Mental Health

Which type of cue is being used when the client states, "Nothing can help me"?

Covert

Which type of touch, according to Knapp, is used in greeting, such as a handshake?

Social-polite

Which is an inaccurate depiction of concrete messages?

They require rephrasing of unclear statements.

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 using a directive role when asking a client which question?

"Are you thinking about hurting someone else right now?"

The nurse is assessing a client who was recently diagnosed with anxiety disorder. Which question asked by the nurse conveys a concrete message?

"At what time did you take the last dose of the antianxiety drugs?"

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 your spouse make you feel?"

A psychiatric-mental health client tells the nurse, "The doctor hates me. The doctor promised to come check on me after dinner yesterday but never came." What is the nurse's most therapeutic response?

"I don't know why the doctor didn't check on you yesterday, but I think it's unlikely that the doctor hates you."

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."

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."

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?

"I'm concerned that you are not exicited about your mother's visit, We can talk if you want."

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?"

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

"It sounds like you're feeling unappreciated."

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?

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

A client on the psychiatric mental health unit has a care plan that includes a break for cigarettes every hour during the afternoon if the client follows the behavioral plan to attend the morning group on anger management. The client asks, "I couldn't get to my group this morning because I overslept. Can I just this one time go for a cigarette now?" Which response by the nurse is most therapeutic?

"No, Joe. Your plan says that you need to attend that group in order to have cigarette breaks."

The nurse is meeting a client for the first time. Which action should the nurse take to establish a rapport with this client? Select all that apply.

*shaking the client's hand when greeting *asking the client to further explain a recurring symptom *remaining neutral when the client states a lack of faith in medical care

A client is speaking with the nurse about the client's difficult relationship with the client's father. The client states, "He never showed me love or approval unless I was perfect." Which response is most likely to encourage the client to continue elaborating?

"Tell me more about that."

The nurse educator is teaching the class about communication. Which statement by the student nurse best describes the basic elements of communication?

"The basic elements of communication include feedback, sender, receiver, and messages."

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 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."

Choose the most therapeutic response to the client's statement, "All I feel like doing is screaming as loudly as I can."

"You look like you are very angry this morning."

Which statement by the nurse reflects the use of a therapeutic statement?

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

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 sad facial expression *A fearful tone of voice

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 constructing a response *Client who is pondering the question

A nurse is engaged in a therapeutic relationship with a client. What should the nurse do in order to ensure therapeutic communication takes place? Select all that apply.

*Focus on the client during the interaction *Ensure the client's confidentiality *Employ theoretically based interventions

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 feet

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

Abstract

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

Broad opening

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

The nurse is assessing a client who is hospitalized for an episode of mania. When the nurse sits down across from the client to begin the interview, the client moves to sit right less than a foot away from the nurse. The client is positioned in which body space zone of the nurse?

Intimate

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?

Cues

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 verbal cue refers to accents on words or phrases that highlight the subject or give insight on the topic?

Emphasis

When the nurse states, "Tell me more about that," the nurse is utilizing which communication technique?

Exploring

A group of students is reviewing the process of verbal communication. The students demonstrate understanding of the information when they identify which as the first component of the process?

Formulation of an idea

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

Impassive

The nurse is caring for a client with schizophrenia. The client says, "Somebody is trying to kill me." The nurse responds by saying, "Isn't the weather nice? You should sit outside for a while." Which type of communication does this indicate?

Introducing an unrelated topic

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 nurse is meeting with a client who just attended a group therapy session. The nurse asks, "How was group for you today?" The client is silent longer than the amount of the time the nurse expected. What can the nurse assume the client needs?

More time to think

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

Personal

A client diagnosed with schizophrenia is hallucinating. Which communication technique may the nurse use to redirect the client?

Presenting reality

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

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?

Probing

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-disclosure

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

A nurse reviews a client's psychiatric and medical history before approaching the client for an assessment. The history reveals the client has a history of sexual abuse from a caregiver in early adolescence. Which zone would be the best place for the nurse to sit the nurse to begin the assessment?

Social

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 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?

The client may have difficulty maintaining spacial boundaries.

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

The client's room

A nurse is caring for a client who is experiencing a decline in the client's chronic illness. The nurse feels that the nurse should speak to the client's spouse, who is extremely worried and anxious, and provide the spouse with support. Which setting should the nurse select to speak to the spouse? Choose the best answer.

The consultation room

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?

active listening

Which is inconsistent with principles of therapeutic communication?

The nurse is the primary focus of the relationship.

During client assessment, the nurse asks the next question as soon as the client finishes answering the previous question. Which most likely explains why the nurse is interacting with the client this way?

The nurse may lack confidence in therapeutic communication.

A client begins discussing frankly the client's history of sexual abuse as a child. The nurse listens for awhile and then asks the client about the client's stressful job situation. The nurse does this for what reason?

To reduce the nurse's own anxiety

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.

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

permit clients to gather their thoughts.

A student nurse is preparing for a clinical placement in a psychiatric-mental health context. In order to best prepare to engage in therapeutic communication with clients, the student should:

reflect critically on the student's own life experiences, perspectives, and characteristics.

The nurse is talking with the client about lowering cholesterol and raising high density lipoproteins (HDLs). The nurse states, "Niacin with applesauce helps to prevent the flushing sensation that often accompanies taking this drug." What is the nurse providing with this statement?

self-disclosure

The nurse wears a cross and has a Facebook page displaying pictures of the family, home and updates on what the nurse is currently doing. These actions are examples of what?

self-disclosure

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

silence

The nurse is caring for a client who is very confused. In addition to verbal communication with the client, which intervention should the nurse use?

using gentle touch during activities of daily living