Psychiatric Nursing - Therapeutic Communication (Nurseslabs)

Psychiatric Nursing - Therapeutic Communication (Nurseslabs) 5.0 (5 reviews) Terms in this set (30) Social SciencesPsychology Clinical Psychology Save A patient with a diagnosis of major depression who has attempted suicide says to the nurse, "I should have died! I've always been a failure.Nothing ever goes right for me." Which response demonstrates therapeutic communication?

• "You have everything to live for."
• "Why do you see yourself as a

failure?"

• "Feeling like this is all part of

being depressed."

• "You've been feeling like a failure

for a while?"

• "You've been feeling like a failure for a while?"

Responding to the feelings expressed by a patient is an effective therapeutic communication technique. The correct option is an example of the use of restating.

Options A, B, C: The remaining options block

communication because they minimize the patient's experience and do not facilitate exploration of the patient's expressed feelings. In addition, use of the word "why" is non-therapeutic.

When the community health nurse visits a patient at home, the patient states, "I haven't slept the last couple of nights." Which response by the nurse illustrates a therapeutic communication response to this patient?

• "I see."
• "Really?"
• "You're having difficulty sleeping?"
• "Sometimes, I have trouble

sleeping too."

• "You're having difficulty sleeping?"

The correct option uses the therapeutic communication technique of restatement. Although restatement is a technique that has a prompting component to it, it repeats the patient's major theme, which assists the nurse in obtaining a more specific perception of the problem from the patient.

Options A, B, and D: The remaining options are not

therapeutic responses since none encourage the patient to expand on the problem. Offering personal experiences moves the focus away from the patient and onto the nurse.A patient experiencing disturbed thought processes believes that his food is has been poisoned. Which communication technique should the use to encourage the patient to eat?

• Using open-ended questions and

silence

• Sharing personal preference

regarding food choices

• Documenting reasons why the

patient does not want to eat

• Offering opinions about the

necessity of adequate nutrition

• Using open-ended questions and silence

Open-ended questions and silence are strategies use to encourage patients to discuss their problems. Sharing personal food preferences is not a patient-centered intervention.

Options B, C, and D: The remaining options are not

helpful to the patient because they do not encourage the patient to express feelings. The nurse should not offer opinions and should encourage the patient to identify the reasons for the behavior.

A patient admitted to a mental health unit for treatment of psychotic behavior spends hours at the locked exit door shouting. "Let me out.There's nothing wrong with me. I don't belong here." What defense mechanism is the patient implementing?

• Denial
• Projection
• Regression
• Rationalization
• Denial.

Denial is a refusal to admit to a painful reality, which was treated as if it does not exist.

Option B: In projection, a person unconsciously

rejects emotionally unacceptable features and attributes them to other persons, objects, or situations.

Option C: Regression allows the patient to return

to an earlier, more comforting, although less mature, a way of behaving.

Option D: Rationalization is justifying illogical or

unreasonable ideas, actions, or feelings by developing acceptable explanations that satisfy the teller and the listener.A patient diagnosed with terminal cancer says to the nurse "I'm going to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this.After all, I'm the one who's dying." Which response by the nurse is therapeutic?

• "Have you shared your feelings

with your family?"

• "I think we should talk more about

your anger with your family."

• "You're feeling angry that your

family continues to hope for you to be cured?"

• "You are probably very depressed,

which is understandable with such a diagnosis."

• "You're feeling angry that your family continues

to hope for you to be cured?" Restating is a therapeutic communication technique in which the nurse repeats what the patient says to show understanding and to review what was said.

Options A and B: While it is appropriate for the

nurse to attempt to assess the patient's ability to discuss feelings openly with family members, it does not help the patient discuss the feelings causing the anger.

Option D: The nurse's attempt to focus on the

central issue of anger is premature. The nurse would never make a judgment regarding the reason for the patient's feeling; this is non- therapeutic in the one-to-one relationship.

On review of the patient's record, the nurse notes the admission was voluntary. Based on this information, the nurse anticipates which patient behavior?

• Fearfulness regarding treatment

measures.

• Anger and aggressiveness

directed toward others.

• An understanding of the

pathology and symptoms of the diagnosis.

• A willingness to participate in the

planning of the care and treatment plan.

• A willingness to participate in the planning of the

care and treatment plan.In general, patients seek voluntary admission. If a patient seeks voluntary admission, the most likely expectation is the patient will participate in the treatment program since they are actively seeking help.

Options A, B, and C: The remaining options are not

characteristics of this type of admission.Fearfulness, anger, and aggressiveness are more characteristic of an involuntary admission.Voluntary admission does not guarantee a patient's understanding of their illness, only of their desire for help.