Ch6 Therapeutic communication

Question 0

Preinteraction Phase Nursing Goal

Answer 0

Explore self-perceptions: obtain info on client from chart, significant others, health team and examine one’s feelings about caring for a particular client

Question 1

Empathy

Answer 1

When the nurse can remain emotionally separate from the other person, even though the nurse can see the patient’s viewpoint clearly. This is different from sympathy. You must show feelings but not get caught up in them.

Question 2

Orientation (introductory) Phase Nursing Goal

Answer 2

To establish trust and formulate contract for intervention: detail the expectations of both client and nurse and set goals, gathering assessment info to build client database, formulate diagnoses, identify clients strength and limits, develop plan of action, explore feelings of both the client and the nurse in terms of the introductory phase

Question 3

In which phase does the nurse and client set goals?

Answer 3

Orientation (introductory) phase

Question 4

In which phase does the nurse identify the clients strengths and limitations?

Answer 4

The orientation phase

Question 5

In which phase does the nurse formulate a nursing diagnosis?

Answer 5

The orientation phase

Question 6

Working Phase Nursing Goal

Answer 6

Promote client change: overcoming resistant behaviors by client, positive feedback for clients that attempt to make changes. Promoting client’s perception and insight of reality. Problem-solving using model. Continuously evaluating progress toward goal.

Question 7

Termination Phase Nursing Goal

Answer 7

Evaluate goal attainment and ensure therapeutic closure. Feelings about termination of the relationship are recognized and explored. Client may feel sad.

Question 8

Transference

Answer 8

When the client unconsciously displaces to the nurse feelings formed toward a person from his or her past

Question 9

Countertransference

Answer 9

Refers to the nurses behavioral and emotional response to the client. These responses may be related to unresolved feelings toward significant others from the nurses past, or they may be generated in response to transparence feelings on the part of the client.

Question 10

Intimate distance

Answer 10

The closest distance that individuals will allow between themselves and others

Question 11

Personal distance

Answer 11

18 to 40 inches and is reserved for interactions that are personal in nature, such as close conversations with friends or colleagues

Question 12

Voicing doubt

Answer 12

Therapeutic.EXPRESSING DOUBT! Often used with clients expressing delusional thinking. “I find that hard to believe”

Question 13

Offering general leads

Answer 13

Therapeutic. offers the client encouragement to continue. “Go on.” “Yes I see” “and after that?”

Question 14

Reflecting

Answer 14

Therapeutic. Used so that the client may recognize that his or her point of view has value. Pt: “what do you think I should do about ____?” Nurse: “what do YOU think you should do?”

Question 15

Restating

Answer 15

Therapeutic. Repeating the main idea to let the client know whether or not an express statement has been understood. Pt: “I can’t study. My mind keeps wandering.” Ns: “you have trouble concentrating.”

Question 16

Focusing

Answer 16

Therapeutic. Taking notice of a single idea or even a single word. Not good w/ anxious pts. Pt: “my DADDY always tucked me in at night.” Ns: “id like to talk about your relationship with your FATHER.”

Question 17

Presenting reality

Answer 17

Therapeutic. The nurse indicates his or her perception of the situation for the client. “There is no one else in the room but you and me”

Question 18

Verbalizing be implied

Answer 18

Therapeutic. Putting into words what the client has implied or said indirectly. Used with mutes. Pt: (mute) Ns: “it must’ve been very difficult for you when your husband died in the fire.” Pt: “it’s a waste of time to be here I can’t talk to anyone.” Ns: “are you feeling that no one understands?”

Question 19

Attempting to translate words into feelings

Answer 19

Therapeutic. “Desymbolizing” Pt: “in way out in the ocean.” Ns: “you must be feeling very lonely right now”

Question 20

Belittling feelings expressed

Answer 20

Nontherapeutic. The nurse may unknowingly tell the client to “perk up” or “get over it.” Pt: “I have nothing to live for I wish I were dead.” Ns: “everybody gets down at times. I feel that way myself sometimes.”

Question 21

Giving advice

Answer 21

Nontherapeutic. Telling the client what to do implies that the nurse knows what is best and that the client is incapable of any self-direction. “I think you should”

Question 22

Indicating the existence of an external source of power

Answer 22

Nontherapeutic. Attributing the source of thoughts and behaviors to others or to outside influences. This encourages the client to project blame for his or her thoughts or behaviors on others rather than accepting the responsibility. “What makes you say such things?”

Question 23

Making stereotyped comments

Answer 23

Nontherapeutic. Clichés are meaningless in a nurse-client relationship. When used it encourages a like response from the client. “I’m fine, how are you?” “Keep your chin up.”

Question 24

Using denial

Answer 24

Nontherapeutic. Denying that a problem exists. Pt: “i’m nothing.” Ns: “of course you are something. Everybody is somebody.”

Question 25

Interpreting

Answer 25

Nontherapeutic. Seeking to make conscious that which is unconscious. “What you really mean is…” “Unconsciously you’re saying…”

Question 26

what is SOLER?

Answer 26

Nonverbal behaviors that facilitate attentive listening. S-sit and face client O-open posture L-lean toward client E-eye contact R-relax

Question 27

True or false? Feedback is evaluative.

Answer 27

False. Feedback should be descriptive rather than evaluative.

Question 28

Feedback should focus on the behavior rather than on

Answer 28

The client

Question 29

Requesting an explanation

Answer 29

Nontherapeutic. Asking “WHY” a client did something. Why isn’t good!