Therapeutic Communication

The nurse is interviewing a client admitted for uncontrolled diabetes after binging on alcohol for the past 2 weeks. The client states, "I am worried about how I am going to pay my bills for my family while I am hospitalized." Which statement by the nurse would best elicit information from the client? -"you are worried about paying your bills?" -Don't worry; your bills will get paid eventually" -"When was the last time you were admitted for hyperglycemia?" -"You really shouldn't be drinking alcohol because of your Dx of diabetes"

You are worried about paying your bills

The wife of a client who has completed alcohol detoxification relates that she is concerned about her husband's behavior if he starts drinking again. She says, "When the drinking starts it really disrupts my family, and I'm not sure how to handle it." What is the best response by the nurse? -"Include your husband in the family's activities even when he's been drinking." -"Attend Al-Anon meetings and avoid assuming responsibility for your husband's behavior." -"Search the house regularly for hidden alcohol and accompany your husband outside the home." -"Help your husband avoid embarrassment by making excuses for him when it's impossible for him to function."

Attend Al-Anon meetings and avoid assuming responsibility for your husband's behavior

A depressed, withdrawn client exhibits sadness through nonverbal behavior. What should the nurse plan to help the client to do? -increase structured physical activity -cope with painful feelings by sharing them -decide which unit activities the client can perform -improve the ability to communicate with significant others

cope with painful feelings by sharing them

A young client who has just lost her first comes to the mental health clinic very upset and says, "I just start crying without any reason and without any warning." How should the nurse respond initially? -"Do you know what makes you cry?" -"Most of us need to cry from time to time." -"Crying unexpectedly can be very upsetting." -"Are you having any other problems at this time?"

crying unexpectedly care be very upsetting

An adult child of a dying client says to the nurse in the nursing home, "I am so upset because my parent is always angry at me." What is the nurse's best initial response? -"your parent is frightened by impending death" -"your parent is working through acceptance of the situation" -"Your parent is attempting to reduce your need for dependency" -"Your parent is hurt that you will not provide physical care at home"

your parent is working through acceptance of the situation

A client who is experiencing acute alcohol withdrawal delirium appears frightened, points toward the bed, and says, "Bugs are crawling all over me and my bed!" What is the most therapeutic response by the nurse? -"just try to brush them off" -"I don't see any bugs on your or your bed" -"They'll go away when you start feeling better" -"The bugs that you see are just the design on the bedspread"

I don't see any bugs on you or your bed

A husband is upset that his wife's alcohol withdrawal delirium has persisted for a second day. What is the most appropriate initial response by the nurse? -"I see that you're worried. We're using medication to ease your wife's discomfort." -"This is expected. I suggest that you go home because there's nothing you can do to help." -"Are you afraid that your wife will die? I assure you, very few alcoholics die during the detoxification process." -"Are you worried that your wife is uncomfortable while she's going through withdrawal? I'm sure that she's not in pain."

I see that you're worried. We're using medication to ease your wife's discomfort

A client leaves group therapy in the middle of the session. The nurse finds the client obviously upset and crying, and the client tells the nurse that the group's discussion was too much to tolerate. What is the most therapeutic initial nursing action at this time? -Request kindly but firmly that the client return to the group to work out conflicts. -Suggest that the client accompany the nurse to a quiet place so that they can talk about the situation. -Ask the group leader what happened in the group session and base interventions on this additional information. -Respect the client's right to decline therapy at this time and report the incident to the rest of the health team members.

Suggest that the client accompany the nurse to a quiet place so that they can talk about the situation.

The day after the birth of their baby, the parents are upset to learn that the baby has a heart defect. At this time it is most helpful for the nurse to do what? -Have the parents talk with other parents. -Explain the diagnosis in a variety of ways. -Encourage the expression of their feelings. -Assure the parents that surgery will correct the problem.

encourage the expression of their feelings

A client in the outpatient clinic is denying that he is addicted to alcohol. He tells the nurse that he is not an alcoholic and that it is his nagging wife who causes him to drink. What is the most therapeutic response by the nurse? -"I don't think that your wife is the problem." -"Everyone is responsible for his own actions." -"Perhaps you should have marriage counseling." -"Why do you think that your wife is the cause of your problems?"

everyone is responsible for his own actions

Which therapeutic communication technique is most useful for the nurse to use when the client begins to repeat previously mentioned issues in the same therapeutic conversation? -focusing -clarifying -paraphrasing -summarizing

focusing

A mother brings her 16-month-old daughter to the well-child clinic for a checkup. She is upset and reports, "My child refuses to eat at mealtimes. It's a battle between us." What is the best response by the nurse? -"How often do you offer her food?" -"What's her daily eating schedule?" -"Does the doctor know that she refuses food?" -"It may be helpful to keep a daily diary of the food she eats."

it may be helpful to keep a daily diary of the food she eats

A nurse is preparing to give a 3-year-old toddler an intramuscular injection when the child starts to cry. What is the most therapeutic approach for the nurse to take? - "It'll be OK because it won't hurt a bit." -"It's all right to cry, it will be quick." -"If you act like a grownup, we can be done really quickly." -"I brought another nurse to hold you while I give you the medicine."

it's all right to cry, it will be quick

A nurse uses therapeutic communication techniques in order to achieve desired client outcomes. Which communication technique is a part of therapeutic communication? -asking for explanations -showing sympathy to the pt -asking personal questions to the pt -Providing relevant information to the pt

providing relevant information to the client

The nurse asks questions to an older client about past experiences and listens attentively. Which therapeutic communication strategy is involved when the older client is recalling the past? -touch -reminiscence -reality orientation -validation therapy

reminiscence

Which therapeutic communication technique involves using a coping strategy to help the nurse and client adjust to stress? -sharing hope -sharing humor -sharing empathy -sharing observations

sharing humor

In order to provide ideal therapeutic communication to clients, a health care facility provides interpreter services. Which statement regarding an interpreter is correct? -Interpreters can be relatives or friends of the client as well. -The interpreter should be able to make literal, word-for-word translations. -The interpreter should be able to interpret not only the language but also the culture. -The interpreter should be available as long as the health care provider is caring for the client.

the interpreter should be able to interpret not only the language but also the culture

Two days after admission to the detoxification program, a client with a long history of alcohol abuse tells the nurse, "I don't know why I came here." What is the most therapeutic response by the nurse? -"You feel that you don't need this program?" -"You realize that you are trying to avoid your problem?" -"I thought that you admitted yourself into the program." -"Don't you remember why you decided to come here in the first place?"

you feel that you don't need this program?

A child is admitted to the pediatric intensive care unit after an accident at school. The mother, at the child's bedside, is visibly upset. What is the most therapeutic statement the nurse can make? -you must be full of emotions right now -let me give you a referral for social services -your child will get excellent care at this hospital -it's a shame that your child has become ill so suddenly

you must be full of emotions right now

A client is dying. Hesitatingly, his wife says to the nurse, "I'd like to tell him how much I love him, but I don't want to upset him." Which is the best response by the nurse? -You must keep up a strong appearance for him -i think he'd have difficulty dealing with that now -don't you think he knows that without you telling him? -you should share your feelings with him while you can

you should share your feelings with him while you can

A 67-year-old man with type 2 diabetes sadly confides in the nurse that he has been unable to have an erection for several years. What is the best response by the nurse? - "At your age sex isn't that important." -"Sex isn't everything it's cracked up to be." -"You sound upset about not being able to have an erection." -"Maybe it's time for you to speak to your primary healthcare provider about this."

you sound upset about not being able to have an erection

A 16-year-old high school student is referred to a community health center by a local hotline because of the fear of having contracted herpes. The teenager is upset and shares this information with the community health center nurse. What should the nurse's initial response be? -let me get a brief health hx now -try not to worry until you know whether you have herpes -you sound worried. let me make arrangements to have you examined. herpes has received too much attention in the media; let's be realistic.

you sound worried. let me make arrangements to have you examined