Therapeutic Communication Mental Health Nursing Townsend Test Bank Chapter 7

29 August 2024

106

Chapter 7. Therapeutic Communication

The rest of the chapters can be found in this test bank: Test Bank for Davis Advantage for Psychiatric Mental Health Nursing 10th Edition Townsend

MULTIPLE CHOICE

1. Which therapeutic communication technique is being used in this nurse-client interaction?

Client: “When I get angry, I get into a fistfight with my partner or I take it out on the

kids.”

Nurse: “I notice that you are smiling as you talk about this physical violence.”

1. Encouraging comparison

2. Exploring

3. Formulating a plan of action

4. Making observations

ANS: 4

Objective: Describe therapeutic and nontherapeutic verbal commaubirbi.ccaomti/otensttechniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. The nurse is using the therapeutic communication technique of making observations by noting that the client smiles when talking about physical violence. The technique of making observations encourages the client to compare personal perceptions with those of the nurse. Encouraging comparison is a therapeutic technique that involves asking the client to compare similarities and differences in ideas, experiences, or interpersonal relationships.
2.	This is incorrect. The nurse is using the therapeutic commuabniirbc.acotimo/ntesttechnique of making observations by noting that the client smiles when talking about physical violence. The technique of making observations encourages the client to compare personal perceptions with those of the nurse.


3.	This is incorrect. The nurse is using the therapeutic communication technique of making observations by noting that the client smiles when talking about physical violence. The technique of making observations encourages the client to compare personal perceptions with those of the nurse. Formulating abpirbla.cnoma/stessitsts the client in making a plan to prevent anger or anxiety from escalating.

4. This is correct. The nurse is using the therapeutic communication technique of making observations by noting that the client smiles when talking about physical violence. The technique of making observations encourages the client to compare personal perceptions with those of the nurse.

CON: Communication

2. Which therapeutic communication technique is being used in this nurse-client

interaction?

Client: “My father spanked me often.”

Nurse: “Your father was a harsh disciplinarian.”

1. Restating

2. Offering general leads

3. Focusing

4. Accepting

ANS: 1

Objective: Describe therapeutic and nontherapeutic verbal commaubirbi.ccaomti/otensttechniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	/test
1.	This is correct. The nurse is using the therapeutic communication technique of restating. Restating involves repeating the main idea of what the client has said. The nurse uses this technique to communicate that the client’s statement has been heard and understood. /test
1.
2.	This is incorrect. The nurse is using the therapeutic communication technique of restating. Restating involves repeating the main idea of what the client has said. The nurse uses this technique to communicate that the client’s satbairtbe.cmome/ntetsthas been heard and understood. Offering general leads to the client encourages the client to continue.
3.	This is incorrect. The nurse is using the therapeutic communication technique of restating. Restating involves repeating the main idea of whaabtirbth.ceomc/lteiestnt has said. The nurse uses this technique to communicate that the client’s statement has been heard and understood. Focusing is when the nurse notices a single idea or even a single word and works especially well with a client who is movinagbirrba.cpoimd/ltestfrom one thought to another. Focusing is not therapeutic with a client who is very anxious.

Feedback

4. This is incorrect. The nurse is using the therapeutic communication technique of restating. Restating involves repeating the main idea of what the client has said. The nurse uses this technique to communicate that the client’s statement has been heard and understood. Accepting conveys an attitude of receptionabairnb.dcorme/tgeastrd.

CON: Communication

3. Which therapeutic communication technique is being used in this nurse-client
interaction?
Client: “When I am anxious, the only thing that calms me down is alcohol.”
Nurse: “Other than drinking, what alternatives have you explored to decrease anxiety?”

1. Reflecting

2. Making observations

3. Formulating a plan of action

4. Giving recognition

ANS: 3

Objective: Describe therapeutic and nontherapeutic verbal commaubirbi.ccaomti/otensttechniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	/test
1.	This is incorrect. The nurse is using the therapeutic communication technique of formulating a plan of action to help the client explore alternatives to drinking alcohol. The use of this technique, rather than direct confrontation regarding the client’s poor coping choice, may serve to prevent anger oraabnirbx.iceotmy/tefsrtom escalating. Reflecting involves referring questions and feelings back to the client so that they may be recognized and accepted and so that the client may recognize that his or her point of view has value. /test
1.
2.	This is incorrect. The nurse is using the therapeutic communication technique of formulating a plan of action to help the client explore alternatives to drinking alcohol. The use of this technique, rather than direct confrontation regarding the client’s poor coping choice, may serve to prevent anger oraabnirbx.iceotmy/tefsrtom escalating. Making observations involves verbalizing what is observed or perceived and encourages the client to recognize specific behaviors and compare perceptions with the nurse. /test
3.	This is correct. The nurse is using the therapeutic communication technique of

Feedback

formulating a plan of action to help the client explore alternatives to drinking alcohol. The use of this technique, rather than direct confrontation regarding the client’s poor coping choice, may serve to prevent anger or anxiety from escalating.

This is incorrect. The nurse is using the therapeutic commuabniirbc.acotimo/ntesttechnique of formulating a plan of action to help the client explore alternatives to drinking

alcohol. The use of this technique, rather than direct confrontation regarding the client’s poor coping choice, may serve to prevent anger oraabnirbx.iceotmy/tefsrtom escalating. Giving recognition is acknowledging and indicating the client’s awareness.

CON: Communication

4. The nurse is interviewing a newly admitted psychiatric client. aWbirhb.iccohm/nteustrsing statement is an example of offering a general lead?

1. “Do you know why you are here?”

2. “Are you feeling depressed or anxious?”

3. “Yes, I see. Go on.

4. “Can you chronologically order the events that led to your admission?”

ANS: 3

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. The question “Do you know why you are here?” is not an example of offering a general lead. Offering a general lead encouragabeisrb.tchoem/ctelsiet nt to continue sharing information with minimal input from the nurse.
2.	This is incorrect. The question “Are you feeling depressed or anxious?” is not an example of offering a general lead. Offering a general leadabeinrbc.cooumr/taegstes the client to continue sharing information with minimal input from the nurse.
3.	This is correct. The nurse’s statement is an example of the therapeutic communication technique of a general lead. Offering a general lead encourages the client to continue sharing information.
4.	This is incorrect. The question “Can you chronologically order the events that led to your admission?” is not an example of offering a general lead. Offering a general lead encourages the client to continue sharing information awbiirbth.comm/itnesitmal input from the nurse.

CON: Communication

5. A nurse states to a client, “Things will look better tomorrow after a good night’s

sleep.” This is an example of which communication technique?

1. The nontherapeutic technique of “giving advice”

2. The therapeutic technique of “formulating a plan of action”

3. The therapeutic technique of “presenting reality”

4. The nontherapeutic technique of “giving false reassurance”

ANS: 4

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 129

Heading: Nontherapeutic Communication Techniques > Table 7–3 Nontherapeutic

Comunication Techniques

Integrated Processes: Caring

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. The nurse’s statement is an example of the nontherapeutic technique of giving false reassurance. Giving false reassurance indicates to the client that there is no cause for anxiety, thereby devaluing the cliaebnirtb’.scofme/etelsitngs. Giving advice is the nontherapeutic technique of telling the client what to do or how to behave and implies that the nurse knows what is best and that the client is incapable of any self-direction.
1.
2.	This is incorrect. The nurse’s statement is an example of the nontherapeutic technique of giving false reassurance. Giving false reassurance indicates to the client that there is no cause for anxiety, thereby devaluing the client’s feelings. Formulating a plan of action encourages a client to identifyabairbp.cloamn/tfeostr behavior change.
3.	This is incorrect. The nurse’s statement is an example of the nontherapeutic technique of giving false reassurance. Giving false reassurabnircbe.coinmd/teicstates to the client that there is no cause for anxiety, thereby devaluing the client’s feelings. Presenting reality is the therapeutic technique used to define reality when a client has a misperception of the environment.
4.	This is correct. The nurse’s statement is an example of theanboirbn.cthomer/taespteutic technique of giving false reassurance. Giving false reassurance indicates to the client that there is no cause for anxiety, thereby devaluing the client’s feelings.

CON: Communication

6. A client diagnosed with posttraumatic stress disorder is admittaebdirbt.ocoamn/teisnt patient psychiatric unit for evaluation and medication stabilization. Which utterance made by the nurse is an example of a broad opening?

1. “What occurred prior to the traumatic event, and when did youabgirob.ctoomt/theest emergency department?”

2. “What would you like to talk about?”

3. “I notice you seem uncomfortable discussing this.”

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

ANS: 2

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1. 2.	This is incorrect. The nurse’s question “What occurred prior to the traumatic event, and when did you go to the emergency department?” is an example of the therapeutic communication technique of placing the event aibnirbti.cmome/toest sequence. 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. This is correct. The nurse’s question “What would you likeabtiorb.tcaolmk/teasbt out?” 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.
1. 2.
3.	This is incorrect. The nurse’s statement “I notice you seemabuirnbc.com/tfeostrtable discussing this” is an example of the therapeutic communication technique of making observations. Using a broad opening allows the client to take the initiative in introducing the topic and emphasizes the importance of theabcirlbi.econmt’/tsesrtole in the interaction.
4.	This is incorrect. The nurse’s question “How can we help you feel safe during your stay here?” is an example of the therapeutic communication technique of formulating a plan of action. Using a broad opening allowsabtihrbe.ccomli/etenstt to take the initiative in introducing the topic and emphasizes the importance of the client’s role in the interaction.

CON: Communication

7. A nurse is assessing a client diagnosed with schizophrenia foratbhireb.pcormes/teesnt ce of

hallucinations. Which therapeutic communication technique used by the nurse is an example of making observations?

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

2. “Please describe what you are seeing.”

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

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

ANS: 1

Objective: Describe therapeutic and nontherapeutic verbal commaubirbi.ccaomti/otensttechniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is correct. The nurse is making an observation when stating, “You appear to be talking to someone I do not see.” Making observations involves verbalizing what is observed or perceived. This encourages the client to recognize specific behaviors and make comparisons with the nurse’s perceptions. /test
2.	This is incorrect. The statement “Please describe what you are seeing” is an example of offering general leads.
3.	This is incorrect. The question “Why do you continually loaobikrb.icnomth/testcorner of this room?” is an example of the nontherapeutic technique of requesting an explanation, which can be intimidating.
4.	This is incorrect. The statement “If you hum a tune, the voices may not be so distracting” is an example of the nontherapeutic techniqueaobfirbg.ciovmin/tegstadvice.

CON: Communication

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

1. S

2. O

3. L

4. E

ANS: 2

Objective: Identify components of nonverbal expression. Page: 131

Heading: Active Listening

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Easy

includes sitting squarely facing the client (S), open posture when interacting with the

1.	Feedback This is incorrect. The S in the acronym SOLER stands for asbiitrtbi.ncogms/tqesutarely facing the client.

2.	This is correct. The nurse’s uncrossed arm and leg posture is nonverbal behavior that
3.	reflects the O in the active-listening acronym SOLER. The acronym SOLER

	client (O), leaning forward toward the client (L), establishing eye contact (E)
	relaxing (R).
	the client.
4.	(E).

, and

This is incorrect. The L in the acronym SOLER stands for albeiarbn.cionmg/tefostrward toward

This is incorrect. The E in the acronym SOLER stands for establishing eye contact

CON: Communication

9. Which action by the nurse, who is first meeting a client, would likely send a nonverbal message that is inappropriate for the therapeutic relatioabnirsbh.ciopm?/test

1. The nurse provides eye contact intermittently during the meeting.

2. The nurse is dressed in business casual attire; a tattoo is visible.

3. The nurse offers a handshake during initial interaction with the client.

4. The nurse gives a client a strong hug at the end of the meetinga.birb.c

ANS: 4

Objective: Identify components of nonverbal communication. Page: 125

Heading: Nonverbal Communication

Integrated Processes: Caring

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. The nurse who provides intermittent eye contact is demonstrating interest in the client.
1.
2.	This is incorrect. The nurse is presenting oneself in a professional manner. Many dress codes allow visible tattoos. While these may be perceived differently by individuals, tattoos are generally acceptable.
2.
3.	This is incorrect. Offering a handshake during the first meeting demonstrates a socially polite behavior that is accepting of the client.
4.	This is correct. A strong hug is typically a gesture that demonstrates an attraction or attachment to another person and is inappropriate for establishing a therapeutic relationship.

CON: Communication

10. 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?

1. Giving approval

2. Interpreting

3. Presenting reality

4. Making observations

ANS: 1

Objective: Describe therapeutic and nontherapeutic verbal commaubirbi.ccaomti/otensttechniques. Page: 128

Heading: Nontherapeutic Communication Techniques > Table 7–3 Nontherapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is correct. 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.

2.	This is incorrect. 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 “goaboirdb.”coomr/t“esbtad.” This creates a conditional acceptance of the client. Interpreting is a nontherapeutic

	technique in which the therapist seeks to make conscious that which is unconscious, telling the client the meaning of his or her experience.
3.	This is incorrect. The group leader has employed the nontherapeutic technique of giving approval. Giving approval implies that the nurse hasabtirhbe.cormig/thesttto pass judgment on whether the client’s ideas or behaviors are “good” or “bad.” This creates a conditional acceptance of the client. Presenting reality is the therapeutic technique used to define reality when a client has a misperacbeirpbt.ciomn/toesft the environment.
4.	This is incorrect. 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 “goaboirdb.”coomr/t“esbtad.” This creates a conditional acceptance of the client. Making observations involves verbalizing what is observed or perceived and encourages the client to recognize specific behaviors and compare perceptions with the nursea.birb.c

CON: Communication

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

1. To provide the client with good advice

2. To advise the client on appropriate behaviors

3. To evaluate the client’s behavior

4. To give the client critical information

est

ANS: 4

Chapter: Chapter 7 Therapeutic Communication

Objective: Discuss therapeutic feedback. Page: 131

Heading: Feedback

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity

Cognitive Level: Comprehension [Understanding] Concept: Communication

Feedback

Difficulty: Easy

1. This is incorrect. The purpose of providing appropriate feeadbbirba.ccokmi/stestot give the client critical information. Feedback should not be used to give advice.

critical information. Feedback should not be used to evaluate behaviors.

2. This is incorrect. The purpose of providing appropriate feedback is to give the client

3. This is incorrect. The purpose of providing appropriate feeadbbirba.ccokmi/stestot give the client critical information. Feedback should not be used to evaluate behaviors.

/test

4. This is correct. The purpose of providing appropriate feedback is to give the client critical information. Feedback should not be used to give aadbvirbic.ceomo/rteestvaluate behaviors.

CON: Communication

12. The nurse is providing therapeutic feedback to a client who exhibited an angry outburst in a group setting. Which is appropriate for the nurse to asbairyb.ctomt/hteestclient?

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

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

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

4. “During group, you raised your voice, yelled at a peer, and slaambimrb.ecodmt/hteest door.”

ANS: 4

Chapter: Chapter 7 Therapeutic Communication

Objective: Discuss therapeutic feedback. Page: 131

Heading: Feedback

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. This feedback does not help the client consider how to modify behavior. This approach will likely put the client in a defensive position and is not a therapeutic response.
2.	This is incorrect. This feedback is nontherapeutic and demaobnirsbt.croamte/tsesjtudgment. The nurse is not allowing the client the opportunity to consider how to modify his or her behavior.
3.	This is incorrect. This is a judgmental response that does naobtirbp.rcomv/itdeset the client the opportunity to modify his or her behavior. This response is likely to alienate the client or put the client in a defensive position, which is not therapeutic.
4.	This is correct. The nurse is providing appropriate feedback when stating, “During group, you raised your voice, yelled at a peer, and slammeadbitrhb.ecodmo/toesrt.” 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 or used to give aadbivrbi.ccoem. /test

CON: Communication

13. A client diagnosed with dependent personality disorder states, “Do you think I should move out of my parents’ house and get a job?” Which nurasbiirnbg.corme/stepsot nse is most appropriate?

1. “It would be best to do that to increase independence.”

2. “Why would you want to leave a secure home?”

3. “Let’s discuss and explore all of your options.”

4. “I’m afraid you would feel very guilty leaving your parents.”

ANS: 3

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. The statement “It would be best to do that to increase independence,” is an example of the nontherapeutic technique of advice giving.
2.	This is incorrect. The question “Why would you want to leaabvirbe.caomse/tecsut re home?” is an example of the nontherapeutic technique of requesting an explanation, which can be intimidating.
3.	This is correct. The most appropriate response by the nurseabiisrb,.c“oLme/tte’sst discuss and explore all of your options.” In this example, the nurse is encouraging the client to formulate ideas and decide independently the appropriate course of action.
4.	This is incorrect. The statement “I’m afraid you would feel very guilty leaving your parents” is an example of the nontherapeutic technique of gabivirbi.ncogma/tdesvtice and implies that the nurse knows what is best and that the client is incapable of any self- direction.

CON: Communication

14. Why is it important for the nurse to demonstrate active listening during a client interaction?

1. The client will be able to understand the nurse’s instructions baebtitreb.rc.

2. The client will feel a sense of trust and acceptance by the nurse.

3. The client will change his or her behavior if active listening is used.

4. The client will be able to provide feedback to the nurse for improvement.

ANS: 2

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe active listening. Page: 131

Heading: Active Listening

Integrated Processes: Nursing Process: Planning

Client Need: Psychosocial Integrity

Cognitive Level: Comprehension [Understanding] Concept: Patient-Centered Care

Difficulty: Moderate

	Feedback
1.	This is incorrect. Active listening does not necessarily improve the client’s ability to understand or follow the nurse’s instructions.
2.	This is correct. Active listening conveys acceptance of theacbliribe.ncotma/ntedst helps to develop trust between the nurse and client.
3.	This is incorrect. Active listening is a part of motivational interviewing but it is not the entire process that would assist in changing the client’sabirebh.caovmi/oters.t
4.	This is incorrect. Active listening does not allow for the client to give the nurse feedback for improvement. A process recording is used for this purpose.

CON: Patient-Centered Care

15. A mother rescues two of her four children from a house fire. In an emergency
department, she cries, “I should have gone back in to get them. I should have died, not
them.” Which of the following responses by the nurse is an examapbilreb.coofmr/teefsltection?

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

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

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

4. “It’s best if you try not to think about what happened. Try to maboirvbe.coomn/.te”st

ANS: 2

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal communication techniques.

Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

Feedback

This is incorrect. The response “The smoke was too thick. You couldn’t have gone

back in” utilizes the nontherapeutic communication technique of disagreeing, which

implies inaccuracy and provokes the need for the client to abbeirbd.ceofme/ntessitve.

This is correct. The best response by the nurse is, “You’re feeling guilty 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 thabtirtbh.ceoym/mtesaty be recognized and accepted.

This is incorrect. The response “Focus on the fact that you could have lost all four of

your children” utilizes the nontherapeutic communication taebcirbh.ncoimq/teestof giving

advice, which implies that the nurse knows what is best and discourages independent thinking.

This is incorrect. The response “It’s best if you try not to think about what happened. Try to move on” utilizes the nontherapeutic communicatioanbitreb.cchomn/itqesut e of giving advice, which implies that the nurse knows what is best and discourages independent thinking.

CON: Communication

16. A newly admitted client diagnosed with obsessive-compulsive disorder (OCD) washes her hands continually. This behavior prevents her from attending unit activities. Which nursing statement made to the client best addresses this siatbuirabt.icoomn?/test

1. “Everyone diagnosed with OCD needs to control their ritualistic behaviors.”

2. “It is important for you to discontinue these ritualistic behaviors.”

3. “Why are you asking for help if you won’t participate in unit tahbeirrba.cpoym?/t”est

4. “Let’s figure out a way for you to attend unit activities and still wash your hands.”

ANS: 4

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Tabhierbr.acopme/utetsitc

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. The statement “Everyone diagnosed with OCD needs to control their ritualistic behaviors” reflects the nontherapeutic communication technique of giving advice. /test
2.	This is incorrect. The statement “It is important for you to discontinue these ritualistic behaviors” is an example of the nontherapeutic technique of giving advice.
3.	This is incorrect. The question “Why are you asking for healbpirbi.coymo/uteswt on’t participate in unit therapy?” is an example of the nontherapeutic technique of requesting an

explanation, which can be intimidating.

This is correct. The most appropriate statement by the nurse is, “Let’s figure out a way for you to attend unit activities and still wash your hands.” This statement

reflects the therapeutic communication technique of formualbaitrbin.cgoma/tepsltan of action. The nurse attempts to work with the client to develop a plan without damaging the

therapeutic relationship or increasing the client’s anxiety.

CON: Communication

17. Which example of a therapeutic communication technique would be most effective in the planning phase of the nursing process?

1. “We’ve discussed past coping skills. Let’s see if these coping asbkiribll.csomca/tnestbe effective

now.”

2. “Please tell me in your own words what brought you to the hospital.”

3. “This new approach worked for you. Keep it up.”

4. “I noticed that you seem to be responding to voices that I do not hear.”

ANS: 1

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Tahbierbr.acopme/utetsitc

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is correct. The nurse’s statement “We’ve discussed past coping skills. Let’s see if these coping skills can be effective now” is an example of the therapeutic communication technique of formulating a plan of action. Tabhiribs.cotemc/thesntique can help the client plan in advance to deal with a stressful situation, which may prevent anger and/or anxiety from escalating to an unmanageable level.
2.	This is incorrect. The nurse’s statement “Please tell me in yaboirub.comw/tnestwords what brought you to the hospital” is an example of the therapeutic communication technique of exploring. This technique is not most effective during the planning phase.
3.	This is incorrect. The nurse’s statement “This new approacahbirwb.coormk/etedstfor you. Keep it up” is an example of the nontherapeutic communication technique of giving advice.
4.	This is incorrect. The nurse’s statement “I noticed that you seem to be responding to voices that I do not hear” is an example of the therapeutic caboirmb.cmomu/nteisctation technique of presenting reality. This technique can help the client who has a misperception of

the environment but is not especially effective during the planning phase.

CON: Communication

18. A client tells the nurse, “I feel like my mother does not want ambireb.tcoomr/etetustrn home after

I leave the hospital.” Which nursing response is therapeutic?

1. “It’s quite common for clients to feel that way after a lengthy hospitalization.”

2. “Why don’t you talk to your mother? You may find out she doesn’t feel that way.”

3. “Your mother seems like an understanding person. I’ll help yoaubirabp.cpormo/taecsth her.”

4. “You feel that your mother does not want you to come back home?”

ANS: 4

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Tabhierbr.acopme/utetsitc

Communication Techniques

Integrated Processes: Caring

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. The nurse’s statement “It’s quite common for clients to feel that way after a lengthy hospitalization” is an example of the noabnirtbh.ceorma/pteesut tic communication technique of belittling or minimizing feelings.
2.	This is incorrect. The nurse’s question “Why don’t you talk to your mother? You may find out she doesn’t feel that way” is an example of thaebirnbo.cnomth/tesrtapeutic communication technique of giving advice.
3.	This is incorrect. The nurse’s statement “Your mother seems like an understanding person. I’ll help you approach her” is an example of the nontherapeutic communication technique of giving false reassurance.
3.
4.	This is correct. The nurse’s question “You feel that your mother does not want you to come back home?” is an example of the therapeutic communication technique of restating. Restating is the repeating of the main idea the cliaebnirtb.hcoams/tvesetrbalized and lets the client know whether the statement has been understood and gives him or her the chance to continue or clarify if necessary.

CON: Communication

19. Which feature distinguishes motivational interviewing from other therapeutic techniques?

1. Motivational interviewing establishes a contract for change.

2. Motivational interviewing is the only patient-centered commuanbiicrba.tcioomn/tessttrategy.

3. Motivational interviewing allows the nurse to inform the client’s choices.

4. Motivational interviewing focuses on what the client wants.

ANS: 4

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe motivational interviewing as a communication strategy.

Page: 131

Heading: Motivational Interviewing

Integrated Processes: Nursing Process: Intervention

Client Need: Psychosocial Integrity

Cognitive Level: Comprehension [Understanding] Concept: Communication

Difficulty: Easy

	Feedback
1.	This is incorrect. Motivational interviewing does not use a contract for change in and of itself, it focuses on the client’s motivation to change.
2.	This is incorrect. Motivational interviewing is one of several patient-centered approaches.
3.	This is incorrect. Motivational interviewing does not rely oanbirtbh.ceomn/utersste informing the client of his/her choices; it focuses on the client’s choices.
4.	This is correct. Motivational interviewing promotes behavior change by focusing on what the client wants.

CON: Communication

20. Which nursing statement is a good example of the therapeutic communication technique of giving recognition?

1. “You did not attend group today. Can we talk about that?”

2. “I’ll sit with you until it is time for your family session.”

3. “I noticed you are wearing a new dress and have washed your hair.”

4. “I’m happy that you are now taking your medications. They waibllirbr.ecoamll/ytesht elp.”

ANS: 3

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal commaubirbi.ccaomti/otensttechniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Easy

	Feedback
1.	This is incorrect. The nurse’s question “You did not attendabgirbo.cuopm/ttoesdt ay. Can we talk about that?” is an example of the therapeutic communication techniques of making observations and exploring.
2.	This is incorrect. The nurse’s statement “I’ll sit with you until it is time for your family session” is an example of the therapeutic communicaabitribo.cnomte/tceshtnique of offering self.
3.	This is correct. This statement is an example of the therapeutic communication technique of giving recognition. Giving recognition acknowablirebd.cgomes/teasnt d indicates awareness. This technique is more appropriate than complimenting the client, which reflects the nurse’s judgment.
4.	This is incorrect. The nurse’s statement “I’m happy that yoaubirabr.ceomn/otewst taking your medications. They will really help” is an example of the nontherapeutic communication technique of giving approval.

CON: Communication

21. A client is trying to explore and solve a problem. Which nursing statement is an

example of verbalizing the implied?

1. “You seem to be motivated to change your behavior.”

2. “How will these changes affect your family relationships?”

3. “Why don’t you make a list of the behaviors you need to change?”

4. “The team recommends that you make only one behavioral change at a time.”

ANS: 1

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 127

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

Feedback

1.	This is correct. This is an example of the therapeutic communication technique of verbalizing the implied. Verbalizing the implied puts into words what the client has only implied or said indirectly.
2.	This is incorrect. The nurse’s question “How will these chanbigrbe.csomaf/tfeestct your family relationships?” is an example of the therapeutic communication technique of reflecting.
3.	This is incorrect. The nurse’s question “Why don’t you maakbeirba.colims/tteostf the behaviors you need to change?” is not an example of verbalizing the implied. Verbalizing the implied puts into words what the client has only implied or said indirectly.
4.	This is incorrect. The nurse’s statement “The team recommends that you make only one behavioral change at a time” is an example of the nontherapeutic communication technique of giving advice.

CON: Communication

22. The nurse says to a newly admitted client, “Tell me more about what led up to your

hospitalization.” What is the purpose of this therapeutic communication technique?

1. To reframe the client’s thoughts about mental health treatment

2. To put the client at ease

3. To explore a subject, idea, experience, or relationship

4. To communicate that the nurse is listening to the conversation

ANS: 3

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 127

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

Feedback

This is incorrect. The nurse’s statement is an example of thaebirtbh.ceorma/pteesut tic communication technique of exploring. The purpose of exploring is not to reframe the client’s thoughts about mental health treatment.

This is incorrect. The nurse’s statement is an example of the therapeutic

communication technique of exploring. The purpose of expabloirbr.icnogm/itesst o facilitate the

client’s understanding of events. It is not meant to put the client at ease.

3.	This is correct. This is an example of the therapeutic communication technique of exploring. The purpose of 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. /test
4.	This is incorrect. The nurse’s statement is an example of the therapeutic communication technique of exploring. The purpose of exploring is not to communicate that the nurse is listening to the conversationa.birb.com/test

CON: Communication

23. A student nurse tells the instructor, “I’m concerned that when a client asks me for advice, I won’t have a good solution.” Which would be the nursianbgirbi.ncosmtr/utecstor’s best response?

1. “It’s scary to feel put on the spot by a client. Nurses don’t always have the answers.”

2. “Remember, clients, not nurses, are responsible for their own choices and decisions.”

3. “Just keep the client’s best interests in mind and do the best that you can.”

4. “Set a goal to continue to work on this aspect of your practice.”

ANS: 2

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 127

Heading: Nontherapeutic Communication Techniques > Table 7–3 Nontherapeutic

Communication Techniques

Integrated Processes: Teaching and Learning

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. The instructor’s statement “It’s scary to feel put on the spot by a client. Nurses don’t always have the answers” does not appabroirbp.croiamt/etelsyt explain why nurses should not use the nontherapeutic communication technique of advice giving.
2.	This is correct. The instructor’s statement “Remember, clients, not nurses, are responsible for their own choices and decisions” provides tahbierbb.ceomst/terasttionale for advising students not to use advice giving. Advice giving is a nontherapeutic communication technique in which the nurse tells the client what to do or how to behave, and it implies the nurse knows what is best and that the client is incapable of any self-direction.
3.	This is incorrect. The instructor’s statement “Just keep the client’s best interests in mind and do the best that you can” does not explain that nurses should not use the nontherapeutic communication technique of advice giving.
4.	This is incorrect. The instructor’s statement “Set a goal to continue to work on this

aspect of your practice” does not explain that nurses should not use the nontherapeutic communication technique of advice giving.

CON: Communication

24. A student nurse is learning about the appropriate use of touch when communicating with clients diagnosed with psychiatric disorders. Which statement made by the instructor best provides information about this aspect of therapeutic communication?

1. “Touch carries a different meaning for different individuals.”

2. “Touch is often used when deescalating volatile client situations.”

3. “Touch is used to convey interest and warmth.”

4. “Touch is best combined with empathy when dealing with anxaiboirub.scocmli/teenstts.”

ANS: 1

Chapter: Chapter 7 Therapeutic Communication Objective: Identify components of nonverbal expression. Page: 124

Heading: Nonverbal Communication > Touch Integrated Processes: Nursing Process: Implementation Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is correct. Touch can elicit both negative and positivearbeir the people involved and the circumstances of the interaction.	ba.cctoimo/ntess,t depending on
2.	This is incorrect. The instructor’s statement “Touch is often used when deescalating volatile client situations” is not accurate. Touch can elicit baboitrbh.cnomeg/teasttive and positive reactions.
3.	This is incorrect. The instructor’s statement “Touch is used to convey interest and warmth” is technically true, but it is not the purpose of touch when communicating with clients.
3.
4.	This is incorrect. The instructor’s statement “Touch is best combined with empathy when dealing with anxious clients” is not necessarily true. Touch can elicit both negative and positive reactions, depending on the people inavbiorbl.vcoemd/teasnt d the circumstances of the interaction.

CON: Communication

25. Which nursing statement is a good example of the therapeuticabcirbo.mcom/tuesntication technique of focusing?

1. “Describe one of the best things that happened to you this week.”

2. “I’m having a difficult time understanding what you mean.”

3. “Your counseling session is in 30 minutes. I’ll stay with you until then.”

4. “You mentioned your relationship with your father. Let’s discuabsisrb.tchoamt/tfeustrther.”

ANS: 4

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Easy

	Feedback
1.	This is incorrect. The statement “Describe one of the best things that happened to you this week” is not an example of the therapeutic communication technique of focusing.

2.	This is incorrect. The statement “I’m having a difficult time understanding what you mean” is an example of the therapeutic communication technique of seeking clarification and validation.

3.	This is incorrect. The statement “Your counseling session is in 30 minutes. I’ll stay with you until then” is an example of the therapeutic communication technique of offering self.
4.	This is correct. The statement “You mentioned your relatioanbisrbh.cipomw/teistht your father. Let’s discuss that further” is an example of the therapeutic communication technique of focusing. Focusing takes notice of a single idea or even a single word and works especially well with a client who is moving rapidly from oanbeirbt.hcomu/gtehst to another.

CON: Communication

26. A client begins fasting at 10 p.m. for a blood test the next morning. The morning of the test, the client finds out that it has been canceled. The client uasbeirbs.cpormo/tfeasnt ity with the nurse and states, “You are incompetent!” Which is the nurse’s best response?

1. “Do you believe that I caused your blood test to be canceled?”

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

3. “Have you ever thought about ways to express anger appropriaatbeirlby.c?o”m/test

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

ANS: 2

Objective: Discuss therapeutic feedback. Page: 124

Heading: Feedback

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. Feedback needs to be directed at a behavaiobirrbt.hcoemc/tleiset nt can modify.
2.	This is correct. The feedback is specific and focuses on a behavior the client can modify.
3.	This is incorrect. The feedback needs to focus on a specificabbireb.hcoamv/itoesrt. The feedback also needs to be descriptive rather than evaluative. This statement does not specifically address the swearing, which the client can modify.
4.	This is incorrect. This statement is not specific and does noatbiarbd.cdorme/stessta behavior the client can modify.

CON: Communication

27. During a nurse-client interaction, which nursing statement mabyirbb.ceolmit/ttleestthe client’s feelings and concerns?

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

2. “You appear uptight.”

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

4. “You are jumping to conclusions.”

ANS: 1

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 127

Heading: Nontherapeutic Communication Techniques > Table 7–ab3irbN.coomnt/theestrapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Easy

Feedback

1. 2.	This is correct. The nursing statement “Don’t worry. Everything will be alright” is an example of the nontherapeutic communication block of belittling feelings.

		Belittling feelings occurs when the nurse misjudges the degree of the client’s
		discomfort, suggesting a lack of empathy and understandinagbi.r .c

3.
4.	This is incorrect. The nursing statement “You are jumping to conclusions” is not an example of the nontherapeutic communication block of belittling feelings. Belittling feelings occurs when the nurse misjudges the degree of theabcirlbie.cnomt’/stedstiscomfort, suggesting a lack of empathy and understanding.

CON: Communication

28. A client on an inpatient psychiatric unit tells the nurse, “I shoaublirdb.choamv/teesdt ied, because I am totally worthless.” To encourage the client to continue talking about feelings, which should be the nurse’s initial response?

1. “How would your family feel if you died?”

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

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

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

ANS: 3

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal commaubirbi.ccaomti/otensttechniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

Feedback

This is incorrect. The question “How would your family feaeblirbif.coymo/utesdt ied?” is an example of the nontherapeutic communication technique of probing.

This is incorrect. The statement “You feel worthless now, but that can change with

time” is an example of the nontherapeutic communication atbeicrbh.cnoimq/uteestof belittling or minimizing feelings.

3.	This is correct. The question “You’ve been feeling sad and alone for some time now?” 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. /test
4.	This is incorrect. The statement “It is great that you have come in for help” is an example of the nontherapeutic communication technique of giving approval.

CON: Communication

29. Which nursing response is an example of the nontherapeutic communication technique of requesting an explanation?

1. “Can you tell me why you said that?”

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

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

4. “Are you not understanding the explanation I provided?”

ANS: 1

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal commaubirbi.ccaomti/otensttechniques. Page: 127

Heading: Nontherapeutic Communication Techniques > Table 7–3 Nontherapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Easy

	Feedback
1.	This is correct. The question “Can you tell me why you said that?” is an example of the nontherapeutic communication technique 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 acbliireb.ncotmd/itedstsomething or feels a certain way can be intimidating and implies that the client must defend his or her behavior or feelings.
2.	This is incorrect. The statement “Keep your chin up” is anaebxirba.mcopml/teesot f the nontherapeutic communication technique of making stereotyped comments. When the nurse uses meaningless expressions, it encourages a similar response from the client.

3.	This is incorrect. The statement “There is always an explanaabitribo.cnomf/oterstboth good and bad behaviors” is an example of the nontherapeutic communication technique of approving or disapproving, as it implies that the nurse has the right to pass judgment on the client’s behaviors as “good” or “bad”.


4.	This is incorrect. The question “Are you not understanding the explanation I

provided?” is not an example of the nontherapeutic communication block of requesting an explanation.

CON: Communication

30. 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?

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

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

3. “Why do you think he behaved like that?”

4. “Describe what happened during your time with your husbanda.”birb.c

ANS: 4

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal commaubirbi.ccaomti/otensttechniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. The nurse’s question “Does your husband treat you like this very often?” is more similar to the nontherapeutic communication technique of probing. The client may not want to answer this question.

2.	This is incorrect. The nurse’s question “What do you think is your role in this relationship?” is more similar to the nontherapeutic communication technique of probing. The client may not want to answer this question.
3.	This is incorrect. The nurse’s question “Why do you thinkahbeirbb.ceohma/tvesetd like that?” is an example of the nontherapeutic communication technique of requesting an explanation.
4.	This is correct. The nurse’s response “Describe what happeabnierbd.codmu/rteisntg your time with your husband” is an example of the therapeutic communication technique of exploring and is especially helpful with clients who tend to remain on a superficial level of communication. The purpose of using exploring is to delve further into the subject, idea, experience, or relationship.

CON: Communication

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

1. “My sister has the same diagnosis as you, and she also hears vaobiicrbe.cso.m”/test

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

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

4. “I wouldn’t worry about these voices. The medication will maakbeirbt.hcoem/tedstisappear.”

ANS: 2

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal commaubirbi.ccaomti/otensttechniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity

Cognitive Level: Comprehension [Understanding] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. The nurse’s statement “My sister has the same diagnosis as you and she also hears voices” does not present reality, which should be used when the client has a misperception of the environment.
2.	This is correct. The nurse’s statement “I understand that the voices seem real to you, but I do not hear any voices” is an example of presenting reality, which should be used when the client has a misperception of the environment. Presenting reality is when the nurse defines or indicates the nurse’s perception aobfirbth.ceoms/itteustation for the client.
3.	This is incorrect. The nurse’s statement “Why not turn up the radio so that the voices are muted” is an example of giving advice, which is a nontahbeirrba.cpoemu/tetisct communication technique and does not present reality.
4.	This is incorrect. The nurse’s statement “I wouldn’t worry about these voices. The medication will make them disappear” does not present reality, which should be used when the client has a misperception of the environmeanbtir.b.c

CON: Communication

32. Which nursing response is the best example of the therapeutic communication technique of offering self?

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

session.”

2. “Would you like me to accompany you to your electroconvulsaivbierb.tchoemr/taepsty treatment?”

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

4. “After discharge, would you like to meet me for lunch to review your outpatient

progress?”

ANS: 2

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. The statement “I think it would be great if you talked about that problem during our next group session” is an example of thabeirbn.oconmth/teesrtapeutic communication technique of giving advice.
2.	This is correct. The question “Would you like me to accompany you to your electroconvulsive therapy treatment?” is the best example oabfirtbh.ceomth/tesrtapeutic communication technique of offering self. Offering self makes the nurse available on an unconditional basis, increasing the client’s feelings of self-worth. When using the technique of offering self, the nurse must maintain professiaobinrba.clobmo/tuesntdaries.
3.	This is incorrect. The statement “I notice that you are offering help to other peers in the milieu” is an example of the therapeutic communication technique of making observations.
4.	This is incorrect. The question “After discharge, would youabliribk.ceomto/temst eet me for lunch to review your outpatient progress?” is not an example of the therapeutic communication technique of offering self. Offering self makes the nurse available on an unconditional basis. In this example, the nurse is askingabtoirbr.ceovmi/etewst the client’s progress.

CON: Communication

33. Which of the following best represents a patient-centered apparboirba.cchomt/hteast promotes a change in behavior?

1. Process recordings

2. Providing guidance

3. Motivational interviewing

4. Therapeutic communication

ANS: 3

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe motivational interviewing as a communication strategy. Page: 131

Heading: Motivational Interviewing

Integrated Processes: Nursing Process: Assessment

Client Need: Psychosocial Integrity

Cognitive Level: Comprehension [Understanding] Concept: Communication

Difficulty: Easy

	Feedback
1.	This is incorrect. Process recordings are used as a tool by tahbeirbn.cuorms/etestot improve interpersonal communication techniques.
2.	This is incorrect. Providing guidance, while an important part of the therapeutic relationship, does not necessarily promote a change in behabviribo.cro.m/test
3.	This is correct. Motivational interviewing is an evidence-based, patient-centered style of communication that promotes behavior change by guiding clients to explore their motivation to change and the advantages and disadvanabtiarbg.ceosmt/otesttheir decisions.
4.	This is incorrect. Therapeutic communication is the foundation of a therapeutic client-nurse relationship; however, it does not necessarily promote a change in behavior. Therapeutic communication is a set of “procedures” used to enhance a therapeutic relationship.

CON: Communication

34. Which statement reflects the model of transactional communication?

/test

1. Individuals use nonverbal body language to communicate.

2. Individuals simultaneously perceive each other.

3. Individuals use touch as a means of social communication.

4. Individuals use facial expressions to convey feelings.

ANS: 2

Chapter: Chapter 7 Therapeutic Communication

Objective: Discuss the transactional model of communication. Page: 122

Heading: What Is Communication?

Integrated Processes: Nursing Process: Assessment

Client Needs: Psychosocial Integrity

Cognitive Level: Comprehension [Understanding] Concept: Communication

Difficulty: Moderate

/test

a b irb

Feedback

1. This is incorrect. In the transactional model of communica ti o n.,cobmo/ttehstparticipants simultaneously perceive each other, listen to each other, and are mutually involved

	in creating meaning in a relationship. Nonverbal communication is only one way in which individuals can communicate.
2.	This is correct. Interpersonal communication is a transaction between the sender and the receiver. In the transactional model of communication,abiorbt.hcopma/tretsitcipants simultaneously perceive each other, listen to each other, and are mutually involved in creating meaning in a relationship.
3.	This is incorrect. In the transactional model of communicaatiboirbn.,cobmo/tehstparticipants simultaneously perceive each other, listen to each other, and are mutually involved in creating meaning in a relationship. Touch is one example of nonverbal communication.
4.	This is incorrect. In the transactional model of communication, both participants simultaneously perceive each other, listen to each other, and are mutually involved in creating meaning in a relationship. The use of facial expressions to convey feelings is one example of communication. /test

CON: Communication

35. The nurse observes a client sitting alone and crying after a group therapy session. The nurse sits in the chair nearest to the client and states, “I see yaobiurb.acroem/ctersyt ing. I’d like to sit with you for a few minutes.” Which communication technique is the nurse using?

1. Making an observation

2. Offering a general lead

3. Presenting reality

4. Silence

ANS: 1

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 126

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Needs: Psychosocial Integrity Cognitive Level: Analysis [Analyzing] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is correct. The nurse is using the therapeutic technique of making an observation by verbalizing and acknowledging that the clieanbitrbi.scocmr/yteisnt g. This assists the client to recognize feelings and behaviors.
2.	This is incorrect. Offering a general lead is used during a therapeutic conversation to encourage the client to continue. This is not an example ofaobifrbfe.croimn/gtesat general lead.
3.	This is incorrect. The nurse presents reality when a client has a misperception of the

environment. This is not an example of presenting reality.

This is incorrect. The nurse uses silence to give the client the opportunity to collect

and organize thoughts, to think through a point, or to consider introducing a topic of greater concern than the one being discussed. The nurse isanboirbt.cdoemm/teosnt strating silence.

CON: Communication

36. A client tells the nurse, “I have nothing left to enjoy in life. My children are grown and married.” The nurse replies, “I’m sure you are looking forwaarbdirbt.ocohma/tvesitng grandchildren.” Which communication technique is this considered?

1. Giving advice

2. Reflecting

3. Using denial

4. Verbalizing the implied

ANS: 3

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal communication techniques. Page: 127

Heading: Nontherapeutic Communication Techniques > Table 7–3 Nontherapeutic

Communication Techniques

Integrated Processes: Nursing Process: Implementation

Client Needs: Psychosocial Integrity Cognitive Level: Analysis [Analyzing] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. The nurse is using the nontherapeutic comabmirbu.cnomic/atetsiton technique of denial. Giving advice is the nontherapeutic technique of telling the client what to do or how to behave and implies that the nurse knows what is best and that the client is incapable of any self-direction.
2.	This is incorrect. The nurse is using the nontherapeutic comabmirbu.cnomic/atetsiton technique of denial. Reflecting is the therapeutic communication technique in which the nurse refers questions and feelings back to the client so they may be recognized and accepted.
3.	This is correct. The nurse is using the nontherapeutic communication technique of denial. Denying that a problem exists blocks discussion with the client and avoids helping the client identify and explore areas of difficulty.
4.	This is incorrect. The nurse is using the nontherapeutic comabmirbu.cnomic/atetsiton technique of denial. Verbalizing the implied is the therapeutic communication technique in which the nurse puts into words what the client has only implied or said indirectly and clarifies that which is implicit rather than explicit.
4.

CON: Communication

MULTIPLE RESPONSE

37. Which individuals are communicating a message? Select all that apply.

1. A parent spanking her child for playing with matches

2. A teenager isolating himself and playing loud music

3. A biker sporting an eagle tattoo on a bicep

4. A teenager writing, “No one understands me”

5. A parent checking for new e-mail on a regular basis

ANS: 1, 2, 3, 4

Chapter: Chapter 7 Therapeutic Communication

Objective: Discuss the transactional model of communication. Page: 122

Heading: What Is Communication?

Integrated Processes: Nursing Process: Assessment

Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Communication

Difficulty: Easy

	Feedback
1.	This is correct. Spanking is a way of communicating a mesasbairbg.eco.mA/tpespt roximately 70% to 90% of communication is nonverbal.
2.	This is correct. Isolating oneself is a way of communicating a message. Approximately 70% to 90% of communication is nonverbaalb.irb.c
3.	This is correct. Getting a tattoo is a way of communicating a message. Approximately 70% to 90% of communication is nonverbal.
4.	This is correct. Writing is a way of communicating a message to others. Approximately 70% to 90% of communication is nonverbaalb.irb.c
5.	This is incorrect. Communication is a transaction between a sender and a receiver in which both participants simultaneously perceive each other, listen to each other, and are mutually involved in creating meaning in a relationshipa.biCrb.hceomck/teinstg e-mail does not involve an interaction between a sender and a receiver.

CON: Communication

38. Which preexisting conditions influence the outcome of commabuirnbi.coamti/toenst? Select all that apply.

1. Gender

2. Distance

3. Eye contact

4. Values

5. Paralanguage

ANS: 1, 2, 4

Objective: Identify types of preexisting conditions that influence the outcome of the communication process.

Heading: The Impact of Preexisting Conditions Integrated Processes: Nursing Process: Evaluation Client Need: Psychosocial Integrity Cognitive Level: Knowledge [Remembering] Concept: Communication

Difficulty: Easy

	Feedback This is correct. Gender is a preexisting condition that influences the manner in which individuals communicate. Most cultures have gender signaalbsirtbh.caotma/treest recognized as either masculine or feminine and provide a basis for distinguishing between members of each gender.
1. 2.
1. 2.	This is correct. Territoriality, density, and distance are aspects of the preexisting condition of the environment in which the transaction takes place.
3.	This is incorrect. Eye contact is a type of nonverbal communication.
4.	This is correct. Values, attitudes, and beliefs are preexisting conditions that impact communication. One’s value system may be communicateadbiwrbi.ctohmb/teshtaviors that are more symbolic in nature.
5.	This is incorrect. Paralanguage is a type of nonverbal communication.

CON: Communication

39. Which nursing statements demonstrate useful feedback? Select all that apply.

1. “Hitting the wall yesterday was not the best way to express your anger.”

2. “The hospital has a support group on Tuesdays for those who wabairbn.tcotmo/tqesutit smoking.”

3. “It appears you want to sit near the nurses’ station when the morning meeting starts.”

4. “Your behavior has been unacceptable since you were admitted to this unit.”

5. “I noticed you participated in group more this afternoon than this morning.”

ANS: 2, 3, 5

Objective: Discuss therapeutic feedback. Page: 131

Heading: Feedback

Integrated Processes: Nursing Process: Implementation

Client Needs: Psychosocial Integrity Cognitive Level: Analysis [Analyzing] Concept: Communication

Difficulty: Moderate

	Feedback
1.	This is incorrect. This is an example of delayed-response feedback, which is not useful to the client. Feedback is most useful when given at the earliest appropriate opportunity following the specific behavior.
1.
2.	This is correct. Feedback is useful when it encourages self-sufficiency and imparts information rather than offering advice.
3.	This is correct. Useful feedback should be directed towardaabirbbe.chomav/teiostr the client has the capacity to modify. In this situation, the nurse can explore the reason the client sits near the nurse’s station and assist the client to modify the behavior when appropriate.
3.
4.	This is incorrect. Useful feedback should be specific rather than general.
5.	This is correct. Useful feedback should be directed toward behavior that the client has the capacity to modify and is specific. This statement is directed toward a specific behavior the client can modify (participating in groabuirpb).c.