PNU 128 Videbeck PrepU Chapter 6: Therapeutic Communication

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

Which zone is an acceptable distance between a speaker and an audience?

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?"

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 mosttherapeutically when answering:

"How would leaving your spouse make you feel?"

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 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."

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 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."

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

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

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

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 opening

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

Cues

Which would not be considered a goal of therapeutic communication?

Self-exploration of feelings by the nurse

The nurse is working with a client from the Middle East. The nurse maintains a distance of approximately 13 feet from the client while talking. The client says that the client is uncomfortable when the nurse talks to the client from such a long distance. How should the nurse interpret this statement?

The client feels that the nurse is indifferent toward the client.

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.

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

Which question should be avoided because it may be perceived as criticism by the client?

Why?

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 nurse is conducting an initial assessment of a client. When the client enters the nurse's office, the client finds the nurse sitting with arms folded across the chest and an emotionless facial expression. The nurse is exhibiting which nonverbal communication technique?

closed body position and impassive face

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.

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 nursing actions if shared with clients, suggest self-disclosure? Select all that apply.

showing family photos attending a weight loss meeting directing to individual Facebook page

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