detailed
SBAR is designed for EFFICIENT, not unnecessarily lengthy, communication.
C. To standardize handoff communication, reducing errors and ensuring key information is conveyed efficiently · correct
SBAR (Situation, Background, Assessment, Recommendation) provides a standardized structure for handoff communication between providers, reducing errors and ensuring critical information is conveyed clearly and efficiently.
D. To discourage nurses from making clinical recommendations
SBAR explicitly includes a "Recommendation" component, encouraging (not discouraging) the reporting clinician to share their assessment and suggested action.
E. To avoid the need for direct physician involvement
SBAR is a tool FOR communicating with physicians, not a way to avoid their involvement.
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