Psych - Videbeck Ch 6

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

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

When considering the zones of distance awareness, the nurse expects that initially the client who exhibits paranoia will be most comfortable interacting within which zone of proximity with the nurse?

Public

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 psychiatric-mental health client tells the nurse, "The doctor hates me. The doctor promised to try to come and 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 come, but I can reassure you that it's not because she 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."

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."

The nurse is working in the mental health clinic communicating with a client who is having auditory hallucinations. What should the nurse say to effectively communicate with this client?

"I understand that the voices seem real to you, but I don't hear them."

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."

The nurse manger is discussing self- awareness during a staff meeting. Which statement(s) by the staff nurse best depicts self-awareness? Select all that apply.

"I'm tired and hungry. I need to take a break and get something to eat." "I asked to be transferred because the nurses on this unit are critical and make me feel inadequate when I work with them."

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 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."

A hospitalized client diagnosed with depression asks a nurse, "Should I go home this weekend?" Which response by the nurse uses the technique of reflection?

"Should you go home for the weekend?"

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."

A client who has tried several different antidepressant medications tells the nurse that uncomfortable side effects make the client want to stop taking medication altogether. What is the nurse's best response?

"Tell me what is it about the medication that is troubling you the most."

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."

A group of nursing students is preparing a presentation about therapeutic communication. As part of the presentation, the group is planning to give examples of maintaining a nonjudgmental attitude. Which would be appropriate to include?

"The client has struggled with domestic violence for a while and is working very hard to make the necessary changes to help oneself."

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."

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?"

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

3 to 6 feet

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

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

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

Abstract

Which form of messaging contain figures of speech that are difficult to interpret and can be a barrier to communication?

Abstract

A nurse engaged in an interaction with a client recognizes body space zones. Which would the nurse identify as the individual's personal zone?

Beginning at the boundary of the intimate zone and ending at the social zone

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 client expresses to the nurse that the client has been unable to sleep due to work. The nurse asks the client, "Do you mean that the work in the office is causing stress, which is why you are not able to sleep?" Which type of therapeutic communication technique is this conversation indicative of?

Consensual validation

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

Covert

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

Cue

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.

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

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

Which communication technique involves giving encouragement to the client, enabling continuance of the conversation and indicting that the nurse is listening?

General leads

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

Impassive

After spending 15 minutes talking with a client, the client leaves the interaction feeling defensive. This is evidence that the communication can be described as what?

Nontherapeutic

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

During a therapy session, the nurse asks the client, "Tell me more about your relationship with your parents." The nurse is using which therapeutic communication technique?

Probing

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 arrangement is likely to be the least threatening to a psychiatric-mental health client?

Sitting at an angle, 4 to 5 feet apart

A mental health nurse is discussing the schedule of events for the day on the unit with a client. The nurse therapeutically communicates within which zone of distance awareness?

Social

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

Social-polite

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 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.

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 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

A client with a history of depression has told the nurse that the client is feeling especially "low" this morning. The nurse has responded by stating, "Try thinking about some of the blessings you have in your life." How should the nurse's statement be best interpreted?

The nurse has inhibited therapeutic communication by giving advice

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.

Which is an inaccurate depiction of concrete questions?

They require rephrasing of unclear questions.

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

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

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.

The nurse is engaging in assertive communication when which communication approach is used? (Select all that apply.)

expressing feelings attached to the concern using "I" statements using direct language

An important part of cultural competence includes the capacity to communicate effectively and convey information that is easily understood. When providing care the nurse should know that cultural competence includes which example?

linguistic competence

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

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.

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

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

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

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 indicates interest in and acceptance of the client by all of the following except:

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

The nurse is caring for a client that is very confused. What intervention should be included with the nurses' non-communication with the client?

use of gentle touch during activities of daily living