Deck 8: Learning to Communicate Professionally

Question 1

Which statement, made by a new psychiatric nurse, best describes the therapeutic use of self?

A) "Most nurses have caring personalities that equip them to be helpful to patients."
B) "It's mostly about using good verbal and nonverbal communication, objectivity, genuineness, and empathy."
C) "It means that you keep yourself at a distance so you are not affected by patients' problems and emotions."
D) "The most important aspect of practice is when and how much to touch, as well as when to listen and give advice."

Answer 1

"It's mostly about using good verbal and nonverbal communication, objectivity, genuineness, and empathy."

Question 2

Effective use of the nursing process is dependent on communication that demonstrates what?

A) Structure and goal-direction
B) Meeting the needs of both patient and nurse
C) Being spontaneous and affording mutual self-disclosure
D) Fostering emotional distance between patient and nurse

Answer 2

Structure and goal-direction

Question 3

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

A) "You are mistaken. No one is laughing at you."
B) "I know the sound of laughter is real to you, but I don't hear it."
C) "Your mind is playing tricks on you, making you think you hear laughter."
D) "When people are mentally ill, they often experience things that others cannot relate to."

Answer 3

"I know the sound of laughter is real to you, but I don't hear it."

Question 4

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

A) Helpful transference
B) Sympathetic listening
C) Supportive confrontation
D) Therapeutic communication

Question 5

A patient is withdrawn, suspicious, and maintains physical distance from staff and other patients.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

A) Refraining from touch without first obtaining permission
B) Patting the patient's arm when fear is expressed
C) Reaching out to shake the patient's hand as an initial greeting
D) Placing an arm around the patient's shoulders while walking down the hall

Question 6

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, what statement should the nurse make to the patient?

A) "Who are the people with whom you are most passive?"
B) "How important is it for you to become more assertive?"
C) "Let's look at how we can address this problem together."
D) "Are you interested in attending the assertiveness class?"

Question 7

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?

A) Clarifying
B) Interpreting
C) Giving information
D) Making observations

Question 8

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

A) "How do you feel about what I just said?"
B) "See, even nurses say stupid things sometimes."
C) "Sorry about that. Let's continue where we left off."
D) "That was an insensitive remark. I'm sorry if it hurt you."

Question 9

What is a common mistake nurses make when developing therapeutic communication techniques?

A) Using too many different techniques during an interaction
B) Allowing patients to become too anxious before responding
C) Giving advice rather than encouraging patients to solve problems
D) Focusing on what patients say rather than on communication techniques

Question 10

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

A) "I notice you keep looking toward the door."
B) "This is our time together. No one is going to interrupt us."
C) "It looks as if you are eager to end our discussion for today."
D) "If you are uncomfortable in this room, we can move someplace else."

Question 11

A patient diagnosed with schizophrenia, paranoid type, frequently gets up, and walks away during interactions with a nurse. How can the nurse best increase the patient's comfort level and so encourage communication?

A) Arranging the chairs side by side, about 2 feet apart
B) Sitting at eye level across the table from the patient
C) Standing a few feet away from where the patient sits
D) Talking in the patient's room with the door closed

Question 12

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

A) "Why are you upset?"
B) "I can hear that you are upset. Let's talk about it."
C) "Just go along with the plan, even if you do not agree."
D) "The groups are carefully planned by staff to benefit patients."

Question 13

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

A) "It will get better if you just keep trying."
B) "You are doing fine. Don't be so hard on yourself."
C) "Tell me more about how the therapy sessions are too much."
D) "I know you find this difficult, but I believe you can get through it."

Question 14

A patient has difficulty expressing anger appropriately. The nurse encourages the patient to set realistic goals by making what statement?

A) "You seem to have problems expressing anger in a nonaggressive way."
B) "I thought you sounded angry when I told you it was time for group."
C) "What do you think needs to change about how you express anger?"
D) "What bothers you about your actions when you get angry?"

Question 15

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

A) Clarifying
B) Role-playing
C) Giving feedback
D) Encouraging evaluation

Question 16

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

A) "How long have you been feeling this way?"
B) "What is different about your feelings today?"
C) "We are here to help you. I'm glad you decided to come to the center."
D) "You said you felt like you could not go on. Tell me more about that."

Question 17

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." What is the nurse's best initial response to the patient's concerns?

A) "Why do you think they were mean?"
B) "Perhaps you overreacted to what they said."
C) "How do you feel about your family treating you that way?"
D) "Describe what happened when your family visited you today."

Question 18

When assessing a patient's social skills, which remark would serve best in seeking clarification?

A) "It sounds as if you need to develop some assertiveness skills."
B) "Describe an example of a time when you felt uncomfortable in a social situation."
C) "It is not easy to be assertive. We can role-play some situations to give you practice."
D) "What do you plan to do the next time you find yourself in an uncomfortable social situation?"

Question 19

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

A) Knowing that patients are usually aware of their nonverbal cues
B) Accepting that verbal responses are more important than nonverbal cues
C) Recognizing that nonverbal cues have obvious meaning and are easily interpreted
D) Validating nonverbal cues to provide significant information

Question 20

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 demonstrates what characteristic regarding therapeutic response by the nurse?

A) Therapeutic use of limit-setting
B) Minimally therapeutic but effective
C) Therapeutic use of self
D) Nontherapeutic and ineffective

Question 21

Which techniques are therapeutic when interacting with a patient? (Select all that apply.)

A) Avoiding direct questions
B) Validating and clarifying
C) Using empathy sparingly
D) Assuming an attending posture
E) Maintaining constant eye contact

Question 22

A patient cries as the nurse explores the patient's feelings about the death of a close friend. The patient sobs, "I shouldn't be crying like this. It happened a long time ago." Which responses by the nurse facilitate communication? (Select all that apply.)

A) "Why do you think you are so upset?"
B) "I can see that you feel sad about this situation."
C) "The loss of your friend is very painful for you."
D) "Crying is a way of expressing the hurt you're experiencing."
E) "Let's talk about something else, since this subject is upsetting you."

Question 23

A patient says to the nurse, "I dreamed I could not breathe and was being attacked. When I woke up, I felt emotionally drained, as though I hadn't rested at all." Which comment would be appropriate if the nurse seeks to interpret the patient's experience?

A) "It sounds as though you were uncomfortable with the content of your dream."
B) "So you are saying that you were not able to breathe and felt in danger?"
C) "I understand. Thank you for telling me about your bad dream."
D) "So, you feel as though you had a poor night's sleep?"

Question 24

What is the best analysis of this described nurse-patient interaction? Patient: I get discouraged when I realize I've been struggling with my problems for over a year.
Nurse: Yes you have, but many people take even longer to resolve their issues. You shouldn't be so hard on yourself.

A) The nurse has responded ineffectively to the patient's concerns.
B) The patient is expressing lack of willingness to collaborate with the nurse.
C) The patient is offering the opportunity for the nurse to revise the plan of care.
D) The nurse is using techniques that are consistent with the evaluation step of the nursing process.