Chapter 5 Relationship Development And Therapeutic Communication

Question 1

Explain the technique of using silence. Therapeutic or nontherapeutic?

Answer 1

therapeutic
encourages patient to organize thoughts and put them into words
allows for the patient time to think about the significance of events, thoughts and feelings
allowing the patient to break the silence gives the nurse important information about the patient’s foremost concerns

Question 2

Explain the technique of accepting. Therapeutic or nontherapeutic?

Answer 2

therapeutic
conveys an attitude of understanding and willingness to interact

Question 3

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“Yes, I understand what you said.”
eye contact
nodding

Answer 3

accepting
therapeutic

Question 4

Explain the technique of giving recognition. Therapeutic or nontherapeutic?

Answer 4

therapeutic
acknowledging and indicating awareness
it is better than complimenting b/c complimenting can reflect the nurse’s judgement

Question 5

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

I notice that you made a ceramic ash tray in OT.
I see you made your bed.

Answer 5

giving recognition
therapeutic

Question 6

Explain the technique of offering self. Therapeutic or nontherapeutic?

Answer 6

willingness to spend time with he patient and show interest on an unconditional basis
increases patient’s feelings of self worth
therapeutic

Question 7

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“I’ll stay with you awhile.”
“How are you feeling today?”
“I’m interested in hearing your thoughts about the group you just attended.”

Answer 7

offering self
therapeutic

Question 8

Explain the technique of giving broad openings. Therapeutic or nontherapeutic?

Answer 8

allows the patient to direct the focus of the interaction
emphasizes importance of the patient’s role in communication
therapeutic

Question 9

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“What would you like to talk about today?”
“Is there anything you want to talk about?”

Answer 9

giving broad openings
therapeutic

Question 10

Explain the technique of offering general leads. Therapeutic or nontherapeutic?

Answer 10

gives the patient encouragement to continue with minimal input from the nurse
therapeutic

Question 11

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“Go on.”
“And after that?”

Answer 11

offering general leads
therapeutic

Question 12

Explain the technique of placing the event in time or sequence. Therapeutic or nontherapeutic?

Answer 12

encouraging patient to identify the sequence of events and when they occurred in time to allow for the patient to organize one’s thoughts about their experiences
therapeutic

Question 13

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“What happened first?”
“What happened next?”
“Was this before or after … ?”
“When did this happen?”

Answer 13

placing the event in time or sequence
therapeutic

Question 14

Explain the technique of making observations. Therapeutic or nontherapeutic?

Answer 14

verbalizing observations about a patient’s behavior or appearance to encourage the patient to develop awareness of how they are perceived by others and to explore the issues that may be problematic
therapeutic

Question 15

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“You appear sad today.”
“I notice you are pacing a lot.”
“I notice that when I ask you about whether you have thoughts of suicide you change the subject.”

Answer 15

making observations
therapeutic

Question 16

Explain the technique of encouraging description of perceptions. Therapeutic or nontherapeutic?

Answer 16

asking the patient to verbalize their perceptions to encourage the patient to develop awareness and understanding
if a patient has hallucinations, it can help the nurse and patient clarify what the patient’s perceptions are communicating
therapeutic

Question 17

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“Tell me more about the voices you said and you are hearing.”
“What was it that increased your agitation during the group activity?”
“Are these voices you hear directing you to take some action?”

Answer 17

encouraging description of perceptions
therapeutic

Question 18

Explain the technique of encouraging comparison. Therapeutic or nontherapeutic?

Answer 18

asking the patient to compare similarities and differences in ideas, experiences, or interpersonal relationships
help the patient recognize life experiences that tend to recur versus experiences that are changeable
therapeutic

Question 19

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“Was this episode similar to … ?”
“How does this compare with the time when …?”
“What was your response the last time this situation occurred?”

Answer 19

encouraging comparison
therapeutic

Question 20

Explain the technique of restating. Therapeutic or nontherapeutic?

Answer 20

repeating the main idea of what the patient has said
lets the patient know that the nurse understands the statements, gives patient chance to continue or clarify
therapeutic

Question 21

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

Patient: “I can’t study. My mind keeps wandering.”
Nurse: “You are having trouble concentrating.”

Patient: “I can’t take that new job. What if I can’t do it?”
Nurse: “You’re afraid you will fail in this new position.”

Answer 21

restating
therapeutic

Question 22

Explain the technique of reflecting. Therapeutic or nontherapeutic?

Answer 22

questions and feelings are referred back to the patient
allows for the patient to be empowered to actively engage in problem solving than just asking the nurse for advice
therapeutic

Question 23

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

Patient: “Don’t you think I should tell my boss I’m not putting up with that?”
Nurse: “What do you think you should do?”
Patient: “She makes me so upset!”
Nurse: “So you’re feeling angry at your boss?”

Answer 23

reflecting
therapeutic

Question 24

Explain the technique of focusing. Therapeutic or nontherapeutic?

Answer 24

taking notice of a single idea/word encourages specific discussion about a relevant issue
especially helpful for patients who are moving rapidly from one thought to another
therapeutic

Question 25

In what patient would the communication technique of focusing be ineffective or nontherapeutic?

Answer 25

focusing is difficult for a patient with severe anxiety
nurse should not use focusing until anxiety level lessens

Question 26

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“Tell me more about this specific point.”

Answer 26

focusing
therapeutic

Question 27

Explain the technique of exploring. Therapeutic or nontherapeutic?

Answer 27

when patient mentions an issue/theme that seems relevant, the nurse asks the patient to explore this further
promotes patient’s development of awareness and understanding about events, thoughts, and feelings
therapeutic

Question 28

The nurse tries to use the communication technique of exploring but the patient reveals they don’t want to talk anymore. How should the nurse respond?

Answer 28

The nurse should refrain from pushing or probing in topics that cause the patient discomfort.

Question 29

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“Please explain that situation in more detail.”
“Tell me more about that particular situation.”
“You mentioned feeling like no one cares about you. Tell me more about those feelings.”

Answer 29

exploring
therapeutic

Question 30

Explain the technique of seeking clarification and validation. Therapeutic or nontherapeutic?

Answer 30

aiming to explain what is vague or incomprehensible to get mutual understanding
increases understand for patient and nurse
therapeutic

Question 31

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“I’m not sure that I understand. Would you please explain?”
“Tell me if my understanding agrees with yours.”
“Do I understand correctly that you said … ?”

Answer 31

seeking clarification and validation
therapeutic

Question 32

Explain the technique of presenting reality. Therapeutic or nontherapeutic?

Answer 32

when the patient has a misperception of the environment, the nurse defines reality by expressing his/her perception of the situation without challenging the patient’s perceptions.
therapeutic

Question 33

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“I understand that the voices seem real to you, but I do not hear any voices.”
“I don’t see anyone else in the room but you and me.”

Answer 33

presenting reality
therapeutic

Question 34

Explain the technique of voicing doubt. Therapeutic or nontherapeutic?

Answer 34

expressing uncertainty about the validity of the patient’s perceptions
often used with patients experiencing delusional thinking
therapeutic

Question 35

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“It’s difficult to believe that the president of the United States would be listening to all of your phone calls.”
“I find that hard to believe [or accept].”
“That seems rather doubtful to me.”

Answer 35

voicing doubt
therapeutic

Question 36

Explain the technique of verbalizing the implied. Therapeutic or nontherapeutic?

Answer 36

putting into words what the patient has implied or said indirectly
helpful with patients experiencing impaired verbal communication
therapeutic

Question 37

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

Patient: “I can’t talk about this … you haven’t been where I’ve been.”
Nurse: “Does it seem like no one could understand your thoughts and feelings unless they’ve had the same experiences you’ve had?”
Patient: “I … I don’t know where to begin.”
Nurse: “So it feels overwhelming to think about sharing the details of this experience.”

Answer 37

verbalizing the implied
therapeutic

Question 38

Explain the technique of attempting to translate words into feelings. Therapeutic or nontherapeutic?

Answer 38

when the patient has difficulty identifying feelings or feelings are expressed indirectly, the nurse tries to interpret the underlying true feelings
therapeutic

Question 39

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

Patient: “I’m just an empty pit.”
Nurse: “It sounds like you are feeling hopeless, is that right?”

Answer 39

attempting to translate words into feelings
therapeutic

Question 40

Explain the technique of formulating a plan of action. Therapeutic or nontherapeutic?

Answer 40

encouraging the patient to identify a plan for behavior change to promote developing better coping skills
therapeutic

Question 41

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“What could you do differently if you are faced with this situation in the future?”
“What are some steps you could take to manage your anger without punching someone?”
“What is one thing you might be willing to try to decrease your anxiety instead of using alcohol?”

Answer 41

formulating a plan of action
therapeutic

Question 42

Explain the SOLER acronym. What is it used for?

Answer 42

used to describe nonverbal behaviors the nurse can do for active listening

S: sit squarely facing the patient
O: open posture, arms and legs uncrossed (closed posture can convey defensiveness)
L: lean forward toward the patient
E: eye contact
R: relax and comfortable; don’t be restless or fidgeting

Question 43

Explain the technique of giving false reassurance. Therapeutic or nontherapeutic?

Answer 43

conveys that the nurse already knows the outcome of the situation
minimizes the patient’s expressed concerns
may discourage patient from expressing feelings if the patient believes their feelings will be downplayed or ridiculed
nontherapeutic

Question 44

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

Patient: “My husband doesn’t love me anymore. I think he wants a divorce.”
Nurse: “I’m sure he must still love you. Everything will be fine.”

Answer 44

giving false reassurance
nontherapeutic
Nurse should say “Tell me more about what’s been happening in your relationship with your husband.”

Question 45

Explain the technique of rejecting. Therapeutic or nontherapeutic?

Answer 45

refusing to consider or show contempt for patient’s ideas or behavior
may cause patient to discontinue interaction with nurse for fear of further rejection
nontherapeutic

Question 46

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

Patient: “Since I started taking this medication, I can’t be intimate with my girlfriend.”
Nurse: “Let’s not talk about that right now.”

Answer 46

rejecting
nontherapeutic
Nurse should say “Tell me more about what you mean by not being able ‘to be intimate’ with your girlfriend.”

Question 47

Explain the technique of approving or disapproving. Therapeutic or nontherapeutic?

Answer 47

approving or denouncing the patient’s ideas or behavior
implies that the nurse’s role is to judge whether the patient’s ideas or behaviors are “good” or “bad” and that the patient is expected to please the nurse
nurse’s acceptance of the patient may be seen as conditional depending on the patient’s behavior
nontherapeutic

Question 48

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“It’s good that you confronted your wife about her behavior.”
“You shouldn’t yell at your wife.”

Answer 48

approving or disapproving
nontherapeutic
nurse should say “What happened after you confronted your wife in a loud voice?”

Question 49

Explain the technique of agreeing or disagreeing. Therapeutic or nontherapeutic?

Answer 49

agreeing or disagreeing with the patient’s ideas/opinions implies that the nurse has the right to judge the patient’s ideas or opinions as right or wrong
agreement prevents patient from later modifying their point of view without risk of displeasing the nurse
disagreement can provoke defensiveness from the patient
nontherapeutic

Question 50

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

Patient: “I think my doctor doesn’t care about me.”
Nurse: “I disagree. Your shouldn’t think that way.” or “I can’t believe that’s true.”

Answer 50

agreeing or disagreeing
nontheapeutic
nurse should say “tell me more about why you think your doctor doesn’t care.”

Question 51

Explain the technique of giving advice. Therapeutic or nontherapeutic?

Answer 51

telling the patient what to do or how to behave
implies that the nurse knows what is best and may cause the patient to be dependent by discouraging independent thinking
nontherapeutic

Question 52

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“You need to do deep breathing exercises when you become anxious.”
“You should stop drinking alcohol and start going to Alcoholics Anonymous meetings.”

Answer 52

giving advice
nontherapeutic
nurse should say “What do you think you should do?” or “Let’s explore some options for solving this problem.”

Question 53

Explain the technique of probing. Therapeutic or nontherapeutic?

Answer 53

persistent questioning of the patient and pushing for answers to issues the patient doesn’t want to discuss or doesn’t know the answers to
can cause the patient to feel used only for information the nurse wants and may make the patient defensive
nontherapeutic

Question 54

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“Why was your family angry with you?”
“How many times did you receive poor evaluations before you got fired?”
“How many girlfriends were you lying to?”

Answer 54

probing
nontherapeutic
nurse should actively listen to patient’s response and discontinue interaction at the first sign of discomfort

Question 55

Explain the technique of defending. Therapeutic or nontherapeutic?

Answer 55

defending someone or something the patient has criticized
minimizes or completely ignores patient’s concerns
may cause the patient to think the nurse is taking sides against them
nontherapeutic

Question 56

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“None of the nurses here would lie to you.”
“You have a very capable physician.”
“Your children want only what’s best for you.”

Answer 56

defending
nontherapeutic
nurse should say “tell me more about these concerns you’ve expressed”

Question 57

Explain the technique of requesting an explanation. Therapeutic or nontherapeutic?

Answer 57

asking the patient why they have certain thoughts, feelings, and behaviors
can be intimidating
implies patient must defend their behavior or feeligns
nontherapeutic

Question 58

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“Why do you think people are out to get you?”
“Why do you feel depressed?”
“Why were you taking drugs?”

Answer 58

requesting an explanation
nontherapeutic
nurse should say “Describe what you were feeling just before that happened.”

Question 59

Explain the technique of indicating the existence of an external source of power. Therapeutic or nontherapeutic?

Answer 59

attributing source of thoughts, feelings, and behavior to someone or something other than the patient encourages patient to project blame for their thoughts/behaviors on others rather than accepting the responsibility personally
nontherapeutic

Question 60

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“What made you go on a drinking binge?”
“What made you say that you are a worthless person?”

Answer 60

indicating the existence of an external source of power
nontherapeutic
nurse should say “What was happening just before you started binge drinking?” or “What do you mean when you say you are ‘a worthless person’?”

Question 61

Explain the technique of belittling feelings expressed. Therapeutic or nontherapeutic?

Answer 61

nurse minimizes degree of patient’s discomfort
can portray a lack of empathy and understanding
patient may feel like their concerns are insignificant or unimportant
nontherapeutic

Question 62

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“Cheer up”
“Everybody feels that way”

Patient: “I don’t even have the energy to go to work.”
Nurse: “We’ve all felt like that at times. You’ve just got to ‘perk up’ and get moving.”

Answer 62

belittling feelings expressed
nontherapeutic
nurse should say “Tell me more about what you are feeling right now.”

Question 63

Explain the technique of making stereotyped comments. Therapeutic or nontherapeutic?

Answer 63

nurse using cliche expressions
meaningless in nurse-patient relationship
encourages similar response from the patient
nontherapeutic

Question 64

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“How are you?”
“Hang in there.”
“It’ll all work out.”

Answer 64

making stereotyped comments
nontherapeutic
nurse should choose words, sentences nonverbal language that convey sincere interest in encouraging patient to share their thoughts, feelings, and behaviors

Question 65

Explain the technique of using denial. Therapeutic or nontherapeutic?

Answer 65

denying that a problem exists
blocks discussion with patient
avoids helping the patient identify and explore areas of difficulty
nontherapeutic

Question 66

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

Patient: “I have a problem interacting with people.”
Nurse: “You’re doing fine.”

Answer 66

using denial
nontherapeutic
nurse should say “tell me more about that”

Question 67

Explain the technique of interpreting. Therapeutic or nontherapeutic?

Answer 67

attempts to tell the patient the meaning of their experience
may leave the patient feeling like the nurse doesn’t understand them or that the nurse is being smug
nontherapeutic

Question 68

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

“What you really mean is … “
“You’re angry because …”

Answer 68

interpreting
nontherapeutic
nurse should leave interpretation of patient’s behavior to a therapist

Question 69

Explain the technique of introducing an unrelated topic. Therapeutic or nontherapeutic?

Answer 69

nurse prematurely changes the topic
conveys that the nurse doesn’t want to discuss the original topic further
can happen if the nurse wants to discuss something else with the patient or the nurse prefers not to discuss this topic
nontherapeutic

Question 70

Name the communication technique the nurse is using. Therapeutic or nontherapeutic? If nontherapeutic, what should the nurse say instead?

Patient: “I don’t have anything to live for.”
Nurse: “How well did you sleep last night?”

Answer 70

introducing an unrelated topic
nontherapeutic
nurse should say “tell me more” or use silence