Psych Chapter 9: Therapeutic Communication

What is the most helpful nursing response to a client who reports thinking of dropping out of college because it is too stressful? a. "School is stressful. What do you find most stressful?" b. "I know just what you are going through. The stress is terrible." c. "Don't let them beat you! Fight back!" d. "You have only two more semesters. You will be glad if you stick it out."

a. "School is stressful. What do you find most stressful?"

Carolina is surprised when her patient does not show up for a regularly scheduled appointment. When contacted, the patient states, "I don't need to come see you anymore. I have found a therapy app on my phone that I love." How should Carolina respond to this news? a. "That sounds exciting, would you be willing to visit and show me the app?" b. "At this time, there is no real evidence that the app can replace our therapy." c. "I am not sure that is a good idea right now; we are so close to progress." d. "Why would you think that is a better option than meeting with me?"

a. "That sounds exciting, would you be willing to visit and show me the app?"

Of the following environments, which would be most conducive to a therapeutic session? a. A quiet section of the day room b. The utility room c. The nurses' station d. A table in the coffee shop

a. A quiet section of the day room

During a clinical interview the client falls silent after disclosing that she was sexually abused as a child. The nurse should engage in which intervention in response to the client's silence? a. Allow the client to break the silence. b. Quickly break the silence and encourage the client to continue. c. Reassure the client that the abuse was not her fault. d. Reach out and gently touch the client's arm.

a. Allow the client to break the silence.

When should a nurse be most alert to the possibility of communication errors resulting in harm to the patient? a. Change of shift report b. Admission interviews c. One-on-one conversations with patients d. Conversations with patients' families

a. Change of shift report

A client is sitting with arms crossed over their chest, with their left leg is rapidly moving up and down, and there is an angry facial expression. When approached by the nurse, the client states harshly, "I'm fine! Everything's great." Which statement related to communication should the nurse focus on when working with this client? a. Nonverbal and verbal communication may be different; nurses must pay attention to the nonverbal communication being presented to get an accurate message. b. Verbal communication is always more accurate than nonverbal communication. c. Verbal communication is more straightforward, whereas nonverbal communication does not portray what a person is thinking. d. Nonverbal communication is about 10% of all communication, and verbal communication is about 90%.

a. Nonverbal and verbal communication may be different; nurses must pay attention to the nonverbal communication being presented to get an accurate message.

What principle about nurse-patient communication should guide a nurse's fear about "saying the wrong thing" to a patient? a. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation. b. The patient is more interested in talking to you than listening to what you have to say and so is not likely to be offended. c. Considering the patient's history, there is little chance that the comment will do any actual harm. d. Most people with a mental illness have by necessity developed a high tolerance of forgiveness.

a. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.

A 55-year-old client recently came to the United States from England on a work visa. The client was admitted for severe depression following the death of a life partner weeks ago. While discussing the death and its effects the client shows little emotion. Which of the following explanations is most plausible for this lack of emotion? a. The response may reflect cultural norms. b. The response may reflect personal guilt. c. The client may have an antisocial personality. d. The client in denial.

a. The response may reflect cultural norms.

What therapeutic communication technique is the nurse using by asking a newly admitted client, "Can you tell me what was happening to you that led to your being hospitalized here?" a. Using an open-ended question b. Paraphrasing c. Reflecting d. Using a minimal encourager

a. Using an open-ended question

Which statement made by the nurse demonstrates the best understanding of nonverbal communication? a. "The patient's verbal and nonverbal communication is often different." b. "When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response." c. "If a patient is slumped in the chair, I can be sure he's angry or depressed." d. "It's easier to interpret verbal communication than to interpret nonverbal communication."

b. "When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response."

You have been working closely with a patient for the past month. Today, he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while reporting this to you. Which of the following responses would most likely be therapeutic? a. "A new psychiatrist is a chance to start fresh; I'm sure it will go well for you." b. "You say you look forward to the meeting, but you appear anxious or unhappy." c. "I notice that you frowned and avoided eye contact just now. Don't you feel well?" d. "I get the impression you don't really want to see your psychiatrist—can you tell me why?"

b. "You say you look forward to the meeting, but you appear anxious or unhappy."

Which communication techniques should the nurse use with a client who has been identified as having difficulty expressing thoughts and feelings? a. Offering opinions and avoiding periods of silence b. Asking open-ended questions and seeking clarification c. Asking closed-ended questions requiring "yes" or "no" answers d. Using emotionally charged words and gestures

b. Asking open-ended questions and seeking clarification

During a therapeutic encounter the nurse remarks to a client, "I noticed anger in your voice when you spoke of your father. Tell me about that." What communication techniques is the nurse using? a. Clarifying and suggesting collaboration b. Reflecting and exploring c. Presenting reality and encouraging planning d. Giving information and encouraging evaluation

b. Reflecting and exploring

Which student behavior is consistent with therapeutic communication? a. Offering your opinion when asked to convey support. b. Summarizing the essence of the patient's comments in your own words. c. Interrupting periods of silence before they become awkward for the patient. d. Telling the patient he did well when you approve of his statements or actions.

b. Summarizing the essence of the patient's comments in your own words.

The preferred seating arrangement for a nurse-client interview should incorporate which positioning? a. The client sitting in a chair and the nurse standing a few feet away. b. The nurse and client sitting at a 90-degree angle to each other. c. The nurse behind a desk and the client in a chair in front of the desk. d. The nurse and client sitting facing each other.

b. The nurse and client sitting at a 90-degree angle to each other.

James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for your day shift and anxiously reports, "Last night, demons came to my room and tried to rape me." Which response would be most therapeutic? a. "There are no such things as demons. What you saw were hallucinations." b. "It is not possible for anyone to enter your room at night. You are safe here." c. "You seem upset. Please tell me more about what you experienced last night." d. "That must have been frightening, but we'll check on you at night and you'll be safe."

c. "You seem upset. Please tell me more about what you experienced last night."

With which client should the nurse make the assessment that not using touch would probably be in the client's best interests? a. A deeply depressed client b. A tearful client reporting pain c. A very private client d. A recent immigrant from Russia

c. A very private client

When discussing her husband, a client shares that "I would be better off alone. At least I would be able to come and go as I please and not have to be interrogated all the time." What therapeutic communication technique is the nurse using when responding, "Are you saying that things would be better if you left your husband?" a. Reflection b. Focusing c. Clarification d. Restating

c. Clarification

After a client discusses a personal relationship with a parent, the nurse asks, "Tell me if I'm correct that you feel dominated and controlled by this person?" What is the purpose of the nurse's question? a. Verbalizing the implied b. Eliciting more information c. Clarifying the message d. Encouraging evaluation

c. Clarifying the message

During a therapeutic encounter, the nurse makes an effort to ensure the use of two congruent levels of communication. What is the rationale for this? a. One statement may simultaneously convey conflicting messages. b. Many of the client's remarks are no more than social phrases. c. Content of messages may be contradicted by process. d. The mental image of a word may not be the same for both nurse and client.

c. Content of messages may be contradicted by process.

When preparing to hold an admission interview with a client, the nurse pulls up a chair and sits facing the client with their knees almost touching. When the nurse leans in close to speak, the client becomes visibly flustered and gets up and leaves the room. What is the most likely explanation for client's behavior? a. The client is responding to the voices by ending the conversation. b. The nurse failed to explain the purpose of the admission interview. c. The nurse violated the client's personal space by physically being too close. d. The client has issues with sharing personal information.

c. The nurse violated the client's personal space by physically being too close.

What is the focus during clinical supervision? a. Devising alternative strategies for client growth b. Assisting the client to develop increased independence c. The nurse's behavior in the nurse-client relationship d. Analysis of the client's motivation for transferences

c. The nurse's behavior in the nurse-client relationship

The client makes the decision to sit about 5 feet away from the nurse during the assessment interview. The nurse can accurately make what assumption about the client's perception of the nurse? a. The nurse is a new friend. b. They view the nurse as a peer. c. They view the nurse as a stranger. d. The nurse is a safe person to interact with.

c. They view the nurse as a stranger.

Which nursing statement is an example of reflection? a. "I think this feeling will pass." b. "So you are saying that life has no meaning." c. "I'm not sure I understand what you mean." d. "You look sad."

d. "You look sad."

Therapeutic communication is the foundation of a patient-centered interview. Which of the following techniques is not considered therapeutic? a. Restating b. Encouraging description of perception c. Summarizing d. Asking "why" questions

d. Asking "why" questions

A recent immigrant to the United States from which country would tend to display little facial emotion when dealing with emotional stress? a. Japan b. Korea c. Mexico d. Germany

d. Germany