Therapeutic Communication | NCLEX Quiz 201

1.

The nurse calls security and has physical restraints applied when a client who admitted voluntarily becomes both physically and verbally abusive while demanding to be discharged from the hospital. Which represents the possible legal ramifications for the nurse associated with these interventions? Select all that apply.

A.

Libel
B.

Battery
C.

Assault
D.

Slander
E.

False Imprisonment

Correct Answer(s)
B. Battery
C. Assault
E. False Imprisonment

Explanation
False imprisonment is an act with the intent to confine a person to a specific area. The nurse can be charged with false imprisonment if the nurse prohibits a patient from leaving the hospital if the patient has been admitted voluntarily and if no agency or legal policies exist for detaining the patient. Assault and battery are related to the act of restraining the patient in a situation that did not meet criteria for such an intervention.Options A and D: Libel and slander are not applicable here since the nurse did not write or verbally make untrue statements about the patient.

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2.

The nurse in the mental health unit recognizes which of the following as therapeutic communication techniques? Select all that apply.

A.

Restating
B.

Listening
C.

Asking the patient “Why?”
D.

Maintaining neutral responses
E.

Providing acknowledgment and feedback
F.

Giving advice and approval or disapproval

Correct Answer(s)
A. Restating
B. Listening
D. Maintaining neutral responses
E. Providing acknowledgment and feedback

Explanation
Therapeutic communication techniques include listening. maintaining silence. maintaining neutral responses. using broad openings and open-ended questions. focusing and refocusing. restating. clarifying and validating. sharing perceptions. reflecting. providing acknowledgment and feedback. giving information. presenting reality. encouraging formulation of a plan of action. providing nonverbal encouragement. and summarizing.Option C: Asking why is often interpreted as being accusatory by the patient and should also be avoided. Providing advice or giving approval or disapproval are barriers to communication.

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3.

A patient being seen in the emergency department immediately after being sexually assaulted appears calm and controlled. The nurse analyzes this behavior as indicating which defense mechanism?

A.

Denial
B.

Projection
C.

Rationalization
D.

Intellectualization

Correct Answer
A. Denial

Explanation
Denial is the refusal to admit to a painful reality and may be a response by a victim of sexual abuse. In this case. the patient is not acknowledging the trauma of the assault either verbally or nonverbally.Option B: Projection is transferring one’s internal feelings. thoughts. and unacceptable ideas and traits to someone else.Option C: Rationalization is justifying the unacceptable attributes about oneself.Option D: Intellectualization is the excessive use of abstract thinking or generalizations to decrease painful thinking.

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4.

A patient’s unresolved feelings related to loss would be MOST LIKELY observed during which phase of the therapeutic nurse-patient relationship?

A.

Trusting
B.

Working
C.

Orientation
D.

Termination

Correct Answer
D. Termination

Explanation
In the termination phase. the relationship comes to a close. Ending treatment sometimes may be traumatic for patients who have come to value the relationship and the help. Because loss is an issue. any unresolved feelings related to loss may resurface during this phase.Options A. B. and C: The remaining options are not specifically associated with this issue of unresolved feelings.

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5.

Which statement demonstrates the BEST understanding of the nurse’s role regarding ensuring that each client’s rights are respected?

A.

“Autonomy is the fundamental right of each and every client.”
B.

“A patient’s rights are guaranteed by both state and federal laws.”
C.

“Being respectful and concerned will ensure that I’m attentive to my patient’s rights.”
D.

“Regardless of the patient’s conditions. all nurses have the duty to respect patient rights.”

Correct Answer
C. “Being respectful and concerned will ensure that I’m attentive to my patient’s rights.”

Explanation
The nurse needs to respect and have concern for the patient; this is vital to protecting the patient’s rights.Option A: While it is true the autonomy is a basic client right. there are other rights that must also be both respected and facilitated.Option B: State and federal laws do protect a patient’s rights. but it is sensitivity to those rights that will ensure that the nurse secures these rights for the patient.Option D: It is a fact that safeguarding a patient’s rights are a nursing responsibility. but stating that fact does not show understanding or respect for the concept.

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6.

Which therapeutic communication technique is being used in this nurse-client interaction? Client: “When I get angry. I get into a fistfight with my wife. or I take it out of the kids.” Nurse: “I notice that you are smiling as you talk about this physical violence.”

A.

Encouraging comparison
B.

Exploring
C.

Formulating a plan of action
D.

Making observations

Correct Answer
D. Making observations

Explanation
The nurse is using the therapeutic communication technique of making observations when noting that the client smiles when talking about physical violence. The technique of making observations encourages the client to compare personal perceptions with those of the nurse.

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7.

Which therapeutic communication technique is being used in this nurse-client interaction? Client: “My father spanked me often.”Nurse: “Your father was a harsh disciplinarian.”

A.

Restatement
B.

Offering general leads
C.

Focusing
D.

Accepting

Correct Answer
A. Restatement

Explanation
The nurse is using the therapeutic communication technique of restatement. Restatement involves repeating the main idea of what the client has said. The nurse uses this technique to communicate that the client’s statement has been heard and understood.

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8.

Which therapeutic communication technique is being used in this nurse-client interaction?Client: “When I am anxious. the only thing that calms me down is alcohol.”Nurse: “Other than drinking. what alternatives have you explored to decrease anxiety?”

A.

Reflecting
B.

Making observations
C.

Formulating a plan of action
D.

Giving recognition

Correct Answer
C. Formulating a plan of action

Explanation
The nurse is using the therapeutic communication technique of formulating a plan of action to help the client explore alternatives to drinking alcohol. The use of this technique. rather than direct confrontation regarding the client’s poor coping choice. may serve to prevent anger or anxiety from escalating.

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9.

Nurse Patrick is interviewing a newly admitted psychiatric client. Which nursing statement is an example of offering a “general lead”?

A.

“Do you know why you are here?”
B.

“Are you feeling depressed or anxious?”
C.

“Yes. I see. Go on.”
D.

“Can you chronologically order the events that led to your admission?”

Correct Answer
C. “Yes. I see. Go on.”

Explanation
The nurse’s statement. “Yes. I see. Go on.” is an example of the therapeutic communication technique of a general lead. Offering a general lead encourages the client to continue sharing information.

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10.

A nurse states to a client. “Things will look better tomorrow after a good night’s sleep.” This is an example of which communication technique?

A.

The therapeutic technique of “giving advice”
B.

The therapeutic technique of “defending”
C.

The nontherapeutic technique of “presenting reality”
D.

The nontherapeutic technique of “giving false reassurance”

Correct Answer
D. The nontherapeutic technique of “giving false reassurance”

Explanation
The nurse’s statement. “Things will look better tomorrow after a good night’s sleep.” is an example of the nontherapeutic technique of giving false reassurance. Giving false reassurance indicates to the client that there is no cause for anxiety. thereby devaluing the client’s feelings.

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