Take The Therapeutic Communication NCLEX Practice Questions!

1. An instructor is correcting a nursing student's clinical worksheet. Which instructor statement is the best example of effective feedback?

“Why did you use the client’s name on your clinical worksheet?”

“You were very careless to refer to your client by name on your clinical worksheet.”

“Surely you didn’t do this deliberately. but you breached confidentiality by using the client’s name.”

“It is disappointing that after being told. you’re still using client names on your worksheet.”

The instructor’s statement. “Surely you didn’t do this deliberately. but you breached confidentiality by using the client’s name.” is an example of effective feedback. Feedback is a method of communication to help others consider a modification of behavior. Feedback should be descriptive. specific. and directed toward a behavior that the person has the capacity to modify and should impart information rather than offer advice or criticize the individual.

Explanation

The instructor’s statement. “Surely you didn’t do this deliberately. but you breached confidentiality by using the client’s name.” is an example of effective feedback. Feedback is a method of communication to help others consider a modification of behavior. Feedback should be descriptive. specific. and directed toward a behavior that the person has the capacity to modify and should impart information rather than offer advice or criticize the individual.

2. A nurse is assessing a client diagnosed with schizophrenia for the presence of hallucinations. Which therapeutic communication technique used by the nurse is an example of making observations?

“You appear to be talking to someone I do not see.”

“Please describe what you are seeing.”

“Why do you continually look in the corner of this room?”

“If you hum a tune. the voices may not be so distracting.”

The nurse is making an observation when stating. “You appear to be talking to someone I do not see.” Making observations involve verbalizing what is observed or perceived. This encourages the client to recognize specific behaviors and make comparisons with the nurse’s perceptions.

Explanation

The nurse is making an observation when stating. “You appear to be talking to someone I do not see.” Making observations involve verbalizing what is observed or perceived. This encourages the client to recognize specific behaviors and make comparisons with the nurse’s perceptions.

3. A client diagnosed with post-traumatic stress disorder is admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which therapeutic communication technique used by the nurse is an example of a broad opening?

“What occurred prior to the rape. and when did you go to the emergency department?”

“What would you like to talk about?”

“I notice you seem uncomfortable discussing this.”

“How can we help you feel safe during your stay here?”

The nurse’s statement. “What would you like to talk about?” is an example of the therapeutic communication technique of giving broad openings. Using a broad opening allows the client to take the initiative in introducing the topic and emphasizes the importance of the client’s role in the interaction.

Explanation

The nurse’s statement. “What would you like to talk about?” is an example of the therapeutic communication technique of giving broad openings. Using a broad opening allows the client to take the initiative in introducing the topic and emphasizes the importance of the client’s role in the interaction.

4. A mother rescues two of her four children from a house fire. In the emergency department. she cries. "I should have gone back in to get them. I should have died. not them." What is the nurse's best response?

“The smoke was too thick. You couldn’t have gone back in.”

“You’re feeling guilty because you weren’t able to save your children.”

“Focus on the fact that you could have lost all four of your children.”

“It’s best if you try not to think about what happened. Try to move on.”

The best response by the nurse is. “You’re experiencing feelings of guilt because you weren’t able to save your children.” This response utilizes the therapeutic communication technique of reflection which identifies a client’s emotional response and reflects these feelings back to the client so that they may be recognized and accepted.

Explanation

The best response by the nurse is. “You’re experiencing feelings of guilt because you weren’t able to save your children.” This response utilizes the therapeutic communication technique of reflection which identifies a client’s emotional response and reflects these feelings back to the client so that they may be recognized and accepted.

5. When interviewing a client. which nonverbal behavior should a nurse employ?

Maintaining indirect eye contact with the client

Providing space by leaning back away from the client

Sitting squarely. facing the client

Maintaining open posture with arms and legs crossed

When interviewing a client. the nurse should employ the nonverbal behavior of sitting squarely. facing the client. Facilitative skills for active listening can be identified by the acronym SOLER. SOLER includes sitting squarely facing the client (S). open posture when interacting with a client (O). leaning forward toward the client (L). establishing eye contact (E). and relaxing (R).

Explanation

When interviewing a client. the nurse should employ the nonverbal behavior of sitting squarely. facing the client. Facilitative skills for active listening can be identified by the acronym SOLER. SOLER includes sitting squarely facing the client (S). open posture when interacting with a client (O). leaning forward toward the client (L). establishing eye contact (E). and relaxing (R).

6. A nurse maintains an uncrossed arm and leg posture. This nonverbal behavior is reflective of which letter of the SOLER acronym for active listening?

S

O

L

E

The nurse should identify that maintaining an uncrossed arm and leg posture is nonverbal behavior that reflects the “O” in the active-listening acronym SOLER. Open posture when interacting with the client (O).The acronym SOLER includes:Option A: Sitting squarely facing the client (S).Option C: Leaning forward toward the client (L).Option D: Establishing eye contact (E).Option E: Relaxing (R).

Explanation

The nurse should identify that maintaining an uncrossed arm and leg posture is nonverbal behavior that reflects the “O” in the active-listening acronym SOLER. Open posture when interacting with the client (O).The acronym SOLER includes:Option A: Sitting squarely facing the client (S).Option C: Leaning forward toward the client (L).Option D: Establishing eye contact (E).Option E: Relaxing (R).

7. A client who frequently exhibits angry outbursts is diagnosed with antisocial personality disorder. Which appropriate feedback should a nurse provide when this client experiences an angry outburst?

“Why do you continue to alienate your peers by your angry outbursts?”

“You accomplish nothing when you lose your temper like that.”

“Showing your anger in that manner is very childish and insensitive.”

“During group. you raised your voice. yelled at a peer. left. and slammed the door.”

The nurse is providing appropriate feedback when stating. “During group. you raised your voice. yelled at a peer. left. and slammed the door.” Giving appropriate feedback involves helping the client consider a modification of behavior. Feedback should give information to the client about how he or she is perceived by others. Feedback should not be evaluative in nature or be used to give advice.

Explanation

The nurse is providing appropriate feedback when stating. “During group. you raised your voice. yelled at a peer. left. and slammed the door.” Giving appropriate feedback involves helping the client consider a modification of behavior. Feedback should give information to the client about how he or she is perceived by others. Feedback should not be evaluative in nature or be used to give advice.

8. After assertiveness training. a formerly passive client appropriately confronts a peer in group therapy. The group leader states. "I'm so proud of you for being assertive. You are so good!" Which communication technique has the leader employed?

The nontherapeutic technique of giving approval

The nontherapeutic technique of interpreting

The therapeutic technique of presenting reality

The therapeutic technique of making observations

The group leader has employed the nontherapeutic technique of giving approval. Giving approval implies that the nurse has the right to pass judgment on whether the client’s ideas or behaviors are “good” or “bad.” This creates a conditional acceptance of the client.

Explanation

The group leader has employed the nontherapeutic technique of giving approval. Giving approval implies that the nurse has the right to pass judgment on whether the client’s ideas or behaviors are “good” or “bad.” This creates a conditional acceptance of the client.

9. What is the purpose of a nurse providing appropriate feedback?

To give the client good advice

To advise the client on appropriate behaviors

To evaluate the client’s behavior

To give the client critical information

The purpose of providing appropriate feedback is to give the client critical information. Feedback should not be used to give advice or evaluate behaviors.

Explanation

The purpose of providing appropriate feedback is to give the client critical information. Feedback should not be used to give advice or evaluate behaviors.

10. When reviewing the admission assessment. the nurse notes that a patient was admitted to the mental health unit involuntarily. Based on this type of admission. the nurse should provide which intervention for this patient?

Monitor closely for harm to self or others.

Assist in completing an application for admission.

Supply the patient with written information about their mental illness.

Provide an opportunity for the family to discuss why they felt the admission was needed.

In cases where a patient is admitted involuntarily to the mental health unit, the nurse's priority intervention is to closely monitor for any signs of harm to self or others. This type of admission suggests that the patient may be at an increased risk of self-harm or posing a threat to others. Therefore, vigilant observation and proactive measures are necessary to ensure the safety and well-being of the patient and those around them. This involves continuous assessment and prompt intervention if any concerning behaviors or situations arise.

Explanation

In cases where a patient is admitted involuntarily to the mental health unit, the nurse's priority intervention is to closely monitor for any signs of harm to self or others. This type of admission suggests that the patient may be at an increased risk of self-harm or posing a threat to others. Therefore, vigilant observation and proactive measures are necessary to ensure the safety and well-being of the patient and those around them. This involves continuous assessment and prompt intervention if any concerning behaviors or situations arise.