NCLEX Style Questions - Therapeutic Communication

NCLEX Style Questions - Therapeutic Communication 5.0 (10 reviews) Students also studied Terms in this set (34) George Brown College Nursing Save NCLEX questions therapeutic comm...83 terms Sal13148Preview Ego Defense Mechanism Practice Q...15 terms quizlette193641 Preview Psychiatric Nursing - Therapeutic C...30 terms caroline_lyons8 Preview Schizop 30 terms dco Which therapeutic communication technique is being used in this nurse-client interaction?

Client: "When I get angry, I get into a fistfight with my

wife or I take it out on the kids."

Nurse: "I notice that you are smiling as you talk about this

physical violence."

• Encouraging comparison
• Exploring
• Formulating a plan of action
• Making observations

ANS: D

The nurse is using the therapeutic communication technique of making observations when noting that the client smiles when talking about physical violence. The technique of making observations encourages the client to compare personal perceptions with those of the nurse.Which therapeutic communication technique is being used in this nurse-client interaction?

Client: "My father spanked me often."

Nurse: "Your father was a harsh disciplinarian."

• Restatement
• Offering general leads
• Focusing
• Accepting

ANS: A

The nurse is using the therapeutic communication technique of restatement.Restatement involves repeating the main idea of what the client has said. The nurse uses this technique to communicate that the client's statement has been heard and understood.

Which therapeutic communication technique is being used in this nurse-client interaction?

Client: "When I am anxious, the only thing that calms me

down is alcohol."

Nurse: "Other than drinking, what alternatives have you

explored to decrease anxiety?"

• Reflecting
• Making observations
• Formulating a plan of action
• Giving recognition

ANS: C

The nurse is using the therapeutic communication technique of formulating a plan of action to help the client explore alternatives to drinking alcohol. The use of this technique, rather than direct confrontation regarding the client's poor coping choice, may serve to prevent anger or anxiety from escalating.The nurse is interviewing a newly admitted psychiatric client. Which nursing statement is an example of offering a "general lead"?

• "Do you know why you are here?"
• "Are you feeling depressed or anxious?"
• "Yes, I see. Go on."
• "Can you chronologically order the events that led to

your admission?"

ANS: C

The nurse's statement, "Yes, I see. Go on." is an example of the therapeutic communication technique of a general lead. Offering a general lead encourages the client to continue sharing information.A nurse states to a client, "Things will look better tomorrow after a good night's sleep." This is an example of which communication technique?

• The therapeutic technique of "giving advice"
• The therapeutic technique of "defending"
• The nontherapeutic technique of "presenting reality"
• The nontherapeutic technique of "giving false

reassurance"

ANS: D

The nurse's statement, "Things will look better tomorrow after a good night's sleep." is an example of the nontherapeutic technique of giving false reassurance.Giving false reassurance indicates to the client that there is no cause for anxiety, thereby devaluing the client's feelings.A client diagnosed with post-traumatic stress disorder is admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which therapeutic communication technique used by the nurse is an example of a broad opening?

• "What occurred prior to the rape, and when did you

go to the emergency department?"

• "What would you like to talk about?"
• "I notice you seem uncomfortable discussing this."
• "How can we help you feel safe during your stay

here?"

ANS: B

The nurse's statement, "What would you like to talk about?" is an example of the therapeutic communication technique of giving broad openings. Using a broad opening allows the client to take the initiative in introducing the topic and emphasizes the importance of the client's role in the interaction.

A nurse is assessing a client diagnosed with schizophrenia for the presence of hallucinations. Which therapeutic communication technique used by the nurse is an example of making observations?

• "You appear to be talking to someone I do not see."
• "Please describe what you are seeing."
• "Why do you continually look in the corner of this

room?"

• "If you hum a tune, the voices may not be so

distracting."

ANS: A

The nurse is making an observation when stating, "You appear to be talking to someone I do not see." Making observations involves verbalizing what is observed or perceived. This encourages the client to recognize specific behaviors and make comparisons with the nurse's perceptions.A nurse maintains an uncrossed arm and leg posture. This nonverbal behavior is reflective of which letter of the SOLER acronym for active listening?

• S
• O
• L
• E
• R

ANS: B

The nurse should identify that maintaining an uncrossed arm and leg posture is nonverbal behavior that reflects the "O" in the active-listening acronym SOLER.The acronym SOLER includes sitting squarely facing the client (S), open posture when interacting with the client (O), leaning forward toward the client (L), establishing eye contact (E), and relaxing (R).An instructor is correcting a nursing student's clinical worksheet. Which instructor statement is the best example of effective feedback?

• "Why did you use the client's name on your clinical

worksheet?"

• "You were very careless to refer to your client by name

on your clinical worksheet."

• "Surely you didn't do this deliberately, but you

breeched confidentiality by using the client's name."

• "It is disappointing that after being told, you're still

using client names on your worksheet."

ANS: C

The instructor's statement, "Surely you didn't do this deliberately, but you breeched confidentiality by using the client's name." is an example of effective feedback. Feedback is a method of communication to help others consider a modification of behavior. Feedback should be descriptive, specific, and directed toward a behavior that the person has the capacity to modify and should impart information rather than offer advice or criticize the individual.After assertiveness training, a formerly passive client appropriately confronts a peer in group therapy. The group leader states, "I'm so proud of you for being assertive. You are so good!" Which communication technique has the leader employed?

• The nontherapeutic technique of giving approval
• The nontherapeutic technique of interpreting
• The therapeutic technique of presenting reality
• The therapeutic technique of making observations

ANS: A

The group leader has employed the nontherapeutic technique of giving approval.Giving approval implies that the nurse has the right to pass judgment on whether the client's ideas or behaviors are "good" or "bad." This creates a conditional acceptance of the client.What is the purpose of a nurse providing appropriate feedback?

• To give the client good advice
• To advise the client on appropriate behaviors
• To evaluate the client's behavior
• To give the client critical information

ANS: D

The purpose of providing appropriate feedback is to give the client critical information. Feedback should not be used to give advice or evaluate behaviors.

A client who frequently exhibits angry outbursts is diagnosed with antisocial personality disorder. Which appropriate feedback should a nurse provide when this client experiences an angry outburst?

• "Why do you continue to alienate your peers by your

angry outbursts?"

• "You accomplish nothing when you lose your temper

like that."

• "Showing your anger in that manner is very childish and

insensitive."

• "During group, you raised your voice, yelled at a peer,

left, and slammed the door."

ANS: D

The nurse is providing appropriate feedback when stating, "During group, you raised your voice, yelled at a peer, left, and slammed the door." Giving appropriate feedback involves helping the client consider a modification of behavior. Feedback should give information to the client about how he or she is perceived by others. Feedback should not be evaluative in nature or be used to give advice.A client diagnosed with dependant personality disorder states, "Do you think I should move from my parent's house and get a job?" Which nursing response is most appropriate?

• "It would be best to do that in order to increase

independence."

• "Why would you want to leave a secure home?"
• "Let's discuss and explore all of your options."
• "I'm afraid you would feel very guilty leaving your

parents."

ANS: C

The most appropriate response by the nurse is, "Let's discuss and explore all of your options." In this example, the nurse is encouraging the client to formulate ideas and decide independently the appropriate course of action.When interviewing a client, which nonverbal behavior should a nurse employ?

• Maintaining indirect eye contact with the client
• Providing space by leaning back away from the client
• Sitting squarely, facing the client
• Maintaining open posture with arms and legs crossed

ANS: C

When interviewing a client, the nurse should employ the nonverbal behavior of sitting squarely, facing the client. Facilitative skills for active listening can be identified by the acronym SOLER. SOLER includes sitting squarely facing the client (S), open posture when interacting with a client (O), leaning forward toward the client (L), establishing eye contact (E), and relaxing (R).A mother rescues two of her four children from a house fire. In the emergency department, she cries, "I should have gone back in to get them. I should have died, not them." What is the nurse's best response?

• "The smoke was too thick. You couldn't have gone

back in."

• "You're feeling guilty because you weren't able to save

your children."

• "Focus on the fact that you could have lost all four of

your children."

• "It's best if you try not to think about what happened.

Try to move on."

ANS: B

The best response by the nurse is, "You're experiencing feelings of guilt because you weren't able to save your children." This response utilizes the therapeutic communication technique of reflection which identifies a client's emotional response and reflects these feelings back to the client so that they may be recognized and accepted.