Chap 6-Therapeutic Communication

Which statement by the nurse demonstrates an understanding of the first step in helping a client learn the problem solving process?

"Can you explain to me what made you so angry?"

A client has repeatedly been physically abused by the spouse. The client asks the nurse whether to leave the spouse like the mother has demanded. The nurse responds most therapeutically when answering:

"How would leaving him make you feel?"

A nurse is assessing an elderly client with a cardiac disorder. Which statement given by the client conveys an abstract message? Choose the best answer.

"I don't really know how it all started. It just happened."

A client who is experiencing depression states, "I can't seem to do anything to take care of myself, how can I get going?" What is the nurse's best response?

"I notice it has been a while since you have had a shower."

Which statement by the nurse is an example of assertive communication?

"I understand that group can be difficult to attend but coming late is disruptive."

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?"

The nurse has entered a client's room and observed that the client has removed the mattress from the bed and is closely scrutinizing the spaces in the bed frame. Which statement is most likely to elicit an explanation of the client's behavior?

"It looks like you're searching for something. Is that right?"

A client says, "Nobody listens to me; even you don't!" Which response is most therapeutic?

"It sounds like you're feeling unappreciated."

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?"

A nurse is seeing a client who has recently been discharged from the hospital for a suicide attempt. When asked about the quality of her relationship with her husband, the client becomes silent, diverts eye contact and says, "It's okay." What is the nurse's best response?

"What you are saying and how you say it does not seem to match."

A nurse is speaking to a client with a smiling expression. Which statement by the nurse would promote the most congruent communication?

"You hard work and determination has really helped you succeed."

A client has recently been diagnosed with cancer. The client says, "What did I do wrong to get such a disease?" Which nonverbal processes, along with the client's statement, would convey a congruent message? Select all that apply.

-A fearful tone of voice -A sad facial expression

A psychiatric-mental health nurse is working with several clients and decides to use silence during the interaction. In which situation would it be therapeutically appropriate to use silence? Select all that apply.

-Client who is experiencing depression -Client who is lost in own thoughts -Client who is constructingh a response -Client who is pondering the question

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.

-Leaning toward the client -Maintaining eye contact with the client

A client has been brought to the psychiatric care unit. During the assessment, the nurse observes the client uses ineffective communication skills. Which are interpersonal factors that may influence the client's mental health? Select all that apply.

-Proxemics -Silence -Inability to use feeling words

A nurse needs to encourage a client who is Hispanic and has severe depression to express the client's feelings. What distance between the nurse and the client may help facilitate therapeutic communication?

3' to 6'

The therapeutic communication interaction is most comfortable when the nurse and the client are how far apart?

3' to 6'

High-pitched, rapid delivery of a message often indicates what?

Anxiety

Which therapeutic communication technique is being utilized when the nurse asks the client, "Is there something you'd like to talk about?"

Broad openings

A psychiatric-mental health nurse is interacting with a client experiencing depression. The nurse is vigilant in observing the nonverbal communication of the client based on the understanding about which aspect associated with clients with mental illness?

Clients have difficulty verbally expressing themselves and interpreting others' emotions

A nurse enters the room of a client who has been on the unit for several weeks. The client states, "I haven't seen you for a while. How were your days off?" What is the nurse's most appropriate response?

It's important to get a break from time to time. How have the last few days been for you?

Which includes the circumstances or parts that clarify the meaning of the content of the message?

Context

Which term is used to refer to signals that encourage effective communication?

Cue

A client is speaking to the nurse and expressing dissatisfaction about the care that was provided to the client during a hospital stay. The nurse tells the client, "This is the best hospital in the state. You could not expect better care anywhere else." Which type of communication does this indicate?

Defending

A nursing student is caring for a client who has been arrested for child abuse. The nurse is very curious about what the client must have done to get into so much trouble, so the nurse asks the client to tell the nurse about the various activities that got the client arrested. This is an example of:

Excessive probing

A client who is schizophrenic is catatonic and has a mask-like face. Which facial expression is being exhibited?

Impassive

A nurse responds to a client's statement with silence based on the rationale that this technique is used primarily to:

Permit the client to gather the client's thoughts

Which zone is a distance that is comfortable between family and friends who are talking?

Personal

When providing information about anorexia to a client, the nurse can ensure that the client can accurately comprehend the information by doing what?

Presenting the information using language and terms the client will understand

A psychiatric-mental health nurse is working to develop a therapeutic relationship with a client. When doing so, which element would the nurse integrate as critical to building this relationship?

Self-awareness

Which is often considered the most difficult yet most effective communication technique?

Silence

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

The nurse is working with a client from the Middle East. The nurse maintains a distance of approximately 13 feet from the client while talking. The client says that the client is uncomfortable when the nurse talks to the client from such a long distance. How should the nurse interpret this statement?

The client feels that the nurse is indifferent toward the client.

When engaged in therapeutic communication with a client who has a mental disorder, which is the most important for a nurse to keep in mind?

The client is the primary focus of the interaction.

The nurse is caring for a client with severe depression. The client tells the nurse, "I really just want to sleep and not have to wake up." What may the nurse interpret from this covert cue?

The client may have suicidal ideations.

Which would be the least optimal environment for therapeutic communication for a client who has difficulty maintaining boundaries?

The client's room

Which is an inaccurate depiction of concrete questions?

They require rephrasing of unclear questions.

When speaking with a client who has a diagnosis of major depression, the nurse has placed a hand lightly on the client's shoulder when responding to one of the client's statements of hopelessness. Which principle should underlie the nurse's use of touch when communicating with clients?

Touch can be a powerful therapeutic tool, but it must be used with caution.

Which question should be avoided because it may be perceived as criticism by the client?

Why?

"Get the stuff from him" is an example of which type of message?

abstract

A nurse is conducting an initial assessment of a client. When the client enters the nurse's office, the client finds the nurse sitting with arms folded across the chest and an emotionless facial expression. The nurse is exhibiting which nonverbal communication technique?

closed body position and impassive face

A group of nursing students is role playing situations to practice using therapeutic communication techniques. What would the students identify as verbal communication?

emotion underlying the words

Which behavior of the nurse indicates that the nurse has a therapeutic relationship with the client?

the nurse expresses empathy to a client who has recently lost his son in an accident