Question 1

A female client discusses her feelings of jealousy regarding the relationship between her mother and her daughter.The nurse responds in a nontherapeutic way by making a statement that is defensive and challenging.Which statement is the best example of a defensive and challenging nontherapeutic response?

Accepted Answer

Defensive,challenging statements such as this one will block communication with the client because she will feel that she needs to respond defensively and answer to the nurse for her feelings.The therapeutic communication response that includes a broad opening statement is used when the nurse asks the client to tell more about her feelings.When the nurse tells the client that she should tell the mother and daughter how she feels,it describes giving advice.The nurse uses the nontherapeutic technique of belittling the client when the nurse states that the client's feelings are childish.

Question 2

A nurse has just graduated from nursing school and has been hired on a mental health unit.The nurse wants to practice good communication skills with clients but knows that a mistake made by many new nurses in trying to communicate effectively involves:

Accepted Answer

Parroting is the extreme form of the therapeutic communication skill of restating.It becomes very annoying to clients when the nurse continually repeats the client's statements in an attempt to show understanding of the client's message.The other options are therapeutic communication skills.

Question 3

The client tells the nurse that she believes there is no improvement in her manic episodes.Her clothing matches and her makeup is more subdued.She sits quietly in the chair during the session.What does this indicate?

Accepted Answer

Verbal and nonverbal communication send and receive messages on every interaction.Neither verbal nor nonverbal communication takes priority over the other.In this case the verbal communication of the client that her episodes are not improving is belied by the obvious improvement in her dress and behavior (nonverbal communication).

Question 4

When asking the adolescent client about the magazine she is reading,she responds,"It's an article about my favorite movie star.Did you see all the stars out last night? I used to be afraid of the dark at night." Which speech pattern is this an example of?

Accepted Answer

Loose association is a pattern in which the speaker shifts between loosely related topics such as a movie star,stars in the sky at night,and darkness at night.

Question 5

The nurse asks a client how she is feeling,and the client provides a detailed description of everything she is experiencing.This is an example of:

Accepted Answer

Circumstantiality is a speech pattern in which the client describes in too much detail and cannot be selective.Echolalia is repeating the last word heard,neologism is the coining of new words or expressions,and perseveration is the repeating of a single activity and the inability to shift from one topic to another.

Question 6

A client has difficulty in communicating as a result of his illness.He displays a rapid,confusing delivery of speech patterns.Which term best describes this difficulty in communicating?

Accepted Answer

Rapid,confusing delivery of speech patterns is called speech cluttering and can result in the client's inability to focus on verbal communication as the main form of interaction.Aphasia refers to the inability to speak,dyslexia refers to the mixing of letters when reading that sometimes results in the mixing of syllables when speaking,and incongruent communications occur when verbal messages do not match nonverbal messages.

Question 7

While the nurse is talking with a female client,the client becomes silent for several seconds.Which is the nurse's best response?

Accepted Answer

This is an example of the therapeutic communication technique of silence.It allows the client time to collect her thoughts.Although most people want to talk away the silence,it is important for the caregiver to become comfortable with the effective technique of silence.The three incorrect options prevent silence from occurring.

Question 8

A female client is being discharged from an inpatient mental health unit after receiving treatment for bipolar disorder.She has responded well to treatment but voices concern about going home and maintaining balance in her life.The client would benefit most by a response from the nurse that conveyed the therapeutic communication principle of:

Accepted Answer

A protective response,such as "Let's look together again at what we have planned for you when you go home," will help the client feel more confident in her ability to do well once she is discharged.The other options are examples of therapeutic principles but do not address the needs of this client at this time.

Question 9

Which nurse response is the best example of the therapeutic principle of respect?

Accepted Answer

Although all of these responses are examples of therapeutic principles,this option best describes respect because it shows consideration and acceptance.The other options convey interest,the principle of concreteness,and honesty.

Question 10

The nurse is talking with a male client regarding his recent relapse of alcohol addiction.The client alludes to the fact that he started to drink again after a fight with his wife.The nurse uses clarification to ensure an accurate understanding of the client.Which statement is the best example of clarification?

Accepted Answer

Clarification helps to confirm feelings,ideas,and perceptions.The other options are examples of restating,focusing,and changing the topic.

Question 11

The nursing student is assigned a client to interview and is asked to practice the therapeutic communication technique of sharing perceptions.Which statement made by the student nurse best describes this technique?

Accepted Answer

Sharing perceptions lets the client know that you are listening and ensures that you understand what he or she is communicating.Asking the client to describe how he or she feels when arguing with his or her daughter describes focusing.Speaking to the client about the plan of care describes informing,and the nursing student is using clarification when asking whether he or she understands the client correctly.

Question 12

A female client has been attending group therapy for support regarding an abusive relationship with her husband.The client voices concern about her 10-year-old daughter growing up in this environment but states that she just can't find the strength to leave her husband.The nurse responds by using the nontherapeutic technique of reassuring.Which statement is the best example of this nontherapeutic technique?

Accepted Answer

This is an example of the nontherapeutic technique of falsely reassuring the client.It dismisses the client's concerns and does not support her.The nurse is showing disapproval in stating that she "can't believe" that the client would want her daughter to grow up in such an environment.The nurse gives an appropriate therapeutic statement when she acknowledges the client's concern and then provides the client with helpful information.The nurse is giving advice in offering her thoughts that the client should just leave.

Question 13

Which elements must be present for communication to occur? (Select all that apply. )

Accepted Answer

Feedback,transmission,sender,receiver,and context are the five elements that must be in place for communication to occur.The sender transmits the message to the receiver,resulting in feedback between them.The context,or setting,is where the communication takes place.Clarification and focusing are types of therapeutic communication.

Question 14

When practicing therapeutic communication with a client,the nurse demonstrates which of the following listening skills?

Accepted Answer

Effective listening improves the ability to meet client needs.Changing the environment to decrease distractions is a practice important to listening skills.Finishing the client's sentences,not clarifying messages,and avoiding taking notes are barriers to listening and may prevent the nurse from picking up hidden messages,minimizing misunderstandings.

Question 15

A client who usually is very active in her therapy group tells the nurse that she really does "not feel well today" and would "rather not attend the group therapy session." Which is the nurse's most appropriate response?

Accepted Answer

The nurse is restating what the client said,which verifies what the client communicated and lets the client know that the nurse listened and understood her.The client did not ask the nurse to sit with her,so this action is inappropriate.Telling the client that it is okay to skip a session is giving advice and is not conveying an understanding of what the client really said.Asking the client why she doesn't want to attend group therapy clearly conveys that the nurse did not listen to what the client communicated.

Question 16

Therapeutic communication techniques support effective communication between the client and the nurse.Which group of therapeutic techniques is most likely to be effective when one is conversing with a client?

Accepted Answer

The techniques of listening,silence,and reflection are all therapeutic.Advising,confronting,and reassuring are all examples of nontherapeutic techniques.

Question 17

The nurse's ability to interpret communication effectively in the mental health setting depends mostly on:

Accepted Answer

Accurate interpretation of the client's communication cannot occur if the nurse does not listen to and observe the client.It is not dependent on how well the client communicates because the nurse has no control over the client.The nurse's relationship with the client and understanding of mental health disorders are important but will not supersede good observation and listening.

Question 18

The theorist Eric Berne theorized that an individual's three ego states of parent,child,and adult make up one's:

Accepted Answer

The three ego states,according to Berne,make up an individual's personality.The parent ego focuses on rules and values,the child ego focuses on emotions and desires,and the focal point of the adult ego is previous observations.He did not address any of the other three options.

Question 19

The nurse is talking with a male client with a diagnosis of schizophrenia who often experiences auditory hallucinations.For this communication to be most effective,the nurse should:

Accepted Answer

Because this client has been given the diagnosis of schizophrenia and frequently has auditory hallucinations,his perception of the communication must be considered.Use of simple,concrete language will assist the client in following the conversation without having to interpret what the nurse means during the interaction.Encouraging the client not to verbalize and doing most of the talking do not allow the client to express himself,and discussing several different topics will be confusing and may cause the client undue stress during the interaction.

Question 20

A male client with a diagnosis of schizophrenia begins to have hallucinations during a conversation with the nurse;this prevents him from receiving the message that the nurse is trying to communicate to him.According to Ruesch's theory of communication,this unsuccessful interaction is called:

Accepted Answer

Ruesch called this type of interrupted communication disturbed communication.In addition to interference with receiving a message,as in the case of this client,the term applies to interference with the sending of messages,problems in language between people,insufficient information,and lack of the opportunity for feedback.Ruesch's theory did not coin the term nontherapeutic or blocked communication,and this interaction would not be considered therapeutic.

Quiz 10: Therapeutic Communication