Therapeutic Communication

Question 1

● The hallmark of the nurse-client relationship
● Purposeful, directed toward a specific outcome
● Nonjudgmental and client-centered.
● Promotes understanding and can help establish a constructive relationship between the nurse and the client.

Answer 1

THERAPEUTIC COMMUNICATION

Question 2

The amount of time the nurse spends with each client and the timing of an interaction has a significant impact on the outcome of the interaction.

Answer 2

Time and Place

Question 3

The nurse should introduce and clarify the purpose of the interaction and the expected duration.

Answer 3

Setting the Stage

Question 4

The nurse remains aware of his own biases and to approach each client from a perspective of acceptance.

Answer 4

ACCEPTING THE CLIENT

Question 5

Communicates acceptance of the person’s thoughts and emotions

Answer 5

ACTIVE LISTENING

Question 6

➔ Most important technique in nursing and is basic to all other techniques
➔ Involves paying attention to the total message, both verbal and nonverbal, and noting whether these communications are congruent.
➔ Absorb both the content and the feeling the client is conveying while putting aside your own judgements and ideas to really hear and focus on the client’s needs.

Answer 6

ATTENTIVE LISTENING

Question 7

May be as important, or more important, than your words. Active learners are engaged physically and mentally in the listening process

Answer 7

Nonverbal Behavior

Question 8

➔ Have good eye contact
➔ Communicate their interest with an intent facial expression

Answer 8

VISIBLY TUNING IN

Question 9

ELEMENTS OF THERAPEUTIC COMMUNICATION
1. ________
2. ________
3. ________
4. ________
5. ________
6. ________

Answer 9

1. Empathy
2. Trust
3. Honesty
4. Validation
5. Active Listening
6. Caring

Question 10

TRUE OR FALSE:
In Therapeutic Communication, the nurse must give reassurance to the patient at all times

Answer 10

FALSE
The nurse must not give FALSE REASSURANCE

Question 11

Giving recognition, in a non-judgmental way, of a change in behavior, an effort that client has made or a contribution to a communication

Answer 11

ACKNOWLEDGING

Question 12

Providing, in a simple & direct manner, specific factual information the client may or may not request

Answer 12

OFFERING / GIVING INFORMATION / EDUCATING

Question 13

Suggesting one’s presence, interest or wish to understand the client without making any demands or attaching conditions that the client must comply with to receive the nurse’s attention

Answer 13

OFFERING SELF

Question 14

● “You appear hungry.”
● “You look uncomfortable when…”
● “I notice you are clenching your fists.”

Answer 14

STATING OBSERVATION

Question 15

Making statements that are specific rather than general, and tentative rather than absolute

Answer 15

BEING SPECIFIC AND TENTATIVE

Question 16

● Method of making the client’s broad overall meaning of the message more understandable
● Used when paraphrasing is difficult or when the communication is rambling or garbled
● Facilitates correct communication of information by asking the client to restate information or provide an example

Answer 16

CLARIFYING/SEEKING CLARIFICATION

Question 17

● Using statements or questions that:
○ Encourage the client to verbalize
○ Choose a topic of conversation
○ Facilitate continued verbalization
● “And then…what?”

Answer 17

PROVIDING GENERAL NEEDS

Question 18

● Asking broad questions that lead or invite the client to explore thoughts or feelings
○ Client: “I had a wonderful dream last night”
○ Nurse: “I’d like to hear more about that”

Answer 18

USING OPEN ENDED QUESTIONS

Question 19

● Helping the client clarify an event, situation, or happening in relationship to time
○ Client: I vomited this morning
○ Nurse: Was that after breakfast?

Answer 19

CLARIFYING TIME OR SEQUENCE

Question 20

● A method similar to clarifying that verifies the meaning of specific words rather than the overall meaning of a message
○ Client: “My wife never gives me any presents”
○ Nurse: “You mean she has never given you a present for your birthday or Christmas?”

Answer 20

PERCEPTION CHECKING OR SEEKING CONSENSUAL VALIDATION

Question 21

● Directing ideas, feelings, questions or content back to clients to enable them to explore their own ideas & feelings about situation
○ Client: “What can I do?”
○ Nurse: “What do you think would be helpful?”

Answer 21

REFLECTING

Question 22

● Helping the client expand on & develop a topic of importance
● Eliminates vagueness
● Limits the area of discussion
● Helps the interviewer to direct attention to the pertinent aspect of client’s message
★ Nurse must wait until client thinks about main concerns before attempting to focus

Answer 22

FOCUSING

Question 23

● Providing appropriate forms of touch to reinforce caring feelings
★ With consent

Answer 23

USING TOUCH

Question 24

● Offering a view of what is real without arguing with the patient
○ Client: “Somebody is calling me!”
○ Nurse: “I hear no voices”

Answer 24

PRESENTING REALITY

Question 25

● Actively listening for the client’s basic message & then repeating those thoughts and/or feelings in similar words.
● Provides opportunity for the interviewer to validate information by asking the client to restate information or provide an example.
○ Client: “I had problem eating dinner last night”
○ Nurse: “You had difficulty eating dinner last night?”

Answer 25

PARAPHRASING or RESTARTING

Question 26

● Accepting pauses / silence for several seconds/ minutes without interjecting verbal response.
● Promotes observations about the client and allows time for the client to organize thoughts

Answer 26

USING SILENCE

Question 27

● Stating the main points of a discussion to clarify the relevant points discussed
● Useful at the end of interview or to review a health-teaching session
● Condenses data to further validate information and tonend a component of the interview or the interview itself
○ Nurse: “During the past half hour, we have talked about…”

Answer 27

SUMMARIZING and PLANNING

Question 28

● Facilitates eye contact with the client and communicates interest in the client’s needs, concerns, and problems
❖ The other attentive listening in the 1st page is the same

Answer 28

ATTENTIVE LISTENING

Question 29

Nurses need to recognize ________ or ________ responses to effective communication

Answer 29

barriers / non-therapeutic

Question 30

● Takes decisionmaking away from the client
● Inhibits spontaneity, stalls problem solving & creates doubt
❖ Nurse: “If I were you, I’ll just go home & have my recovery there”

Answer 30

GIVING AN OPINION OR COMMON ADVICE

Question 31

● Using cliches or comforting statements of advice as a means to reassure the client
○ Nurse: “This shot will make you feel better. Trust me.”

Answer 31

OFFERING FALSE REASSURANCE

Question 32

● Suggests that the interviewee has no right to an opinion
➔ Attempting to protect an individual or healthcare services from negative comments.
➔ Prevents the client from expressing true concerns
➔ Defensive responses protect the nurse from admitting weaknesses in healthcare services, including personal weakness

Answer 32

BEING DEFENSIVE

Question 33

● Can be as harmful to an interviewee-interviewer relationship
● Implies that the behavior being praised is the only acceptable one.

Answer 33

SHOWING APPROVAL OR DISAPPROVAL

Question 34

● Are generalized beliefs held about people
➔ Categorizes clients and negate their uniqueness as individuals

Answer 34

STEREOTYPING

Question 35

● Asking for information chiefly out of curiosity, rather than with the intent to assist the client
● “Why” questions can cause resentment, insecurity & mistrust.

Answer 35

PROBING

Question 36

● Stalls progress of the communication process.
➔ Directing the communication into areas of self-interest rather than considering the client’s concern is often a self-protective response to a topic that causes anxiety.

Answer 36

CHANGING THE SUBJECT INAPPROPRIATELY

Question 37

● Refusing to discuss certain topics with the client
○ Client: “Nurse, why do I have difficulty urinating?
○ Nurse: “Shut up! We’re having an endorsement here.”

Answer 37

REJECTING

Question 38

● Giving a response that makes clients prove their statement or point of view
➔ This response indicates that the nurse is failing to consider the client’s feelings, making the client feel it is necessary to defend a position.
○ Client: “I felt nauseated after that red pill”
○ Nurse: “Surely you don’t think I gave you the wrong pill”

Answer 38

CHALLENGING

Question 39

● Imply that the client must think as the nurse thinks, fostering client dependency
➔ Giving opinions and approving or disapproving responses, moralizing, or implying one’s own values
○ Client; does something
○ Nurse: “You should not do that!

Answer 39

PASSING JUDGEMENT

Question 40

● Communication and culture are closely interconnected.
● Communicating effectively with clients of various ethnic and cultural backgrounds is critical to providing culturally competent nursing care.
● Consider cultural differences in expressing nonverbal communication.

Answer 40

TRANSCULTURAL THERAPEUTIC COMMUNICATION