Therapeutic Communication | NCLEX Quiz 204

1. Which therapeutic communication technique should the nurse use when communicating with a client who is experiencing auditory hallucinations?

“My sister has the same diagnosis as you and she also hear voices.”

“I understand that the voices seem real to you. but I do not hear any voices.”

“Why not turn up the radio so that the voices are muted.”

“I wouldn’t worry about these voices. The medication will make them disappear.”

This is an example of the therapeutic communication technique of presenting reality. Presenting reality is when the client has a misperception of the environment. The nurse defines reality or indicates his or her perception of the situation for the client.

Explanation

This is an example of the therapeutic communication technique of presenting reality. Presenting reality is when the client has a misperception of the environment. The nurse defines reality or indicates his or her perception of the situation for the client.

2. A client states. "You won't believe what my husband said to me during visiting hours. He has no right treating me that way." Which nursing response would best assess the situation that occurred?

“Does your husband treat you like this very often?”

“What do you think is your role in this relationship?”

“Why do you think he behaved like that?”

“Describe what happened during your time with your husband.”

This is an example of the therapeutic communication technique of exploring. The purpose of using exploring is to delve further into the subject. idea. experience. or relationship. This technique is especially helpful with clients who tend to remain on a superficial level of communication.

Explanation

This is an example of the therapeutic communication technique of exploring. The purpose of using exploring is to delve further into the subject. idea. experience. or relationship. This technique is especially helpful with clients who tend to remain on a superficial level of communication.

3. After fasting from 10 p.m. the previous evening. a client finds out that the blood test has been canceled. The client swears at the nurse and states. "You are incompetent!" Which is the nurse's best response?

“Do you believe that I was the cause of your blood test being canceled?”

“I see that you are upset. but I feel uncomfortable when you swear at me.”

“Have you ever thought about ways to express anger appropriately?”

“I’ll give you some space. Let me know if you need anything.”

This is an example of the appropriate use of feedback. Feedback should be directed toward behavior that the client has the capacity to modify.

Explanation

This is an example of the appropriate use of feedback. Feedback should be directed toward behavior that the client has the capacity to modify.

4. Which nursing statement is a good example of the therapeutic communication technique of offering self?

“I think it would be great if you talked about that problem during our next group session.”

“Would you like me to accompany you to your electroconvulsive therapy treatment?”

“I notice that you are offering help to other peers in the milieu.”

“After discharge. would you like to meet me for lunch to review your outpatient progress?”

This is an example of the therapeutic communication technique of offering self. Offering self-makes the nurse available on an unconditional basis. increasing client’s feelings of self-worth. Professional boundaries must be maintained when using the technique of offering self.

Explanation

This is an example of the therapeutic communication technique of offering self. Offering self-makes the nurse available on an unconditional basis. increasing client’s feelings of self-worth. Professional boundaries must be maintained when using the technique of offering self.

5. 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.

6. A client on an in-patient psychiatric unit tells the nurse. "I should have died because I am totally worthless." In order to encourage the client to continue talking about feelings. which should be the nurse's initial response?

“How would your family feel if you died?”

“You feel worthless now. but that can change with time.”

“You’ve been feeling sad and alone for some time now?”

“It is great that you have come in for help.”

This nursing statement is an example of the therapeutic communication technique of reflection. When reflection is used. questions and feelings are referred back to the client so that they may be recognized and accepted.

Explanation

This nursing statement is an example of the therapeutic communication technique of reflection. When reflection is used. questions and feelings are referred back to the client so that they may be recognized and accepted.

7. During a nurse-client interaction. which nursing statement may belittle the client's feelings and concerns?

“Don’t worry. Everything will be alright.”

“You appear uptight.”

“I notice you have bitten your nails to the quick.”

“You are jumping to conclusions.”

This nursing statement is an example of the nontherapeutic communication block of belittling feelings. Belittling feelings occur when the nurse misjudges the degree of the client’s discomfort. Thus a lack of empathy and understanding may be conveyed.

Explanation

This nursing statement is an example of the nontherapeutic communication block of belittling feelings. Belittling feelings occur when the nurse misjudges the degree of the client’s discomfort. Thus a lack of empathy and understanding may be conveyed.

8. A client slammed a door on the unit several times. The nurse responds. "You seem angry." The client states. "I'm not angry." What therapeutic communication technique has the nurse employed and what defense mechanism is the client unconsciously demonstrating?

Making observations and the defense mechanism of suppression

Verbalizing the implied and the defense mechanism of denial

Reflection and the defense mechanism of projection

Encouraging descriptions of perceptions and the defense mechanism of displacement

This is an example of the therapeutic communication technique of verbalizing the implied. The nurse is putting into words what the client has only implied by words or actions. Denial is the refusal of the client to acknowledge the existence of a real situation. the feelings associated with it. or both.

Explanation

This is an example of the therapeutic communication technique of verbalizing the implied. The nurse is putting into words what the client has only implied by words or actions. Denial is the refusal of the client to acknowledge the existence of a real situation. the feelings associated with it. or both.

9. Which nursing response is an example of the nontherapeutic communication block of requesting an explanation?

“Can you tell me why you said that?”

“Keep your chin up. I’ll explain the procedure to you.”

“There is always an explanation for both good and bad behaviors.”

“Are you not understanding the explanation I provided?”

This nursing statement is an example of the nontherapeutic communication block of requesting an explanation. Requesting an explanation is when the client is asked to provide the reason for thoughts. feelings. behaviors. and events. Asking “why” a client did something or feels a certain way can be very intimidating and implies that the client must defend his or her behavior or feelings.

Explanation

This nursing statement is an example of the nontherapeutic communication block of requesting an explanation. Requesting an explanation is when the client is asked to provide the reason for thoughts. feelings. behaviors. and events. Asking “why” a client did something or feels a certain way can be very intimidating and implies that the client must defend his or her behavior or feelings.

10. Which of the following individuals are communicating a message? (Select all that apply.)

A mother spanking her son for playing with matches

A teenage boy isolating himself and playing loud music

A biker sporting an eagle tattoo on his biceps

A teenage girl writing. “No one understands me.”

A father checking for new e-mail on a regular basis

The nurse should determine that spanking. isolating. getting tattoos. and writing are all ways in which people communicate messages to others. It is estimated that about 70% to 90% of communication is nonverbal.

Explanation

The nurse should determine that spanking. isolating. getting tattoos. and writing are all ways in which people communicate messages to others. It is estimated that about 70% to 90% of communication is nonverbal.

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