Chapter 9: Communication and the Therapeutic Relationship

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When attempting to discuss the feelings associated with an impending divorce, a client begins crying after stating, "I will never be able to get over this failure." Which statement made by the nurse will most likely support the client's ability to adopt a more positive view of the divorce? A) "I agree that you are never the same after a divorce." B) "Let's talk about what is making you feel so hopeless." C) "Many people experience these feelings; things will improve." D) "Let's talk about this later after you have a change to compose yourself."

"B) Let's talk about what is making you feel so hopeless."

A psychiatric-mental health nurse has entered a client's room, made an introduction, and asked if the nurse and the client could speak for a few minutes. The clients states, "Yep. Glad to talk." However, the nurse observes that the client is looking at the floor and the client's arms and legs are crossed. How should the nurse best interpret this situation? A) The client may be reluctant to dialogue despite the statement to the contrary B) The client is eager to dialogue with the nurse but is unsure how best to proceed C) The client is glad to talk to the nurse because that is what the client stated D) The disconnect between the client's verbal and nonverbal messages confirms the presence of mental illness

A) The client may be reluctant to dialogue despite the statement to the contrary

A nurse is assigned to care for a client whose sexual orientation differs from the nurse's sexual orientation. At which time should the nurse seek guidance from the supervisor? A) When the nurse desires to assist the client to change values B) When the nurse wants to discuss goals and the plan of care C) When the nurse begins to empathize with the client D) When the nurse accepts the client's values and sexuality

A) When the nurse desires to assist the client to change values

The nurse is caring for a client with cellulitis. The client responds, "I feel kind of 'blah'," after the nurse asks, "How do you feel?" After the client's reply, the nurse states, "Can you tell me what 'blah' feels like?" The client responds, "I don't have any energy, and I don't feel like doing anything." Using therapeutic communication, how should the nurse respond? A) "Oh, it is just the infection; in a day or so you'll feel better." B) "Let's talk about infections, and how they heal." C) "Why don't you just rest in bed?" D) "Why don't you call a friend in to watch TV with you?"

B) "Let's talk about infections, and how they heal."

A nurse and client are engaged in a discussion. The client says, "I feel really close to you. You are the only true friend I have." Which response by the nurse would be most therapeutic? A) "I am sure there are other people in your life who are your friends; besides, we just met." B) "It makes me feel good that you trust me so much; it is important for the work we are doing together." C) "Since ours is a professional relationship, let's explore other opportunities in your life for friendship." D) "We are definitely not friends. This is strictly professional."

C) "Since ours is a professional relationship, let's explore other opportunities in your life for friendship."

During the mental status assessment, the client expresses the belief that the CIA is stalking the client and plans to kidnap the client. Which would be the best response by the nurse? A) "That makes no sense at all." B) "You can tell me about that after I finish asking these questions." C) "What kinds of things have been happening?" D) "Why would the CIA be interested in you?"

C) "What kinds of things have been happening?"

The nurse is trying to obtain some information about family relationships from the client. Which statement is best? A) "Is it upsetting for you to talk about your family?" B) "Is your family ready for you to come home?" C) "So, how is your family?" D) "Tell me your feelings about your family situation."

D) "Tell me your feelings about your family situation."

A client arrives for a scheduled meeting with the nurse. Which statement should the nurse make that indicates the working phase of the relationship? A) "Thank you for arriving on time." B) "I do not give out my cell phone number to clients." C) "You have learned how to handle that problem already." D) "Your idea would help prevent this from happening again."

D) "Your idea would help prevent this from happening again."


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