mental health ch 9 therapeutic communication

During a clinical interview the client falls silent after disclosing that she was sexually abused as a child. The nurse should engage in which intervention in response to the client's silence?

Allow the client to break the silence.

Which communication techniques should the nurse use with a client who has been identified as having difficulty expressing thoughts and feelings?

Asking open-ended questions and seeking clarification

nonverbal communication

used to understand behaviors and attitudes

The preferred seating arrangement for a nurse-client interview should incorporate which positioning?

The nurse and client sitting at a 90-degree angle to each other.

A patient is presenting with behaviors that indicate anger. When approached, the patient states harshly, "I'm fine! Everything's great." Which response should the nurse provide to the patient?

"It looks as though you are saying one thing but feeling another. Can you tell me what may be upsetting you?"

What is the most helpful nursing response to a client who reports thinking of dropping out of college because it is too stressful?

"School is stressful. What do you find most stressful?"

Which of the following statements represent a nontherapeutic communication technique?

"Why didn't you attend group this morning?" "What did your boyfriend do that made you leave? Are you angry at him? Did he abuse you in some way?" "If I were you, I would quit the stressful job and find something else." "I'm really proud of you for the way you stood up to your brother when he visited today."

personal space

0-18 inches

With which client should the nurse make the assessment that not using touch would probably be in the client's best interests?

A Chinese American client

The client makes the decision to sit about 5 feet away from the nurse during the assessment interview. The nurse can accurately make what assumption about the client's perception of the nurse?

They view the nurse as a stranger.

Of the following environments, which would be most conducive to a therapeutic session?

A quiet section of the day room

When discussing her husband, a client shares that "I would be better off alone. At least I would be able to come and go as I please and not have to be interrogated all the time." What therapeutic communication technique is the nurse using when responding, "Are you saying that things would be better if you left your husband?"

Clarification

After a client discusses his/her relationship with his/her father, the nurse asks, "Tell me if I'm correct that you feel dominated and controlled by him?" What is the purpose of the nurse's question?

Clarifying the message

During a therapeutic encounter, the nurse makes an effort to ensure the use of two congruent levels of communication. What is the rationale for this?

Content of messages may be contradicted by process.

A recent immigrant to the United States from which country would find direct eye contact a positive therapeutic technique?

Germany

reflecting

Directs questions, feelings, and ideas back to the patient. Encourages the patient to accept his or her own ideas and feelings. Acknowledges the patient's right to have opinions and make decisions and encourages the patient to think of self as a capable person. ex: "you look sad"

A patient is sitting with arms crossed over his or her chest, his or her left leg is rapidly moving up and down, and there is an angry expression on his or her face. When approached by the nurse, the patient states harshly, "I'm fine! Everything's great." Which statement related to communication should the nurse focus on when working with this patient?

Nonverbal and verbal communication may be different; nurses must pay attention to the nonverbal communication being presented to get an accurate message.

During a therapeutic encounter the nurse remarks to a client, "I noticed anger in your voice when you spoke of your father. Tell me about that." What communication techniques is the nurse using?

Reflecting and exploring

Attending Behavior

Responses to relevant stimuli primarily through the use of eye contact, posture, gestures, and verbal behavior

When preparing to hold an admission interview with a client, the nurse pulls up a chair and sits facing the client with his or her knees almost touching. When the nurse leans in close to speak, the client becomes visibly flustered and gets up and leaves the room. What is the most likely explanation for client's behavior?

The nurse violated the client's personal space by physically being too close.

What is the focus during clinical supervision?

The nurse's behavior in the nurse-client relationship

A 55-year-old patient recently came to the United States from England on a work visa. The patient was admitted for severe depression following the death of a life partner weeks ago. While discussing the death and its effects the patient shows little emotion. Which of the following explanations is most plausible for this lack of emotion?

The response may reflect cultural norms.

What therapeutic communication technique is the nurse using by asking a newly admitted patient, "Please tell me what was happening that led to your hospitalization here?"

Using an open-ended question

nonverbal communication

check congruent between verbal and nonverbal to validate the response

Nontherapeutic Communication Techniques

giving advice; approval, asking excessive questions, and asking "why"