Nontherapeutic Communication Techniques

Question 1

Conveys that the nurse already knows the outcome of a situation and minimizes the patient’s expressed concerns. It may discourage the patient from further expression of feelings if he or she believes the feelings will be downplayed or ridiculed.

Answer 1

Giving false reassurance

Question 2

Refusing to consider or showing contempt for the patient’s ideas or behavior may cause the patient to discontinue interaction with the nurse for fear of further [blank].

Answer 2

Rejecting

Question 3

Sanctioning or denouncing the patient’s ideas or behavior implies that the nurse’s role is to pass judgment on whether the patient’s ideas or behaviors are “good” or “bad” and that the patient is expected to please the nurse. The nurse’s acceptance of the patient is then seen as conditional depending on the patient’s behavior.

Answer 3

Approving or disapproving

Question 4

Indicating accord with or opposition to the patient’s ideas or opinions implies that the nurse has the right to pass judgment on whether the patient’s ideas or opinions are “right” or “wrong.” [Blank] prevents the patient from later modifying his or her point of view without the risk of displeasing the nurse. [Blank] may provoke defensiveness on the part of the patient.

Answer 4

Agreeing or disagreeing

Question 5

Telling the patient what to do or how to behave implies that the nurse knows what is best and nurtures the patient in the dependent role by discouraging independent thinking.

Answer 5

Giving advice

Question 6

Persistent questioning of the patient and pushing for answers to issues the patient does not wish to discuss or does not know the answers to may contribute to the patient feeling used only for what information the nurse is seeking and may place the patient on the defensive.

Answer 6

Probing

Question 7

[Blank] someone or something the patient has criticized minimizes or completely ignores the patient’s concerns. [Blank] may cause the patient to think the nurse is taking sides against him or her.

Answer 7

Defending

Question 8

This technique involves asking the patient why he or she has certain thoughts, feelings, and behaviors. Asking “why” a patient did something or feels a certain way can be very intimidating and implies that the patient must defend his or her behavior or feelings.

Answer 8

Requesting an explanation

Question 9

Attributing the source of thoughts, feelings, and behavior to something or someone other than the patient encourages the patient to project blame for his or her thoughts or behaviors on others rather than accepting the responsibility personally.

Answer 9

Indicating the existence of an external source of power

Question 10

When the nurse minimizes the degree of the patient’s discomfort, a lack of empathy and understanding may be conveyed. When the nurse tells the patient to “cheer up” or “everybody feels that way,” the patient may feel that his or her concerns are insignificant or unimportant.

Answer 10

Belittling feelings expressed

Question 11

Trite expressions are meaningless in a nurse-patient relationship. When the nurse uses meaningless expressions, it encourages a similar response from the patient.

Answer 11

Making stereotyped comments

Question 12

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

Answer 12

Using denial

Question 13

Attempts to tell the patient the meaning of his or her experience. Erroneous [blank] may leave the patient feeling that the nurse doesn’t understand him or her, or that the nurse is being smug.

Answer 13

Interpreting

Question 14

When the nurse prematurely changes the subject, it conveys to the patient that the nurse does not want to discuss the original topic any further. This may occur in order to get to something that the nurse wants to discuss with the patient or to get away from a topic that he or she would prefer not to discuss.

Answer 14

Introducing an unrelated topic

Question 15

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.”
Better alternative: “Tell me more about what’s been happening in your relationship with your husband.”

Answer 15

Giving false reassurance

Question 16

Patient: “Since I started taking this medication I can’t be intimate with my girlfriend.”
Nurse: “Let’s not talk about that right now.”
Better alternative: “Tell me more about what you mean by not being able ‘to be intimate’ with your girlfriend.”

Answer 16

Rejecting

Question 17

“It’s good that you confronted your wife about her behavior.”
“You shouldn’t yell at your wife.”
Better alternative: “What happened after you confronted your wife in a loud voice?”

Answer 17

Approving or disapproving

Question 18

Patient: “I think my doctor doesn’t care about me.”
Nurse: “I disagree. You shouldn’t think that way.” or
“I can’t believe that’s true.”
Better alternative: “Tell me more about why you think your doctor doesn’t care.”

Answer 18

Agreeing or disagreeing

Question 19

“You need to do deep breathing exercises when you become anxious.”
“You should stop drinking alcohol and start going to Alcoholics Anonymous meetings.”
Better alternative: “What do you think you should do?” or “Let’s explore some options for solving this problem.”

Answer 19

Giving advice

Question 20

“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?”
Better alternative: The nurse should actively listen to the patient’s response and discontinue the interaction at the first sign of discomfort.

Answer 20

Probing

Question 21

“None of the nurses here would lie to you.”
“You have a very capable physician.”
“Your children want only what’s best for you.”
Better alternative: “Tell me more about these concerns you’ve expressed.”

Answer 21

Defending

Question 22

“Why do you think people are out to get you?”
“Why do you feel depressed?”
“Why were you taking drugs?”
Better alternative: “Describe what you were feeling just before that happened.”

Answer 22

Requesting an explanation

Question 23

“What made you go on a drinking binge?”
“What made you say that you are a worthless person?”
Better alternative: “What was happening just before you started binge drinking?”
“What do you mean when you say you are ‘a worthless person’?”

Answer 23

Indicating the existence of an external source of power

Question 24

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.”
Better alternative: “Tell me more about what you are feeling right now.”

Answer 24

Belittling feelings expressed

Question 25

“How are you?”
“Hang in there.”
“It’ll all work out.”
Better alternative: Choose words, sentences, and nonverbal language that convey a sincere interest in encouraging the patient to share more about the patient’s thoughts, feelings, and behaviors.

Answer 25

Making stereotyped comments

Question 26

Patient: “I have a problem interacting with people.”
Nurse: “You’re doing fine.”
Better alternative: “Tell me more about that.”

Answer 26

Using denial

Question 27

“What you really mean is….”
“You’re angry because….”
Better alternative: The nurse must leave interpretation of the patient’s behavior to a therapist who is trained to use interpretation in the context of specialized therapy.

Answer 27

Interpreting

Question 28

Patient: “I don’t have anything to live for.”
Nurse: “How well did you sleep last night?”
Better alternative: “Tell me more.” Sometimes silence may be appropriate to convey that the nurse is willing to hear all of what the patient wants to say before moving on to a different topic.

Answer 28

Introducing an unrelated topic