The nurse tells an advanced nurse practitioner that the patient is slipping a little in reference to ...

D

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A Brevity means that communication is simple, brief, and direct. Slipping a little is not an example of using brevity.
B Relevance means that the message is relevant or important to the situation at hand. Slipping a little is not an example of using relevance.
C Pacing and control means speaking slowly enough to enunciate clearly and not changing subjects rapidly. Saying that a patient is slipping a little is not an example of using pacing and control.
D The connotative meaning is the shade or interpretation of a word's meaning influenced by the thoughts, feelings, or ideas people have about the word. Slipping a little in reference to hemodynamic pressures is an example of using connotative meaning.