Question 1

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

Accepted Answer

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." C

Question 2

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

Accepted Answer

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 D

Question 3

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

Accepted Answer

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 B

Question 4

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?

Accepted Answer

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 5

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?

Accepted Answer

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 6

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.

Accepted Answer

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 7

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.

Accepted Answer

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 8

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

Accepted Answer

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 9

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

Accepted Answer

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 10

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

Accepted Answer

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."

Question 11

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

Accepted Answer

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

Question 12

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?

Accepted Answer

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

Question 13

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.

Accepted Answer

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 14

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?

Accepted Answer

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 15

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?

Accepted Answer

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

Question 16

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?

Accepted Answer

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 17

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:

Accepted Answer

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 18

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

Accepted Answer

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 19

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?

Accepted Answer

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

Question 20

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?

Accepted Answer

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."

Exam 4: Therapeutic Communication: Interviews and Interventions