Question 1

When observing and interpreting a patient's nonverbal communication, which nursing consideration is important?

Accepted Answer

Body language has meaning, but meaning cannot be globally ascribed. Validation with the individual is necessary to accurate interpretation. The other options are incorrect.

Question 2

A patient says to the nurse, "My family was mean to me when they visited today. They have no right to treat me like that." Select the nurse's best initial response.

Accepted Answer

Before proceeding, the nurse needs to have a better understanding of what happened in the interaction between the patient and family. The correct option seeks that clarification, whereas none of the other options takes that approach.

Question 3

During a one-on-one interaction with the nurse, a patient frequently looks nervously at the door. Select the best comment by the nurse to this nonverbal cue.

Accepted Answer

Making observations and encouraging the patient to describe perceptions are useful therapeutic communication techniques for this situation. The other responses are assumptions made by the nurse.

Question 4

A patient diagnosed with schizophrenia, paranoid type, frequently gets up and walks away during interactions with a nurse. The nurse can best increase the patient's comfort level by:

Accepted Answer

Suspicious patients require increased personal space. Sitting across the table provides that space. Being at the same eye level fosters communication. Side-by-side placement of chairs might not give the suspicious patient the ability to watch the nurse closely enough for comfort. Being in a closed room might be threatening to the patient.

Question 5

A nurse realizes that the comment just made to a patient was inconsiderate. Select the nurse's most therapeutic statement in this situation.

Accepted Answer

Acknowledging insensitivity and apologizing for it will usually repair damage. Patients usually evaluate the nurse on overall caring rather than on one single comment. None of the other options includes both acknowledgment and apology.

Question 6

A nurse wants to provide opportunities for a patient to try out new, more assertive behaviors. Which technique should the nurse use?

Accepted Answer

Role-playing permits the patient to practice new behaviors in a safe setting and to develop comfort with the use of the new behaviors. The nurse plays a particular role and provides coaching and feedback. The other techniques given as options do not encourage the patient to practice new behaviors.

Question 7

A newly admitted patient asks the nurse, "Can you hear those people laughing at me? They are making fun of me." Select the nurse's best response.

Accepted Answer

This reply acknowledges the patient's perceptions and gently casts doubt on the reality of the patient's conclusions through the use of an "I" statement. It is not argumentative or accusative.

Question 8

During an interview with a depressed patient, the nurse sits with folded arms and fidgets when long silences occur. When the patient expresses hopelessness about getting better, the nurse replies, "You will feel better when your medication takes effect." This interaction:

Accepted Answer

The nurse is demonstrating a closed posture, suggesting lack of interest in the interaction. Fidgeting suggests boredom or lack of comfort during the interaction. The quoted response minimizes the patient's problem and sounds short. Cumulatively, these indicate that the nurse's behaviors are nontherapeutic and ineffective.

Question 9

A patient has difficulty expressing anger appropriately. The nurse encourages the patient to set realistic goals by stating:

Accepted Answer

Goal-setting is most directly related to the technique of asking patients to decide on the type of change needed. The distracters demonstrate making observations and exploring.

Question 10

The nurse tells a patient, "I noticed that you frowned when we discussed your relationship with your family." Which communication technique is the nurse using?

Accepted Answer

Making observations is defined as commenting on what is seen or heard to encourage discussion. The nurse's statement cannot be interpreted as using any of the other techniques listed.

Question 11

Select the best description of therapeutic use of self to provide to a new psychiatric nurse.

Accepted Answer

The correct answer lists several of the components of therapeutic use of self. The other options provide less information for the new nurse to use to continue to develop skills.

Question 12

A patient at the crisis intervention clinic states, "When I got up this morning, I realized I could not go on any longer." Select the nurse's best response to facilitate analyzing the problem and making a nursing diagnosis.

Accepted Answer

Encouraging comparison is a useful technique when the nurse wishes to analyze the problem and draw conclusions to facilitate establishing a nursing diagnosis. None of the other options would be as effective in encouraging the patient to analyze feelings.

Question 13

A common mistake nurses make when developing therapeutic communication techniques is:

Accepted Answer

Giving advice is a common pitfall for nurses who are unsure of how to encourage patients to become involved in analyzing and problem solving. The other options are incorrect, because most novice nurses tend to rely heavily on direct questions, avoid anxiety-producing topics, and focus on communication techniques.

Question 14

A patient states, "I'm tired of all these therapy sessions. It's just too much for me." Using supportive confrontation, the nurse should reply:

Accepted Answer

Supportive confrontation is a technique in which the nurse acknowledges the difficulty in changing, but pushes for action. The other options clarify or give reassurance.

Question 15

A patient's plan of care includes this nursing diagnosis: Impaired verbal communication related to lack of assertiveness skills. To include the patient in prioritizing this problem, the nurse should say:

Accepted Answer

The technique of encouraging evaluation is useful to the nurse who is attempting to interpret meaning and importance. It seeks the patient's view of the situation and provides a basis for setting priorities. The other options are not concerned with priority.

Question 16

Which skill is most important for a nurse preparing to work in the psychiatric setting?

Accepted Answer

Therapeutic communication provides the basis for effective use of each stage of the nursing process, as explained by the authors. The other options are skills basic to effective use of the nursing process.

Question 17

A patient is withdrawn, suspicious, and maintains physical distance from staff and other patients. Which intervention demonstrates appropriate use of touch with this patient?

Accepted Answer

Withdrawn, suspicious patients often consider touch a violation of personal space or might misinterpret touch as being sexual or aggressive. Refraining from touching a suspicious patient is wise until there is evidence that the patient can tolerate touch. The more intimate or extensive the touching, the more threatening it might be to the patient.

Question 18

Effective use of the nursing process is dependent on communication that:

Accepted Answer

Therapeutic communication occurs with the purpose of helping patients. It is patient-centered, structured, and goal-directed. It is not expected to meet the needs of the nurse or to include mutual self-disclosure. These are characteristics of social communication. The nurse maintains objectivity, rather than emotional distance.

Question 19

A patient scheduled to attend various group sessions complains, "I'm really mad about having to attend all those groups. No one else spends all day in a circle in a little room." Select the nurse's best response.

Accepted Answer

This remark exemplifies therapeutic listening. It acknowledges the patient's negative feelings and the nurse's willingness to listen as the patient offers his concerns. It implies a willingness to assist with problem solving. "Why" questions are not therapeutic, because they often elicit rationalization. Justification is defensive and closes off communication.

Question 20

When assessing a patient's social skills, which remark would serve the nurse best?

Accepted Answer

The nurse is seeking clarification, a therapeutic technique that is a useful assessment tool. Mention of assertiveness skill development indicates that the assessment has been made. Asking for the patient's plan would occur during problem solving rather than assessment.

Quiz 8: Learning to Communicate Professionally