Deck 4: Therapeutic Communication: Interviews and Interventions

Question 1

A patient expresses a sense of genuineness in the nurse providing care when sharing with family members that:

A) "I believe the nurse can feel what I'm feeling."
B) "I always know what the nurse expects of me; the explanations are always clear."
C) "I can tell the nurse is sincere because the face supports what the mouth is saying."
D) "I may not always like what the nurse has to say but I can always depend on what I'm told."

Answer 1

"I can tell the nurse is sincere because the face supports what the mouth is saying."

Question 2

Which statement indicates that a novice nurse understands the purpose of therapeutic communication? "My goal for communication with any patient is to:

A) maintain relationships."
B) mutually share information."
C) promote growth and change."
D) offer advice and make suggestions."

Answer 2

promote growth and change."

Question 3

The nurse is considering the need for both effective means of communication and safety when caring for a patient with impulse control issues and poor social skills.Which nursing intervention is most appropriate to address these needs?

A) Reminding the patient with each interaction what space boundaries are considered safe and desired
B) Asking the patient to describe and set space boundaries that feel safe and facilitate effective communication
C) Clearly setting space boundaries for the patient so both patient and staff feel safe and can communicate more effectively
D) Discussing the need for space boundaries and how they help both the patient and the staff feel safe and aide in communicating effectively

Answer 3

Discussing the need for space boundaries and how they help both the patient and the staff feel safe and aide in communicating effectively

Question 4

Which nursing response would indicate an empathetic approach to a patient who is depressed over recent losses in her life?

A) "Losing a job isn't always a bad thing."
B) "I lost my parents last year and still feel sad."
C) "Please tell me more about what you are feeling."
D) "Let's not focus on what's sad but rather what is good about life."

Question 5

A patient indicates that he is about to share information about his illness that is shocking and embarrassing.Which nursing intervention has priority in this situation in facilitating the communication process?

A) Reassuring the patient that talking will be therapeutic
B) Assuring the patient the information will be kept confidential
C) Responding to the patient's information in an accepting manner
D) Providing the patient with a private place for the discussion to occur

Question 6

During the termination phase of the nurse-patient relationship with a dependent patient,the nurse evaluates the effectiveness of coping techniques learned by:

A) Role playing with the patient in order to practice being assertive
B) Asking the patient to define the difference between being assertive and being aggressive.
C) Discussing how her father effectively used both assertiveness and aggressiveness to control her
D) Asking, "When you used assertiveness to deal with your father during his visit, how did it work?"

Question 7

A nurse is considering the therapeutic value of touch when planning care for an anxious patient.What is the initial question the nurse should answer before initiating this technique?

A) "How comfortable am I with touching this patient?"
B) "Will the patient find therapeutic touch supportive?"
C) "Does research support the use of therapeutic touch?"
D) "Has therapeutic touch proven to be therapeutic with anxious patients?"

Question 8

The nature of the communication characterized in this exchange between a nurse and a chronically depressed patient is:
Nurse: Is it true that you enjoy knitting?
Patient: Yes,I've done it for years and am pretty good at it.
Nurse: I'm just a beginner.Do you think you could give me some tips?
Patient: I guess so.What would you like to know?

A) Therapeutic
B) Collegial
C) Social
D) Intrapersonal

Question 9

The nurse has developed a plan in which nursing interventions are used to reinforce the patient's healthy behaviors.Which statement by the nurse will positively reinforce the patient's efforts regarding the plan?

A) "How can a stress reduction plan help you at home?"
B) "It sounds like you have the incentive to make healthy choices."
C) "When you tried to follow the plan, how well did it work for you?"
D) "It sounds as though making healthy choices is very important to you."

Question 10

A nurse has for the past 4 weeks been working with a psychotic patient who has been mute and very withdrawn.The patient suddenly encroaches on the nurse's personal space by touching inappropriately.What is the most therapeutic response by the nurse to address this behavior?

A) Ignore it this time because the patient is, at last, responding.
B) Firmly communicate acceptable boundaries to the patient.
C) Gently touch the patient's head and then observe the reaction.
D) Smile while telling the patient that people don't like being touched like that.

Question 11

A novice nurse asks,"What is so wrong about being sympathetic with a patient who has also lost a parent like I did?" The psychiatric nurse manager responds:

A) "There is a fine line between empathy and sympathy that when crossed makes you less able to be therapeutic."
B) "Rather than discussing the loss of your parent with the patient, you can talk to me about it whenever you need to."
C) "I'll provide you with some excellent materials that I'm sure will help you to understand why sympathy is less therapeutic."
D) "Sympathy indicates that you are sharing your personal feelings and that changes the focus of the communication from the patient to you."

Question 12

The expected outcome of conducting a periodic self-evaluation of one's own responses to patients is for the nurse to continue:

A) Recognizing the nurse's need for therapy
B) Recognizing personal problems and strengths
C) Maintaining distance from the patients' problems
D) Maintaining professional boundaries with the patients

Question 13

The nurse mentions,"I like to use open-ended questions and statements because they result in fuller,more revealing responses by the patient,and they stimulate discussion." What statement would the nurse ask to best stimulate conversation with a patient about their family?

A) "Where does your family live?"
B) "Tell me about your family."
C) "Do you have a family nearby?"
D) "Would you like to talk about your family?"

Question 14

A patient whose history includes physically abusing his spouse and children has been admitted to the unit for alcohol and drug dependency.Which nurse will likely experience difficulty establishing a therapeutic relationship with this patient?

A) The nurse who has experienced physical abuse
B) The novice nurse who has never cared for an abuser
C) The experienced nurse who has 'seen too many abusers'
D) The nurse who has been in treatment for abusing a spouse

Question 15

When providing discharge teaching to a patient for whom English is a second language,what technique will the nurse use to assess the patient's understanding of the information being shared verbally?

A) Continuously evaluating the patient's nonverbal cues
B) Periodically asking the patient if they have any questions
C) Asking the patient to repeat the information they are given
D) Providing the information in concise, written form

Question 16

When communicating with a psychotic,schizophrenic patient,the nurse avoids the use of slang phrases most importantly because:

A) Such phrases have different meanings for different people.
B) Such phrases will likely trigger anxiety and frustration in the patient.
C) The use of such phrases is not appropriate when communicating therapeutically with a patient.
D) This patient's altered thought processes will serve to make understanding such phrases very unlikely.

Question 17

The nurse suspects that the patient's communication is being negatively influenced by personal attitude when he is heard stating:

A) "They think I'm mentally ill but I'm not; I just get a little depressed at times."
B) "I can't concentrate on anything besides getting out of here and back to my kids."
C) "Obviously my therapist can't understand where I'm coming from because our lives are so different."
D) "There isn't anyone here in this hospital I can trust enough to talk to about why I abuse alcohol and drugs."

Question 18

An example of an environmental factor that would cause a nurse to modify a planned critical interaction occurs when the:

A) Patient expresses a personal dislike for the nurse
B) Patient is in total denial about her condition
C) Nurse lacks the degree of knowledge required for the interaction
D) Nurse learns that the patient's mother has been hospitalized with a stroke

Question 19

A patient is struggling to explore and solve a problem.The nurse determines that it would be therapeutic to offer alternatives.Which verbal introduction should the nurse incorporate in order to achieve this objective?

A) "Have you thought of..."
B) "You should..."
C) "Why don't you..."
D) "I think you need to..."

Question 20

A nurse is contemplating the use of self-disclosure.The expected outcome of this strategy is that the patient will:

A) be informed about expected behaviors
B) express previously withheld feelings
C) foster a mutually supportive relationship with the nurse
D) recognize that the nurse can empathize through shared experiences

Question 21

A nurse is discussing unit expectations with a newly admitted patient diagnosed with poor impulse control.The nurse shows an understanding of the use of body language to convey feelings when documenting that the patient is angry and resistant to authority based on which of the following? Select all that apply.

A) Patient's reluctance to make eye contact
B) Crossed-arm posture the patient assumes
C) Quizzical expression on the patient's face
D) Sharp rapping of the patient's fingers against the table
E) Patient's tendency to lean forward when seated in the chair

Question 22

The nurse shows an understanding of an essential purpose of therapeutic communication when (select all that apply):

A) Asking the patient, "How did it make you feel when your son died?"
B) Encouraging the patient to assume responsibility for the problems he or she has
C) Attentively listening as the patient describes the reasons he or she is seeking help
D) Providing the patient with feedback regarding how he or she is implementing stress relief techniques
E) Sharing with the patient the details of several extremely stressful personal events and how they were managed

Question 23

The nurse is planning approaches to use to begin the establishment of the nurse-patient relationship.Which therapeutic communication techniques will be most useful to achieve this goal? Select all that apply.

A) Attentively listening as the patient describes their obsessive compulsive rituals
B) Asking the anxious patient if they have a plan for controlling their current anxiety
C) Encouraging the depressed patient to "come and talk with me whenever you want"
D) Sitting quietly in the room while the non-communicating patient unpacks their belongings
E) Responding to the patient's feelings of loss by stating, "I know that must have made you very sad."

Question 24

The novice nurse is learning about the appropriate use of touch with patients experiencing psychiatric disorders.Which statement about touch will provide the nurse with the best basis for successful practice in psychiatric nursing situations?

A) Touch carries a different meaning for different individuals.
B) Touch is rarely misinterpreted by patients because of its universal appeal.
C) It is seldom inadvisable to touch a patient to convey interest and warmth.
D) Paranoid patients accept procedural touch best when combined with humor.

Question 25

The nurse manager suspects that a novice nurse is experiencing countertransference regarding a chronically ill,psychotic patient.Which response is most effective at this time?

A) "I realize this is a difficult situation but it will occur again if you don't manage it now."
B) "I want you to see our hospital counselor so that you can regain your professional attitudes."
C) "I believe you are no longer able to be therapeutic so I'm changing your patient assignment."
D) "I'd like to help you begin to self-reflect on the feelings you seem to have for this patient."

Question 26

The nurse has been working for several weeks with a single mom who has been both verbally and physically abused by her children's father.Which nursing actions are appropriate for this stage of treatment? Select all that apply.

A) Asking, "How does it make you feel when he hits you?"
B) Providing information regarding women's shelters in the local area
C) Assuring the patient that her children can visit when she wants to see them
D) Sharing that, "I know leaving him is difficult but you need a plan if he abuses you again."
E) Responding, "You've certainly become more assertive; don't be afraid to stand up for yourself."

Question 27

A patient who has shown good progress with treatment has shown great resistance to being discharged to an outpatient program.Based on an understanding of the underlying pathology of resistance,the nurse:

A) Recognizes that the behavior will cease when discharge has occurred
B) Refers back to the patient's progress as an indication of the patient's strengths
C) Assures the patient that outpatient therapy services will continue to be supportive
D) Shares that although scary, discharge to outpatient therapy is a sign of improvement

Question 28

The nurse is working on the inclusion of therapeutic humor in interactions with a chronically ill schizophrenic patient who was hospitalized after an attempted suicide.Which outcomes are realistic expectations for this patient? Select all that apply.

A) Improved cognition
B) Decreased interest in self-harm
C) Increased ability to experience pleasure
D) Decrease in the expression of fear and anxiety
E) Appropriate expression of emotions through affect

Question 29

Which of the following nursing responses is an example of the therapeutic technique of empathizing?

A) "I think you may be finding this very difficult."
B) "I see you have been crying since your wife left."
C) "Help me to understand how this is affecting you."
D) "It sounds as if this is important to you."

Question 30

What statements indicate that the patient has an understanding of assertive behavior? Select all that apply.

A) "Always stand up for your own rights."
B) "I say what it takes to make my wishes known."
C) "Talking really loud seems to get the focus on me."
D) "I'm not uncomfortable telling someone 'No' when I need to."
E) "You don't have to ignore the rights of others to stand up for yourself."