Quiz - Therapeutic Communication Flashcards
A client cries as the nurse explores the client’s feelings about the death of a close friend. The client sobs, “I shouldn’t be crying like this. It happened a long time ago.” Which responses by the nurse facilitate communication? (Select all that apply.)
“Why do you think you are so upset?”
“Let’s talk about something else because this subject is upsetting you.”
“Crying is a way of expressing the hurt you are experiencing.”
“I can see that you feel sad about this situation.”
“The loss of a close friend is very painful for you.”
“Crying is a way of expressing the hurt you are experiencing.”
“I can see that you feel sad about this situation.”
“The loss of a close friend is very painful for you.”
A client tells the nurse, “I don’t think I’ll ever get out of here.” What is the nurse’s most therapeutic response?
“Everyone feels that way sometimes.”
“You don’t think you’re making progress?”
“Keep up the good work, and you certainly will.”
“Don’t talk that way. Of course, you will leave here!”
“You don’t think you’re making progress?”
Which comments by a nurse demonstrate use of therapeutic communication techniques? (Select all that apply.)
“I’m glad you were able to tell me how you felt about your loss.”
“I noticed your hands trembling when you told me about your accident.”
“You look very nice today. I’m proud you took more time with your appearance.”
“There are people with problems much worse than yours.”
“Why do you think these events have happened to you?”
“I’m glad you were able to tell me how you felt about your loss.”
“I noticed your hands trembling when you told me about your accident.”
During the first interview with a parent whose child died in a car accident, the nurse feels empathic and reaches out to take the client’s hand. Select the correct analysis of the nurse’s behavior.
The action is inappropriate. Psychiatric clients should not be touched.
The client will perceive the gesture as intrusive and overstepping boundaries.
It shows empathy and compassion. It will encourage the client to continue to express feelings.
The gesture is premature. The client’s cultural and individual interpretation of touch is unknown.
The gesture is premature. The client’s cultural and individual interpretation of touch is unknown.
The client says, “My marriage is just great. My spouse and I always agree.” The nurse observes the client’s foot moving continuously as the client twirls a shirt button. What conclusion can the nurse draw about the client’s statement?
It is clear.
It may be distorted.
It is incongruous.
It is inadequate.
It is incongruous.
A nurse interacts with a newly hospitalized client. Which of the nurse’s comments applies the communication technique of “offering self?”
“I’ve also had traumatic life experiences. Maybe it would help if I told you about them.”
“Why do you think you had so much difficulty adjusting to this change in your life?”
“I’d like to sit with you for a while to help you get comfortable talking to me.”
“I hope you will feel better after getting accustomed to how this unit operates.”
“I’d like to sit with you for a while to help you get comfortable talking to me.”
Which benefits are most associated with use of telehealth technologies? (Select all that apply.)
Prompt reimbursement by third-party payers
Maximize care management
Rapid development of trusting relationships with clients
Cost savings for clients
Access to services for clients in rural areas
Maximize care management
Cost savings for clients
Access to services for clients in rural areas
During a one-on-one interaction with the nurse, a client frequently looks nervously at the door. What is the best comment by the nurse regarding this nonverbal communication?
“This is our time together. No one is going to interrupt us.”
“If you are uncomfortable in this room, we can move someplace else.”
“I notice you keep looking toward the door.”
“It looks as if you are eager to end our discussion for today.”
“I notice you keep looking toward the door.”
A client diagnosed with acute depression states, “God is punishing me for my past sins.” What is the nurse’s most therapeutic response?
“You sound very upset about this.”
“Why do you think you are being punished?”
“If you feel this way, you should talk to your minister.”
“God always forgives us for our sins.”
“You sound very upset about this.”
A client diagnosed with schizophrenia tells the nurse, “The Central Intelligence Agency is monitoring us through the fluorescent lights in this room. The CIA is everywhere, so be careful what you say.” Which response by the nurse is most therapeutic?
“You have lost touch with reality, which is a symptom of your illness.”
“The CIA is prohibited from operating in health care facilities.”
“Let’s talk about something other than the CIA.”
“It sounds like you’re concerned about your privacy.”
“It sounds like you’re concerned about your privacy.”
A school age child tells the school nurse, “Other kids call me mean names and will not sit with me at lunch. Nobody likes me.” what is the nurse’s most therapeutic response?
“Call them names if they do that to you.”
“You should make friends with other children.”
“Just ignore them and they will leave you alone.”
“Tell me more about how you feel.”
“Tell me more about how you feel.”
A ethnic client uses dramatic body language when describing emotional discomfort. Which analysis most likely explains the client’s behavior?
The client wishes to impress upon staff the degree of emotional pain they are experiencing.
The client believes dramatic body language is sexually appealing.
This may be a characteristic of a culture where dramatic body language is the norm.
This is a characteristic of a histrionic personality disorder.
This may be a characteristic of a culture where dramatic body language is the norm.
Documentation in a client’s chart states, “Throughout a 5-minute interaction, client fidgeted and tapped left foot, periodically covered face with hands, and looked under chair while stating, ‘I enjoy spending time with you.’” Which analysis is most accurate?
The client is giving positive feedback about the nurse’s communication techniques.
The client is demonstrating psychotic behaviors.
The client’s verbal and nonverbal messages are incongruent.
The nurse is viewing the client’s behavior through a cultural filter.
The client’s verbal and nonverbal messages are incongruent.
Which technique will best communicate to a client that the nurse is interested in listening?
Asking a direct question, such as “Did you feel angry?”
Restating a feeling or thought the client has expressed.
Saying, “I understand what you’re saying.”
Making a judgment about the client’s problem.
Restating a feeling or thought the client has expressed.
A client is having difficulty making a decision. The nurse has mixed feelings about whether to provide advice. Which principle regarding giving advise usually applies?
It helps lift the burden of personal decision making.
It tends to foster independence.
It helps the client develop feelings of personal adequacy.
It is rarely helpful.
It is rarely helpful.
While talking with a client diagnosed with major depressive disorder, a nurse notices the client is unable to maintain eye contact. The client’s chin lowers to the chest. The client looks at the floor. Which aspect of communication has the nurse assessed?
Nonverbal communication
A message filter
Social skills
A cultural barrier
Nonverbal communication
A newly immigrated client had a nursing diagnosis of situational low self-esteem related to poor social skills as evidenced by lack of eye contact. Interventions were applied to increase the client’s self-esteem but after 3 weeks, the client’s eye contact did not improve. What is the most accurate analysis of this scenario?
The nurse should not have independently embarked on assessment, diagnosis, and planning for this client.
The client’s poor eye contact is indicative of anger and hostility that were unaddressed.
The client’s eye contact should have been directly addressed by role playing to increase comfort with eye contact.
The nurse should have assessed the client’s culture before making this diagnosis and plan.
The nurse should have assessed the client’s culture before making this diagnosis and plan.
A client of color says to a Caucasian nurse, “There’s no sense talking about how I feel. You wouldn’t understand because you live in a white world.” What is the nurse’s best action ?
Change the subject to one that is less emotionally disturbing.
Explain, “Yes, I do understand. Everyone goes through the same experiences.”
Reassure the client that nurses interact with people from all cultures.
Say, “Please give an example of something you think I wouldn’t understand.”
Say, “Please give an example of something you think I wouldn’t understand.”
During an interview, a client attempts to shift the focus from self to the nurse by asking personal questions. How should the nurse respond?
“Why do you keep asking about me?”
“The time we spend together is to discuss your concerns.”
“Do not ask questions about my personal life.”
“Nurses direct the interviews with clients.”
“The time we spend together is to discuss your concerns.”
Which principle should guide the nurse in determining the extent of silence to use during client interview sessions?
Silence helps clients know that what they said was understood.
A nurse is responsible for breaking silences.
Silence can provide meaningful moments for reflection.
Clients withdraw if silences are prolonged.
Silence can provide meaningful moments for reflection.
A nurse interacts with clients diagnosed with various mental illnesses. Which statements reflect use of therapeutic communication? (Select all that apply.)
“Let’s talk about something else.”
“I’ll stay with you a while.”
“Tell me more about that situation.”
“Why did you do that?”
“I notice you are pacing a lot.”
“I’ll stay with you a while.”
“Tell me more about that situation.”
“I notice you are pacing a lot.”
When a specific client and the nurse sit together, the client often holds the nurse’s hand. The client also links arms with the nurse when they walk. The nurse is uncomfortable with this behavior. Which analysis is most accurate?
The client is trying to manipulate the nurse using nonverbal techniques.
The client is afraid of being alone. When touching the nurse, the client is reassured and comforted.
The client is accustomed to touch during conversation, as are members of many ethnic subcultures.
The client understands that touch makes the nurse uncomfortable and controls the relationship based on that factor.
The client is accustomed to touch during conversation, as are members of many ethnic subcultures.
A client discloses several concerns and associated feelings. If the nurse wants to seek clarification, which comment would be appropriate?
“Tell me again about your experiences.”
“Am I correct in my understanding of that?”
“What are the common elements here?”
“Tell me everything from the beginning.”
“Am I correct in my understanding of that?”
A client says to the nurse, “I dreamed I was stoned. When I woke up, I felt emotionally drained, as though I hadn’t rested well.” Which response should the nurse use to clarify the client’s comment?
“So you feel as though you did not get enough quality sleep last night?”
“I understand what you’re saying. Bad dreams leave me feeling tired, too.”
“Can you give me an example of what you mean by ‘stoned’?”
“It sounds as though you were uncomfortable with the content of your dream.”
“Can you give me an example of what you mean by ‘stoned’?”
A community mental health nurse has worked with a patient for 3 years but is moving out of the city and terminates the relationship. When a novice nurse begins work with this patient, what is the starting point for the relationship?
Return to the emotional catharsis phase.
Initially establish a social relationship.
Resume the working relationship.
Begin at the orientation phase.
Begin at the orientation phase.
A nurse caring for a withdrawn, suspicious patient recognizes development of feelings of anger toward the patient. The nurse should take what action?
Suppress the angry feelings.
Ask the nurse manager to assign the patient to another nurse.
Discuss the anger with a clinician during a supervisory session.
Express the anger openly and directly with the patient.
Discuss the anger with a clinician during a supervisory session.
Which remark by a patient indicates passage from orientation to the working phase of a nurse–patient relationship?
“I don’t have any problems.”
“I want to find a way to deal with my anger without becoming violent.”
“It is so difficult for me to talk about problems.”
“I don’t know how it will help to talk to you about my problems.”
“I want to find a way to deal with my anger without becoming violent.”
Termination of a therapeutic nurse–patient relationship has been successful when the nurse engages in what activity?
Gives the patient a personal telephone number and permission to call after discharge.
Avoids upsetting the patient by shifting focus to other patients before the discharge.
Offers to meet the patient for coffee and conversation three times a week after discharge.
Discusses with the patient changes that happened during the relationship and evaluates outcomes.
Discusses with the patient changes that happened during the relationship and evaluates outcomes.
After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference?
The nurse develops a trusting relationship with the patient.
The nurse feels unusually happy when the patient’s mood begins to lift.
The patient’s reactions toward the nurse seem realistic and appropriate.
The patient states, “Talking to you feels like talking to my parents.”
The nurse feels unusually happy when the patient’s mood begins to lift.
At what point in the nurse–patient relationship should a nurse plan to first address termination?
Near the beginning of the termination phase
At the end of the working phase
When the patient initially brings up the topic
During the orientation phase
During the orientation phase
