349 ch 8 prep u therapeutic communication

A client diagnosed with borderline personality disorder is pitting one nurse against the other, calling one a best friend and declaring that the other is horrible. The client is using which defense mechanism?

splitting

After reviewing information about defense mechanisms, a group of students demonstrates the need for additional review when they identify which defense mechanism as almost always maladaptive

denial

which zone is an acceptable distance between a speaker and an audience

public

A nurse has invited a client to sit down and have a conversation. The client takes the first seat. The nurse pulls up another chair to sit with the client. Approximately how far from the client should the nurse place her chair?

3-6 feet

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?

During the admission interview, the nurse asks the client what led to the client's hospitalization. The client responds, "They lied about me. They said I murdered my mother. You're the killers. You all killed my mother. She died before I was born." What would be the best initial response by the nurse

"you're having very frightening thoughts"

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

The nurse and the client are using therapeutic communication skills. Which statements are true of concrete and abstract messages?

abstract messages include figures of speech that are difficult to interpret concrete messages are clear, direct, and easy to understand

which communication technique does a nurse use in establishing trust and developing empathy

acceptance

The client says to the nurse, "I wonder what's playing at the movies tonight." Which response by the nurse would be most therapeutic

are you telling me you would like to go to the movies

The nurse uses a variety of therapeutic communication skills when working with clients. Which is a therapeutic goal that can be accomplished through the use of therapeutic communication skills?

assess the clients perception of a problem

Which goal of therapeutic communication would the nurse strive to attain first?

establish a therapeutic nurse client relationship

the nurse fails to assess personal values surrounding homosexuality before caring for. client who is openly gay. the nurse is most at risk for what when working with this client

holding a prejudice towards this client

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?

im concerned that you are not excited about your mothers visit. we can talk if you want

a client remarks "you know, it the same thing every time" the nurse should respond by stating

im not sure what you mean, please explain

A client has been making sexual comments when communicating with the nurse. The nurse wants to spend some time talking to the client while respecting the client's right to privacy. Which setting would be the most appropriate setting for the nurse to talk with the client?

in a quiet corner of the dayroom at least 4 feet away from others

The parent of a child client holds the child close during the initial assessment. Which distance zone is acceptable for people who mutually desire personal contact?

intimate

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?

its important to get a break from time to time. how have the last few days been for you?

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?

lets talk about infections, and how they heal

While the nurse and client are in a therapy session, the nurse says to the client, "You become very anxious when we start talking about your drinking." Which technique is the nurse using

making an observation

The nurse uses self-disclosure for what purpose?

meet therapeutic goals

the nurse watches the expressions the client is making as group therapy is conducted. Which statement about verbal and nonverbal communication skills is accurate?

nonverbal communication is as important, if not more than, verbal communication

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

personal

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

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 experience, 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

Which of the following statements is true about a nurse's self-disclosure?

self-disclosure on the nurses part should benefit the client

which would not be considered a goal of therapeutic communication

self-exploration of feelings by the nurse

Which nursing actions, if shared with clients, suggest self-disclosure?

showing family photos telling the client the nurse attends a weight loss meeting directing the client to the nurse's facebook page

which is often considered the most difficult yet most effective communication techique

silence

the nurse asks the client, "what was it like for you first knew you had no place to go?" the client looks down and pauses for quite some time, which action by the nurse is most therapeutic

sit quietly until the patient responds

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 sitting down with a client to begin a conversation. Which position should the nurse take to convey acceptance of the client

sitting upright facing the client with both feet on the floor

A client has undergone diagnostic testing to determine whether she has breast cancer. She goes shopping at the mall to stop thinking about the possibility of cancer. She is using which of the following defense mechanisms?

suppression

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

which inconsistent with principles of therapeutic communication

the nurse is the primary focus of the relationship

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

The nurse must be alert to the nonverbal expressions of the client. Because the meaning attached to nonverbal behavior is subjective, it is important for the nurse to

validate the meaning of the nonverbals

Which communication technique involves expressing uncertainty about the reality of the client's perception?

voicing doubt

During the mental status assessment, the client expresses the belief that the CIA is stalking the client and plans to kidnap the client. Which would be the best response by the nurse

what kinds of things have been happening

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

Which of the following statements would be an empathetic response in a client interaction?

you must have been embarrassed when your father yelled at you in the grocery store