prepU chapter 8

The client says to the nurse, "I wonder what's playing at the movies tonight." Which response by the nurse would be most therapeutic? "Are you telling me you would like to go to the movies?" "Why don't you look in the newspaper." "There's nothing worth watching." "We may have some DVDs available."

Correct response: "Are you telling me you would like to go to the movies?" Explanation: This nurse is restating or verbalizing the implied, which involves voicing what the client has hinted at or suggested. The nurse should apply this technique to confirm the implications of the client's statement before suggesting solutions to the presumed meaning.

The nurse is working in the mental health clinic communicating with a client who is having auditory hallucinations. What should the nurse say to effectively communicate with this client? "My aunt has the same diagnosis as you and also hears voices." "Turn the radio up so the voices are muted." "I understand that the voices seem real to you, but I don't hear them." "Don't worry about the voices. The medications will make them disappear."

Correct response: "I understand that the voices seem real to you, but I don't hear them." Explanation: An example of therapeutic communication technique is presenting reality. The nurse should define reality or indicates perception of the situation for the client. "Don't worry about the voices. The medications will make them disappear," "Turn the radio up so the voices are muted" and "My aunt has the same diagnosis as you and also hears voices" are not examples of therapeutic communication techniques.

During a client interview, the client tells the psychiatric-mental health nurse, "If I told you what I did to my son, you'd never want to speak to me again." What is the nurse's most therapeutic response? "I'd very much like to hear about that, and it is okay for you to talk about it with me." "I don't know what you did, but it's likely that it's not nearly as bad as you think it is." "Speaking with you is an important part of my job, and it's helpful for us to know what you did so we can help you." "You don't need to be embarrassed about what you did. This is a safe place to talk."

Correct response: "I'd very much like to hear about that, and it is okay for you to talk about it with me." Explanation: Nonjudgmental acceptance should be the nurse's best approach to the client's statement. Saying, "It's my job to speak to you," is not therapeutic. The nurse must avoid false reassurance that the event was likely not that bad. The nurse should avoid presuming that embarrassment is the motivation behind the client's reluctance.

The client tells the nurse, "My mom is coming in to see me today," while sighing and looking out the window. The nurse states, "You don't seem very excited about the visit, is everything OK?" The client affirms. Using therapeutic communication, how should the nurse respond? "Why are you sad about your mother's visit?" "I'm concerned that you are not exicited about your mother's visit, We can talk if you want." "I need to know why you are sad." "Is your mother giving you trouble for being here?"

Correct response: "I'm concerned that you are not exicited about your mother's visit, We can talk if you want." Explanation: Therapeutic communication is an interpersonal interaction between the nurse and the client during which the nurse focuses on the client's needs to promote an effective exchange of information. Skilled use of therapeutic communication techniques helps the nurse understand and empathize with the client's experience. "Why are you sad about your mother's visit?," "I need to know why you are sad" and "Is your mother giving you trouble for being here?" are not examples of therapeutic communication.

A client remarks, "You know, it's the same thing every time." The nurse should respond by stating: "I understand." "I'm sure everyone is doing their best." "I'm not sure what you mean. Please explain." "It's the same thing every time?"

Correct response: "I'm not sure what you mean. Please explain." Explanation: Sometimes, words, phrases, or slang terms have different meanings and can be easily misunderstood. In this case, it is important for the nurse to clarify the meaning in order to avoid making assumptions. Stating that everyone is doing their best is a response that is based on an assumed meaning. Restating the client's statement will not necessarily provide clarification. Stating, "I understand" is simplistic and inaccurate because the nurse cannot claim to fully understand the client's situation.

A client says, "It's been so long since I've been with my family." Which statement by the nurse is an example of restating? "You say you haven't seen your family in a while." "Tell me what happened when you last saw your family." "Go on. Tell me more." "When was the last time you saw your family?"

Correct response: "You say you haven't seen your family in a while." Explanation: Restating is repeating the main idea expressed and lets the client know that he or she communicated the idea effectively. Each of the other listed statements prompts to the client to address another aspect of the situation, but none restate the essence of the client's statement.

The nurse manger is discussing self- awareness during a staff meeting. Which statement(s) by the staff nurse best depicts self-awareness? Select all that apply. "I'm tired and hungry. I need to take a break and get something to eat." "Yes, I can help with the nurse retention committee, but I don't know when I'll find the time." "I asked to be transferred because the nurses on this unit are critical and make me feel inadequate when I work with them." "Yes, I'll work again this evening; I don't need any more than four hours of sleep." "I worry about interrupting the doctor's sleep when I call him at home."

Correct response: "I'm tired and hungry. I need to take a break and get something to eat." "I asked to be transferred because the nurses on this unit are critical and make me feel inadequate when I work with them." Explanation: Self-awareness is the process of understanding one's own beliefs, thoughts, motivations, biases and limitations. A well-defined sense of self-awareness can only come after nurses carry out self-examination. Stating, "Yes, I'll work again this evening," "I don't need any more than four hours of sleep," "I worry about interrupting the doctor's sleep when I call him at home" or "Yes, I can help with the nurse retention committee, but I don't know when I'll find the time" are not depicting self-awareness.

A psychiatric-mental health nurse has been off of work for the past 4 days, as per the normal work schedule on the unit. On the nurse's first day back, a longterm client says, "I haven't seen you around here since Thursday. How was your time off?" What is the nurse's most appropriate response? "I've been off for the past four days. What have you done since I last saw you?" "I'm not at liberty to talk about my personal life outside of work, unfortunately. How have you been?" "How do you like to spend your time when you're able to do whatever you like?" "If you had to guess, what do you think I might have done on my days off?"

Correct response: "I've been off for the past four days. What have you done since I last saw you?" Explanation: The nurse should avoid self-disclosure. Whenever possible, it is more therapeutic to redirect the conversation rather than setting an explicit boundary. Saying, "How do you like to spend your time when you're able to do whatever you like?" redirects the conversation but is less therapeutic because the nurse has ignored the client's question. Asking the client to speculate serves no therapeutic purpose.

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? "That makes no sense at all." "You can tell me about that after I finish asking these questions." "What kinds of things have been happening?" "Why would the CIA be interested in you?"

Correct response: "What kinds of things have been happening?" Explanation: When the nurse responds, "What kinds of things have been happening?" the nurse is seeking information. "That makes no sense at all," is inappropriate because it may make perfect sense to the client. "You can tell me about that after I finish asking these questions," shows that the nurse is not interested in what the client has to say. "Why would the CIA be interested in you?" feeds into the notion that the CIA is stalking the client.

When a novice psychiatric nurse shares with the nurse manager that talking about sexual abuse with clients is very uncomfortable, which would be the most effective response from the nurse manager? "What specifically makes you uncomfortable?" "I can take that client off of your assignment this shift." "It would be great if you could attend an in-service on therapeutic communication." "Have you ever been sexually abused?"

Correct response: "What specifically makes you uncomfortable?" Explanation: It is important for the novice nurse to identify what it is about discussing sexual abuse that is anxiety producing so that those issues can be addressed and resolved. Asking this question will assist the novice nurse in engaging in self reflection that can lead to a greater awareness of self and thus enhance the ability to be therapeutic. Suggesting the nurse have such abuse victims released from the nurse's care ignores the problem and minimizes the nurse's therapeutic effectiveness. Arranging for training is appropriate only if it is discovered that the problem relates to a lack of skills related to the nurse's therapeutic communication techniques. While prior sexual abuse may be the cause of the nurse's discomfort, it is not appropriate for the nurse manager to initiate this discussion in that manner.

A client is sitting alone, slouched, with eyes closed. The nurse approaches. Which statement is most likely to encourage the client to talk? "If you are sleepy, would you like me to help you back to your room?" "You look like you are deep in thought." "Is something wrong?" "Why are you sitting with your eyes closed?"

Correct response: "You look like you are deep in thought." Explanation: Verbalizing what the nurse perceives can give a natural opening for the client to engage in dialogue. The nurse cannot presume the meaning of the client's behavior (i.e. that he or she is sleepy). Asking if something is wrong may put the client on the defensive. Asking why the client is sitting this way is a blunt question that may limit, rather than enhance, dialogue.

Which statement by the nurse reflects the use of a therapeutic statement? "You look upset. Would you like to talk about it?" "I'd like to know more about your children. Tell me about them." "I understand your husband passed away. I couldn't bear that." "You look very sad. How long have you been this way? Have you been taking care of yourself?"

Correct response: "You look upset. Would you like to talk about it?" Explanation: The correct answer reflects validation of the client's feelings and further exploration. Asking about the client's children seeks more information, while discussing the death of the client's husband reveals personal information and a nonhelpful personal reflection by the nurse. Asking multiple questions may be confusing.

Which of the following statements would be an empathetic response in a client interaction? "You must have been embarrassed when your father yelled at you in the grocery store." "You really should find your own housing and get out of the situation with your father." "Well, it sounds like your father has difficulty controlling his temper." "Why do you think your father chose that time and place to yell at you?"

Correct response: "You must have been embarrassed when your father yelled at you in the grocery store." Explanation: This statement conveys the nurse's understanding of the client's feelings. Empathy is the ability to perceive the meanings and feelings of another person and to communicate that understanding to that person. Choices B, C, and D do not convey empathy.

During the admission interview, the nurse asks the client what led to the client's hospitalization. The client responds, "They lied about me. They said I murdered my mother. You're the killers. You all killed my mother. She died before I was born." What would be the best initial response by the nurse? "I just saw your mother. She's fine." "You're having very frightening thoughts." "We'll put you in a private room until you're in better control." "If your mother died before you were born, you wouldn't be here."

Correct response: "You're having very frightening thoughts." Explanation: When the nurse states, "You're having very frightening thoughts," the nurse is verbalizing the implied or voicing what the client has hinted or suggested. Confrontation or rationalization are likely to make the client agitated and will ultimately harm the therapeutic relationship and communication.

The nurse and the client are using therapeutic communication skills. Which statements are true of concrete and abstract messages? Select all that apply. Abstract messages include figures of speech that are difficult to interpret. Abstract messages are important for accurate information exchange. Concrete messages require the listener to interpret what the speaker says. Concrete messages are clear, direct, and easy to understand. Abstract messages are best used for persons who are anxious.

Correct response: Abstract messages include figures of speech that are difficult to interpret. Concrete messages are clear, direct, and easy to understand. Explanation: Abstract messages include figures of speech that are difficult to interpret. Concrete messages are clear, direct, and easy to understand. Concrete (not abstract) messages are important for accurate information exchange. Abstract (not concrete) messages require the listener to interpret what the speaker says. Concrete (not abstract) messages are best used for persons who are anxious.

Which communication technique does a nurse use in establishing trust and developing empathy? Acceptance Confrontation Doubt Observation

Correct response: Acceptance Explanation: Acceptance is the encouraging and receiving of information in a nonjudgmental and interested manner. It is used in establishing trust and developing empathy. A nurse uses confrontation when presenting a client with a different reality of the situation. Doubt is the expression or voicing of skepticism when a client relates a situation. Observation is the act of stating to the client what the nurse is observing.

How can a nurse avoid the possibility of finding the client's behavior unacceptable or distasteful? By being aware of the client's behavior and background before beginning the relationship, and exploring with a colleague the possibility of a conflict. By using silence instead of verbal responses for all instances of the client describing his or her behavior. By using facial expressions of annoyance if the client expresses behavior that the nurse disapproves of. By turning away from the client when the nurse does not want the client to see his or her facial expression.

Correct response: By being aware of the client's behavior and background before beginning the relationship, and exploring with a colleague the possibility of a conflict. Explanation: The nurse--client relationship can be jeopardized if the nurse finds the client's behavior unacceptable or distasteful and allows these feelings to show by avoiding the client or making verbal responses or facial expressions of annoyance or turning away from the client. The nurse should be aware of the client's behavior and background before beginning the relationship; if the nurse believes there may be conflict, he or she must explore this possibility with a colleague. Overusing the technique of silence does not help the nurse provide therapeutic responses. Showing annoyance and turning away from the client inhibit therapeutic rapport and communication.

Client: "I was so upset about my sister ignoring me when I was talking about being ashamed."Nurse: "How are your stress reduction classes going?"This is a nontherapeutic response because the nurse has ... Changed the topic Offered advice Challenged the client Demonstrated disapproval

Correct response: Changed the topic Explanation: The nurse did not respond to the client's statement and instead asked an unrelated question.

Which goal of therapeutic communication would the nurse strive to attain first? Facilitate the client's expression of emotions. Establish a therapeutic nurse-client relationship. Teach the client and family necessary self-care skills. Implement interventions designed to address the client's needs.

Correct response: Establish a therapeutic nurse-client relationship. Explanation: Establishing a therapeutic relationship is one of the most important responsibilities of the nurse when working with clients. It is foundational to each of the other listed nursing actions so it must be established first.

The nurse fails to assess personal values surrounding homosexuality before caring for a client who is openly gay. The nurse is most at risk for what when working with this client? Holding a prejudice toward this client Neglecting to include the client's desires in the plan of care Being manipulated by this client Expressing shock when assessing the client's history

Correct response: Holding a prejudice toward this client Explanation: A person who does not assess personal attitudes and beliefs may hold a prejudice or bias toward a group of people because of preconceived ideas or stereotypical images of that group. This oversight may or may not cause the nurse to overlook the client's expressed desires. Manipulation results from a failure to maintain boundaries. Shock is unlikely because the nurse is evidently aware of the client's sexual orientation before caring for the client.

A client has been making sexual comments when communicating with the nurse. The nurse wants to spend some time talking to the client while respecting the client's right to privacy. Which setting would be the most appropriate setting for the nurse to talk with the client? In the client's room when the client's roommate is present and 3 feet away At the nurse's station when other clients and visitors are less than 4 feet away In an interview room in a remote section of the unit with the nurse 1 foot away from the client In a quiet corner of the dayroom at least 4 feet away from others

Correct response: In a quiet corner of the dayroom at least 4 feet away from others Explanation: A quiet corner of the dayroom at least 4 feet away from others would allow the patient privacy while being to deter any inappropriate activity would be the most appropriate setting. Being in the patient's room when the patient's roommate is present and 3 feet away or at the nurse's station when other patients and visitors are less than 4 feet away would not allow for the patient's privacy and may facilitate more inappropriate statements. An interview room in a remote section of the unit would not be a good choice as the area is too isolated and could exacerbate the problem. Additionally, the nurse should maintain a distance of more than 1.5 feet away from the patient as closer distances are within the intimate zone.

The parent of a child client holds the child close during the initial assessment. Which distance zone is acceptable for people who mutually desire personal contact? Social Intimate Personal Public

Correct response: Intimate Explanation: The intimate zone is the amount of space that is comfortable for parents with young children and those who desire personal contact. The social zone is the distance acceptable for communication in social, work, and business settings. The personal zone is comfortable between family and friends who are talking. The public zone is an acceptable distance between a speaker and an audience.

A client is discussing the client's problems at the workplace. Which nonverbal cues would indicate that the nurse is attentive to the client? Select all that apply. Looking down to the floor Leaning toward the client Mirroring the client's facial expression Maintaining eye contact with the client Sitting with closed arms and crossed legs

Correct response: Leaning toward the client Maintaining eye contact with the client Explanation: The nonverbal cues that convey that the nurse is paying attention are leaning toward the client and maintaining eye contact while speaking to the client. If the nurse looks down toward the floor when the client is trying to talk, this indicates that the nurse is disinterested. Having a sad facial expression does not indicate attentiveness. Sitting with closed arms and crossed legs indicates that the nurse is not willing to listen to the client.

While the nurse and client are in a therapy session, the nurse says to the client, "You become very anxious when we start talking about your drinking." Which technique is the nurse using? Confronting behavior Making an observation Translating into feelings Verbalizing the implied

Correct response: Making an observation Explanation: The nurse is stating what he or she sees; the client can validate it or reject it. The nurse is not confronting the behavior in this situation. The nurse is not translating the message into feelings (seeking to verbalize client's feelings that he or she expresses only indirectly), nor is the nurse verbalizing the implied (voicing what the client has hinted at or suggested). The nurse is elaborating on an observation, not addressing an implied statement by the client.

The nurse is conducting a presentation on the importance of medication compliance to a community group. Which zone is an acceptable distance between a speaker and an audience? Intimate Personal Social Public

Correct response: Public Explanation: The public zone is an acceptable distance between a speaker and an audience. The intimate zone is the amount of space that is comfortable for parents with young children and people who mutually desire personal contact. The personal zone is the distance comfortable between family and friends who are talking. The social zone is the distance acceptable for communication in social, work, and business settings.

A client with a diagnosis of schizophrenia has confided in the nurse that he has the ability to manipulate the exchange rates between foreign currencies. What is the nurse's most appropriate action? Recognize that the client is exhibiting omnipotence and choose interventions accordingly Dialogue with the client about the complex mechanisms involved in foreign currency markets Document the fact that the client is experiencing autistic fantasy Ask the client about the way that he is able to achieve this difficult task

Correct response: Recognize that the client is exhibiting omnipotence and choose interventions accordingly Explanation: The client's statement suggests the defense mechanism of omnipotence.Asking the client about how he does this inadvertently validates the delusion. Autistic fantasy is characterized by excessive daydreaming. The nurse should avoid trying to convince the client that this is not possible by explaining the complexities involved.

Which would not be considered a goal of therapeutic communication? Self-exploration of feelings by the nurse Establishing rapport Active listening Guiding the client in problem solving

Correct response: Self-exploration of feelings by the nurse Explanation: Self-exploration of feelings by the nurse is not considered a goal of therapeutic communication. Establishing rapport, active listening, and guiding the client in problem solving are goals of therapeutic communication.

The nurse asks the client, "What was it like for you when you first knew you had no place to go?" The client looks down and pauses for quite some time. Which action by the nurse is mosttherapeutic? Change the subject to something the patient will discuss Encourage the patient to express any unpleasant feelings Apologize for asking such a personal question Sit quietly until the patient responds

Correct response: Sit quietly until the patient responds Explanation: Silence or long pauses in communication may indicate many different things. It is important to allow the client sufficient time to respond, even if it seems like a long time. Prompting, apologizing and changing the subject do not allow the client time to respond.

Which form of nonverbal communication would be least effective for the nurse to engage in to demonstrate interest in and acceptance of the client? Sitting behind a desk Leaning slightly forward to the client Facing the client at eye level Keeping arms and legs uncrossed

Correct response: Sitting behind a desk Explanation: Therapeutic nonverbal communication uses positive body language, such as sitting at the same eye level as the client with a relaxed posture that projects interest and attention. Leaning slightly forward helps engage the patient. Generally, the nurse should not cross his or her arms or legs during therapeutic communication because such postures erect barriers to interaction. Uncrossed arms and legs project openness and a willingness to engage in conversation.

The nurse is sitting down with a client to begin a conversation. Which position should the nurse take to convey acceptance of the client? Leaning forward with arms on the table sitting directly across from the client Turned slightly to the side of the client with arms folded across the chest Leaning back in the chair next to the client with legs crossed at the knees Sitting upright facing the client with both feet on the floor

Correct response: Sitting upright facing the client with both feet on the floor Explanation: Closed body positions, such as crossed legs or arms folded across the chest, indicate that the interaction might threaten the listener who is defensive or not accepting. A better, more accepting body position is to sit facing the client with both feet on the floor, knees parallel, hands at the side of the body, and legs uncrossed or crossed only at the ankle. Leaning forward toward the client may be perceived as invasive.

A client experienced physical abuse by his father when he was a child. The client explains some of the intense financial and interpersonal stress that his father was experiencing at the time and describes the relationship between psychosocial stress and abuse. How should the nurse best interpret the client's statement? The client is intellectualizing this traumatic event in order to deal with the emotions involved The client is in denial that his father's actions were abusive The client has likely processed this trauma successfully as evidenced by his ability to discuss it The client has delusions about the circumstances surrounding his abuse

Correct response: The client is intellectualizing this traumatic event in order to deal with the emotions involved Explanation: Detached rationalization and discussion of a trauma suggests the client is using the defense mechanism of intellectualization. This is not synonymous with delusion thinking, however, and the client is not necessarily in denial that the experience was wrong and painful. Intellectualization does not indicate successful processing of a trauma.

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? The client may be reluctant to dialogue despite the statement to the contrary The client is eager to dialogue with the nurse but is unsure how best to proceed The client is glad to talk to the nurse because that is what the client stated The disconnect between the client's verbal and nonverbal messages confirms the presence of mental illness

Correct response: The client may be reluctant to dialogue despite the statement to the contrary Explanation: In general, nonverbal messages supersede verbal messages. This disconnect between the two types of communication, however, are not limited to persons with mental illness.

A client with a history of depression has told the nurse that the client is feeling especially "low" this morning. The nurse has responded by stating, "Try thinking about some of the blessings you have in your life." How should the nurse's statement be best interpreted? The nurse has inhibited therapeutic communication by giving advice The nurse made an inappropriate suggestion because it was not preceded by assessment The nurse has inhibited the nurse-client relationship by challenging the client The nurse has violated the ethical principles of beneficence and nonmaleficence

Correct response: The nurse has inhibited therapeutic communication by giving advice Explanation: The nurse has blocked communication by giving advice. This action generally inhibits communication, whether or not it is preceded by assessment. This is not an example of challenging. The statement is inappropriate and simplistic but not necessarily a violation of beneficence and nonmaleficence.

Which is inconsistent with principles of therapeutic communication? The nurse is the primary focus of the relationship. The nurse must maintain client confidentiality. Interventions are implemented from a theoretical base. A professional attitude sets the tone of the therapeutic relationship.

Correct response: The nurse is the primary focus of the relationship. Explanation: The client, not the nurse, should be the primary focus of the interaction. The nurse must maintain client confidentiality and use a professional attitude. The interventions are implemented from a theoretical base.

Which communication technique involves expressing uncertainty about the reality of the client's perception? Voicing doubt Silence Restating Reflecting

Correct response: Voicing doubt Explanation: Voicing doubt is expressing uncertainty about the reality of the client's perceptions. Silence is the absence of communication. Restating is repeating the main idea expressed. Reflecting is directing client actions, thoughts, and feelings back to the client.

The nurse is talking with the client and demonstrates concern for the way the client is feeling by using verbal affirmations and paraphrasing to show understanding. What communication techniques are being used by the nurse? empathetic linkages self awareness self disclosure active listening

Correct response: active listening Explanation: Active listening is refraining from other internal mental activities and concentrating exclusively on what the client says. Self disclosure, empathetic linkages and self awareness are not communication techniques. Empathetic linkages are the communication of feelings. Self-awareness is having a clear perception of your personality, including strengths, weaknesses, thoughts, beliefs, motivation and emotions. Self-disclosure is communication by which one person reveals information like thoughts, feelings, aspirations, goals, failures, successes, fears and dreams, as well as one's likes, dislikes and favorites.

The nurse is talking with a married client just diagnosed with syphilis. The nurse talks with the client about disclosing the information to the spouse and/or any other sexual partners. The client cries and asks the nurse, "Have you ever had an affair?" The nurse states, "Yes, it usually doesn't turn out well." The nurse proceeds to answer other questions about the affair. By answering these personal questions the nurse is divulging what? self-awareness empathetic linkages self- disclosure rapport

Correct response: self- disclosure Explanation: Self-disclosure is letting the client know personal information. The conversation should focus on the client, and not the nurse. On revealing personal information the nurse should be purposeful and have identified therapeutic outcomes. Rapport, empathetic linkages, and self-awareness are not included in self-disclosure.

Which is often considered the most difficult yet most effective communication technique? silence restating reflecting clarifying

Correct response: silence Explanation: Although restating, reflecting, and clarifying are effective therapeutic communication techniques, one of the most difficult but often most effective communication techniques is the use of silence during verbal interactions. By maintaining silence, a nurse allows the client to gather thoughts and to proceed at his or her own pace.

A client diagnosed with borderline personality disorder is pitting one nurse against the other, calling one a best friend and declaring that the other is horrible. The client is using which defense mechanism? splitting sublimation self-observation suppression

Correct response: splitting Explanation: Splitting is compartmentalizing opposite affect states, and failing to integrate the positive and negative qualities of the self or others into cohesive images. Sublimation is the channeling of potentially maladaptive feelings or impulses into socially acceptable behavior. Self-observation is the reflecting of feelings, thoughts, motivation, and behavior and responding to them appropriately. Suppression is intentionally avoiding thoughts about disturbing problems, wishes, feelings, or experiences.

The nurse is offering an demonstration session on what is done in group. Which client(s) would the nurse determine as conveying a message? Select all that apply. the teenager who writes "No one loves me" in a journal the mother checking her makeup in a mirror the father slapping his son for picking a wallet from a pocket a girl with headphones playing loud music away from everyone else a boy displaying a rainbow tattoo on his arm

Correct response: the teenager who writes "No one loves me" in a journal the father slapping his son for picking a wallet from a pocket a girl with headphones playing loud music away from everyone else a boy displaying a rainbow tattoo on his arm Explanation: Non-verbal communication can include gestures, facial expressions, body language, writing, displaying tattoos and slapping another; these are all ways of communicating with others. Checking make-up in a mirror is not a non-verbal communication.

The nurse is caring for a client that is very confused. What intervention should be included with the nurses' non-communication with the client? instructions for feeding the confused client speaking louder so the client can hear a flat affect so the client will not be misinterpreted use of gentle touch during activities of daily living

Correct response: use of gentle touch during activities of daily living Explanation: Non-verbal communication includes gentle touch to reinforce caring feelings for the confused client. Instructions for feeding the confused client, speaking louder so the client can hear and displaying a flat affect so the client will not be misinterpreted are not including in non-verbal communication.

The nurse must be alert to the nonverbal expressions of the client. Because the meaning attached to nonverbal behavior is subjective, it is important for the nurse to ... increase the client's awareness of nonverbal behavior. investigate the source of nonverbal behavior. validate the client's feelings. validate the meaning of the nonverbal behavior.

Correct response: validate the meaning of the nonverbal behavior. Explanation: It is essential to validate the meaning of nonverbal behavior (rather than assuming what it means) before proceeding with anything else. The nurse's priority is to understand nonverbal behavior more than teach the client about it. Before the nurse can investigate the source of nonverbal behavior or validate the client's feelings the nurse must be clear about the meaning of the nonverbal behavior.

Defense mechanisms and coping styles are always maladaptive. Defense mechanisms and coping styles are always maladaptive. TRUE FALSE

FALSE

If the nurse seeks to support the client through the decision-making process, giving advice is an important therapeutic intervention. If the nurse seeks to support the client through the decision-making process, giving advice is an important therapeutic intervention. FALSE TRUE

FALSE

When a client's verbal and nonverbal communication are contradictory, priority should be given to what the client communicates verbally. When a client's verbal and nonverbal communication are contradictory, priority should be given to what the client communicates verbally. TRUE FALSE

FALSE

__________________ is a process of understanding one's own beliefs, thoughts, motivations, biases, and limitations. is a process of understanding one's own beliefs, thoughts, motivations, biases, and limitations.

Self-awareness

Self-awareness is crucial to the establishment and maintenance of therapeutic relationships with patients. Self-awareness is crucial to the establishment and maintenance of therapeutic relationships with patients. FALSE TRUE

TRUE

Termination begins the first day of the relationship. Termination begins the first day of the relationship. FALSE TRUE

TRUE

....._________ listening is a priority intervention in which the nurse focuses on what the client is saying in order to search for underlying meaning. listening is a priority intervention in which the nurse focuses on what the client is saying in order to search for underlying meaning.

active

___________________ recordings are verbatim transcripts of interactions, which are useful to the nurse as he or she seeks to learn therapeutic communication. recordings are verbatim transcripts of interactions, which are useful to the nurse as he or she seeks to learn therapeutic communication.

process

One of the most difficult but often most effective communication techniques is the use of One of the most difficult but often most effective communication techniques is the use of ____________ during verbal interactions. during verbal interactions.

silence

When using When using ______________, the nurse uses "I" statements to check his or her own thoughts and feelings with another person., the nurse uses "I" statements to check his or her own thoughts and feelings with another person.

validation