Question 1

During the first interview with a parent whose child died in a car accident, the nurse feels empathic and reaches out to take the patient's hand. Select the correct analysis of the nurse's behaviour.

Accepted Answer

The gesture is premature because the nurse does not yet know the patient's cultural and individual interpretation of touch, which could affect how the gesture is received.

Question 2

When a female Indigenous patient and a female nurse sit together, the patient often holds the nurse's hand. The patient also links arms with the nurse when they walk. The nurse is uncomfortable with this behaviour. Which analysis is most accurate?

Accepted Answer

Many Indigenous cultures have norms that include touch as a part of communication and relationship-building, which may explain the patient's behavior.

Question 3

A school-age child tells the school nurse, "Other kids call me mean names and will not sit with me at lunch. Nobody likes me." Select the nurse's most therapeutic response.

Accepted Answer

The most therapeutic response is to allow the child to express their feelings and concerns. Asking the child to share more about how they feel can help the nurse better understand and address the issue. A and C are dismissive and may not address the underlying problem. B places the responsibility solely on the child, and may not be possible or realistic for them to do without additional assistance.

Question 4

An Indigenous patient had a nursing diagnosis of situational low self-esteem related to poor social skills as evidenced by lack of eye contact. Interventions were used to raise the patient's self-esteem, but after 3 weeks, the patient's eye contact did not improve. What is the most accurate analysis of this scenario?

Accepted Answer

The patient's lack of eye contact may be culturally appropriate and not indicative of low self-esteem. Cultural assessment is crucial to avoid misinterpretation of behaviors.

Question 5

Documentation in a patient's chart shows, "Throughout a 5-minute interaction, patient fidgeted and tapped left foot, periodically covered face with hands, and looked under chair while stating, 'I enjoy spending time with you.'" Which analysis is most accurate?

Accepted Answer

The patient's verbal message of enjoying the interaction is incongruent with their nonverbal behaviors, which suggest discomfort or anxiety.

Question 6

A patient is having difficulty making a decision. The nurse has mixed feelings about whether to provide advice. Which principle usually applies?

Accepted Answer

Giving advice is rarely helpful because it can undermine the patient's autonomy and ability to make independent decisions, which is crucial for their personal growth and self-efficacy.

Question 7

A black patient says to a white nurse, "There's no sense talking. You wouldn't understand because you live in a white world." Which of the following would be the nurse's best action?

Accepted Answer

This response invites the patient to share their experiences and feelings, showing that the nurse is open to understanding and learning from the patient's perspective.

Question 8

Which principle should guide the nurse in determining the extent of silence to use during patient interview sessions?

Accepted Answer

The principle that should guide the nurse in determining the extent of silence to use during patient interview sessions is that silence can provide meaningful moments for reflection. While the nurse is responsible for breaking silences, patients may not necessarily withdraw if silences are prolonged. Additionally, while silence can help patients know that what they said was understood, this should not be the primary principle guiding the extent of silence used during patient interviews.

Question 9

While talking with a patient diagnosed with major depression, a nurse notices the patient is unable to maintain eye contact. The patient's chin lowers to the chest, while the patient looks at the floor. Which aspect of communication has the nurse assessed?

Accepted Answer

The nurse has assessed the patient's nonverbal communication, which includes body language such as avoiding eye contact and looking at the floor.

Question 10

During an interview, a patient attempts to shift the focus from self to the student nurse by asking personal questions. The student nurse should respond by saying:

Accepted Answer

The student nurse should gently redirect the focus back to the patient by emphasizing that the purpose of their time together is to address the patient's concerns, maintaining professional boundaries.

Question 11

A patient discloses several concerns and associated feelings. If the nurse wants to seek clarification, which comment would be appropriate?

Accepted Answer

Asking for clarification through restating and summarizing what the patient has said is an effective technique for ensuring that the nurse has understood the patient's concerns correctly. This can also help the patient feel heard and validated. Choice B may be seen as dismissive or uninterested, while Choice A and D are vague and may not lead to clarification.

Question 12

The patient says, "My marriage is just great. My spouse and I always agree." The nurse observes the patient's foot moving continuously as the patient twirls a shirt button. The conclusion the nurse can draw is that the patient's communication is which of the following?

Accepted Answer

The patient's verbal communication (saying the marriage is great) is contradicted by non-verbal cues (foot moving continuously and twirling a button), indicating mixed communication.

Question 13

A patient diagnosed with schizophrenia tells the nurse, "The CIA is monitoring us through the fluorescent lights in this room. Be careful what you say." Which response by the nurse would be most therapeutic?

Accepted Answer

The nurse's response acknowledges the patient's concerns and shows empathy without agreeing or disagreeing with the delusion. It is important to maintain a therapeutic relationship and avoid confrontation with the patient's beliefs. Redirecting the conversation or dismissing the delusion could cause the patient to become defensive or mistrusting of the nurse. Option C is not entirely accurate as the CIA can operate within the bounds of the law, and option D is confrontational and dismissive of the patient's experience.

Question 14

A patient with acute depression states, "God is punishing me for my past sins." What is the nurse's most therapeutic response?

Accepted Answer

The most therapeutic response is to acknowledge the patient's feelings without challenging or dismissing them. Option A shows empathy and validation of the patient's emotions. Option B may be perceived as dismissive or platitudinous. Option C may be interpreted as confrontational or probing. Option D assumes the patient is religious or has a minister and may not address the patient's immediate emotional distress.

Question 15

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

Accepted Answer

This comment acknowledges the nonverbal communication and shows that the nurse is paying attention to the patient's behavior. It allows the patient to express any concerns or discomfort they may have about the situation without assuming anything.

Question 16

An Italian Canadian patient uses dramatic body language when describing emotional discomfort. Which analysis most likely explains the patient's behaviour?

Accepted Answer

In some cultures, including Italian culture, expressive body language is a common way to communicate emotions. This behavior is likely a cultural norm rather than a sign of a disorder or an attempt to impress.

Question 17

Which technique will best communicate to a patient that the nurse is interested in listening?

Accepted Answer

Restating a feeling or thought the patient has expressed shows active listening and understanding, encouraging the patient to share more.

Question 18

A patient says to the nurse, "I dreamed I was stoned. When I woke up, I felt emotionally drained, as though I hadn't rested well." Which response should the nurse use to clarify the patient's comment?

Accepted Answer

The nurse should ask for clarification about the meaning of "stoned" to ensure that they fully understand what the patient is describing before responding. This will allow the nurse to provide an appropriate and accurate response. The other options make assumptions about what the patient is feeling and may not fully address their concerns.

Question 19

A patient tells the nurse, "I don't think I'll ever get out of here." Select the nurse's most therapeutic response.

Accepted Answer

This response acknowledges the patient's statement and allows them to further express their feelings about their progress. It also opens up the opportunity for the nurse to discuss specific ways in which the patient may be making progress. Option A is dismissive and may invalidate the patient's feelings, Option B is a positive affirmation but does not address the patient's statement, and Option D may minimize the patient's feelings by suggesting that everyone feels the same way even if it's not true.

Question 20

A nurse interacts with a newly hospitalized patient. Select the nurse's comment that applies the communication technique of "offering self."

Accepted Answer

Option D, "I'd like to sit with you for a while to help you get comfortable talking to me," is the only comment that offers the nurse's presence and support to the patient, demonstrating the communication technique of "offering self." The other options do not show the nurse offering their presence or support to the patient.

Quiz 10: Communication and the Clinical Interview