9 (Communication & the Clinical Interview) Flashcards
You enter the room of Andrea, a patient on the psychiatric unit. Andrea is sitting with her arms crossed over her chest and her left leg rapidly moving up and down, and she has an angry expression on her face. When you approach her, she states harshly, “I’m fine! Everything’s great.” Which of the following is true regarding verbal and nonverbal communication?
a. ) Verbal communication is always more accurate than nonverbal communication.
b. ) Verbal communication is more straightforward, whereas nonverbal communication does not portray what a person is thinking.
c. ) Nonverbal and verbal communication may be different; nurses must pay attention to the nonverbal communication being presented to get an accurate message.
d. ) Nonverbal communication is about 10% of all communication, and verbal communication is about 90%.
c.) Nonverbal and verbal communication may be different; nurses must pay attention to the nonverbal communication being presented to get an accurate message.
Communication is roughly 10% verbal and 90% nonverbal, so nurses must pay close attention to nonverbal cues to accurately assess what the patient is really feeling. The other options are all untrue of verbal and nonverbal communication and are actually the opposite of what is believed of communication.
You enter the room of Andrea, a patient on the psychiatric unit. Andrea is sitting with her arms crossed over her chest and her left leg rapidly moving up and down, and she has an angry expression on her face. When you approach her, she states harshly, “I’m fine! Everything’s great.” Which of the following responses would be therapeutic?
a. ) “Okay, but we are all here to help you, so come get one of the staff if you need to talk.”
b. ) “I’m glad everything is good. I am going to give you your schedule for the day and we can discuss how the groups are going.”
c. ) “I don’t believe you. You are not being truthful with me.”
d. ) “It looks as though you are saying one thing but feeling another. Can you tell me what may be upsetting you?”
d.) “It looks as though you are saying one thing but feeling another. Can you tell me what may be upsetting you?”
This response uses the therapeutic technique of clarifying; it addresses the difference between the patient’s verbal and nonverbal communication and encourages sharing of feelings. The other options do not address the patient’s obvious distress or are confrontational and judgmental.
You are caring for William, a 55-year-old patient who recently came to the United States from England on a work visa. He was admitted for severe depression following the death of his wife from cancer 2 weeks ago. While telling you about his wife’s death and how it has affected him, William shows little emotion. Which of the following explanations is most plausible?
a. ) William did not love his wife.
b. ) William’s response may reflect cultural norms.
c. ) William’s response may reflect guilt.
d. ) William may have an antisocial personality, which would explain his lack of feeling.
b.) William’s response may reflect cultural norms.
Showing little emotion while in distress may be a cultural phenomenon. Some cultures, such as the British and German cultures, tend to value highly the concept of self-control and may show little facial emotion in the presence of emotional turmoil.
There is no evidence to suggest the patient did not love his wife, and this would be jumping to conclusions.
There is also nothing in the scenario to suggest guilt and there is no evidence in the scenario to suggest antisocial personality disorder.
You are admitting 32-year-old Louisa to the psychiatric unit. You pull up your chair and sit close to the patient, with your knees almost touching hers, and lean in close to her to speak. Louisa becomes visibly flustered and gets up and leaves the room. What is the most likely explanation for Louisa’s behavior?
a. ) You have violated Louisa’s personal space by physically being too close.
b. ) Louisa has issues with sharing personal information.
c. ) You have not made the patient feel comfortable by explaining the purpose of the admission interview.
d. ) Louisa is responding to the voices in her head telling her to leave.
a.) You have violated Louisa’s personal space by physically being too close.
By sitting and leaning in so closely, you have entered into intimate space (0 to 18 inches), rather than social distance and the patient may feel uncomfortable with being so close to someone she does not know. All the other options lack evidence and jump to conclusions regarding the patient’s behavior.
Which of the following statements indicate a nontherapeutic communication technique? (select all that apply):
a. ) “Why didn’t you attend group this morning?”
b. ) “From what you have said, you have great difficulty sleeping at night.”
c. ) “What did your boyfriend do that made you leave? Are you angry at him? Did he abuse you in some way?”
d. ) “If I were you, I would quit the stressful job and find something else.”
e. ) “I’m really proud of you for the way you stood up to your brother when he visited today.”
f. ) “You mentioned that you have never had friends. Tell me more about that.”
g. ) “It sounds like you have been having a very hard time at home lately.”
a, c, d, e
a.) “Why didn’t you attend group this morning?”
c.) “What did your boyfriend do that made you leave? Are you angry at him? Did he abuse you in some way?”
d.) “If I were you, I would quit the stressful job and find something else.”
e.) “I’m really proud of you for the way you stood up to your brother when he visited today.”
All these options reflect the nontherapeutic techniques of (in order) asking “why” questions; using excessive questioning; giving advice; and giving approval. The other options describe therapeutic techniques of restating, exploring, and reflecting.
