Chapter 9 Review Questions (Therapeutic Communication)
A 55-year-old client recently came to the United States from England on a work visa. The client was admitted for severe depression following the death of a life partner weeks ago. While discussing the death and its effects the client shows little emotion. Which of the following explanations is most plausible for this lack of emotion? A) The response may reflect cultural norms. B) The response may reflect personal guilt. C) The client may have an antisocial personality. D) The client in denial.
A
A client is sitting with arms crossed over their chest, with their left leg is rapidly moving up and down, and there is an angry facial expression. When approached by the nurse, the client states harshly, "I'm fine! Everything's great." Which statement related to communication should the nurse focus on when working with this client? A) Nonverbal and verbal communication may be different; nurses must pay attention to the nonverbal communication being presented to get an accurate message. B) Verbal communication is always more accurate than nonverbal communication. C) Verbal communication is more straightforward, whereas nonverbal communication does not portray what a person is thinking. D) Nonverbal communication is about 10% of all communication, and verbal communication is about 90%.
A
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? A) Allow the client to break the silence. B) Quickly break the silence and encourage the client to continue. C) Reassure the client that the abuse was not her fault. D) Reach out and gently touch the client's arm.
A
What is the most helpful nursing response to a client who reports thinking of dropping out of college because it is too stressful? A) "School is stressful. What do you find most stressful?" B) "I know just what you are going through. The stress is terrible." C) "Don't let them beat you! Fight back!" D) "You have only two more semesters. You will be glad if you stick it out."
A
Which of the following statements represent a nontherapeutic communication technique? (Select all that apply.) Select all that apply. A) "What did your boyfriend do that made you leave? Are you angry at him? Did he abuse you in some way?" B) "From what you have said, you have great difficulty sleeping at night." C) "Why didn't you attend group this morning?" D) "It sounds like you have been having a very hard time at home lately." E) "If I were you, I would quit the stressful job and find something else." F) "You mentioned that you have never had friends. Tell me more about that." G) "I'm really proud of you for the way you stood up to your brother when he visited today."
A, C, E, & G
A client is presenting with behaviors that indicate anger. When approached, the client states harshly, "I'm fine! Everything's great." Which response should the nurse provide to the client? A) "I'm glad everything is good. I am going to give you your schedule for the day and we can discuss how the groups are going." B) "It looks as though you are saying one thing but feeling another. Can you tell me what may be upsetting you?" C) "I don't believe you. You are not being truthful with me." D) "Okay, but we are all here to help you, so come get one of the staff if you need to talk."
B
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? A) Clarifying and suggesting collaboration B) Reflecting and exploring C) Presenting reality and encouraging planning D) Giving information and encouraging evaluation
B
After a client discusses a personal relationship with a parent, the nurse asks, "Tell me if I'm correct that you feel dominated and controlled by this person?" What is the purpose of the nurse's question? A) Verbalizing the implied B) Eliciting more information C) Clarifying the message D) Encouraging evaluation
C
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? A) One statement may simultaneously convey conflicting messages. B) Many of the client's remarks are no more than social phrases. C) Content of messages may be contradicted by process. D) The mental image of a word may not be the same for both nurse and client.
C
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?" A) Reflection B) Focusing C) Clarification D) Restating
C
When preparing to hold an admission interview with a client, the nurse pulls up a chair and sits facing the client with their 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? A) The client is responding to the voices by ending the conversation. B) The nurse failed to explain the purpose of the admission interview. C) The nurse violated the client's personal space by physically being too close. D) The client has issues with sharing personal information.
C
With which client should the nurse make the assessment that not using touch would probably be in the client's best interests? A) A deeply depressed client B) A tearful client reporting pain C) A very private client D) A recent immigrant from Russia
C