Chapter 6: Therapeutic Communication

The nurse is asking a client for feedback on the services provided in the hospital. The client responds, "Yeah. It was great." The client spoke in a disgusted and hurried tone and did not make eye contact with the nurse. What is the message conveyed here? A. "Don't waste my time asking about your services." B. "Your services were not good at all." C. "Your services were good, but you could provide much better service." D. "Your services were wonderful. Keep up the good work."

A. "Don't waste my time asking about your services."

The therapeutic communication interaction is most comfortable when the nurse and the client are how far apart? A. 0 to 18 inches B. 3 to 6 feet C. 12 to 25 feet D. 18 to 36 inches

B. 3 to 6 feet

Which zone is an acceptable distance between a speaker and an audience? A. Social B. Public C. Intimate D. Personal

B. Public

The nurse is sitting behind a table while speaking to a client on the other side of the table. What is the most appropriate reason for this nurse's action? A. The client may be physically expressive. B. The client may have difficulty maintaining spacial boundaries. C. The client can communicate freely. D. The client can open up easily.

B. The client may have difficulty maintaining spacial boundaries.

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? A. self disclosure B. active listening C. self awareness D. empathetic linkages

B. active listening

The nurse indicates interest in and acceptance of the client by all of the following except: A. facing the client. B. sitting behind a desk. C. slightly leaning toward the client. D. maintaining a nonthreatening eye contact.

B. sitting behind a desk.

A client diagnosed with schizophrenia is hallucinating. Which communication technique may the nurse use to redirect the client? A. Reflecting B. Making observations C. Seeking information D. Presenting reality

D. Presenting reality

Which statement by the nurse is an example of assertive communication? A. "I'm so happy that you finally decided to join us here in group." B. "Oh, you must be really busy to be this late getting to group." C. "I understand that group can be difficult to attend but coming late is disruptive." D. "You are so rude; I just won't tolerate that in my group."

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

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

C. "You look upset. Would you like to talk about it?"

"Get the stuff from him" is an example of which type of message? A. Clear B. Concrete C. Abstract D. Direct

C. Abstract

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? A. Challenging B. Belittling C. Defending D. Agreeing

C. Defending

A client from which cultural background would most likely have an older family member present when discussing health issues with the nurse? A. Italian B. French C. Korean D. Australian

C. Korean

During a therapy session, the nurse asks the client, "Tell me more about your relationship with your parents." The nurse is using which nontherapeutic communication technique? A. Clarification B. Confrontation C. Probing D. Reflecting

C. Probing

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

D. Sitting behind a desk

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? A. "Don't worry, take as long as you need before you get going." B. "I think you need to take a shower." C. "Why haven't you taken a shower yet?" D. "I notice it has been a while since you have had a shower."

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

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 disconnect between the client's verbal and nonverbal messages confirms the presence of mental illness 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 client may be reluctant to dialogue despite the statement to the contrary

D. The client may be reluctant to dialogue despite the statement to the contrary

Which would be the least optimal environment for therapeutic communication for a client who has difficulty maintaining boundaries? A. The end of a hall B. An interview room C. A conference room D. The client's room

D. The client's room

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? A. The nurse should explicitly ask permission before touching a client in any capacity. B. Touching a client is inappropriate and opens the nurse to legal action. C. Physical touch should be used solely with clients of the same gender as the nurse. D. Touch can be a powerful therapeutic tool, but it must be used with caution.

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

A nurse responds to a client's statement with silence based on the rationale that this technique is used primarily to: A. encourage self-reflection by the nurse. B. demonstrate passive listening. C. allow the nurse to determine an appropriate response. D. permit clients to gather their thoughts.

D. permit clients to gather their thoughts.

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? A. self-awareness B. empathetic linkages C. rapport D. self- disclosure

D. self- disclosure