NCLEX Review Questions Ch 9
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? "Okay, but we are all here to help you, so come get one of the staff if you need to talk." "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." "I don't believe you. You are not being truthful with me." "It looks as though you are saying one thing but feeling another. Can you tell me what may be upsetting you?"
"It looks as though you are saying one thing but feeling another. Can you tell me what may be upsetting you?" This response uses the therapeutic technique of clarifying; it addresses the difference between the client's verbal and nonverbal communication and encourages sharing of feelings. The other options do not address the client's obvious distress or are confrontational and judgmental. None of the other options provides this support.DIF: Cognitive Level: Apply (Application)TOP: Nursing Process: ImplementationMSC: NCLEX: Psychosocial Integrity
Which of the following statements represent a nontherapeutic communication technique? (Select all that apply.) "Why didn't you attend group this morning?" "From what you have said, you have great difficulty sleeping at night." "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." "You mentioned that you have never had friends. Tell me more about that." "It sounds like you have been having a very hard time at home lately."
"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." All these options reflect the nontherapeutic techniques of (in order) asking "why" questions; using excessive questioning; giving advice; and giving approval. The other options describe therapeutic techniques of restating, exploring, and reflecting.DIF: Cognitive Level: Apply (Application)TOP: Nursing Process: ImplementationMSC: NCLEX: Psychosocial Integrity
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? Verbal communication is always more accurate than nonverbal communication. Verbal communication is more straightforward, whereas nonverbal communication does not portray what a person is thinking. Nonverbal and verbal communication may be different; nurses must pay attention to the nonverbal communication being presented to get an accurate message. Nonverbal communication is about 10% of all communication, and verbal communication is about 90%.
Nonverbal and verbal communication may be different; nurses must pay attention to the nonverbal communication being presented to get an accurate message. Communication is roughly 10% verbal and 90% nonverbal, so nurses must pay close attention to nonverbal cues to accurately assess what the client is really feeling. The other options are all untrue of verbal and nonverbal communication and are actually the opposite of what is believed of communication.DIF: Cognitive Level: Analyze (Analysis)TOP: Nursing Process: PlanningMSC: NCLEX: Psychosocial Integrity
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? The nurse violated the client's personal space by physically being too close. The client has issues with sharing personal information. The nurse failed to explain the purpose of the admission interview. The client is responding to the voices by ending the conversation.
The nurse violated the client's personal space by physically being too close. By sitting and leaning in so closely, the nurse has entered into intimate space (0 to 18 inches), rather than social distance. This has likely made the client may feel uncomfortable with being so close to someone unknown to them. All the other options lack evidence and jump to conclusions regarding the client's behavior.DIF: Cognitive Level: Analyze (Analysis)TOP: Nursing Process: AssessmentMSC: NCLEX: Psychosocial Integrity
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? The client in denial. The response may reflect cultural norms. The response may reflect personal guilt. The client may have an antisocial personality.
The response may reflect cultural norms. Showing little emotion while in distress may be a cultural phenomenon. Some cultures, such as the British and German cultures, tend to value highly the concept of self-control and may show little facial emotion in the presence of emotional turmoil. There is no evidence to suggest the client's lack of emotion is a result of any of the other options.DIF: Cognitive Level: Analyze (Analysis)TOP: Nursing Process: AssessmentMSC: NCLEX: Psychosocial Integrity