Therapeutic Communication NCLEX - Questions, Answers and Rationales A mother rescues two of her four children from a house fire. In the emergency
... [Show More] department, she cries, "I should have gone back in to get them. I should have died, not them." What is the nurse's best response? A "The smoke was too thick. You couldn't have gone back in." B "You're feeling guilty because you weren't able to save your children." C "Focus on the fact that you could have lost all four of your children." D "It's best if you try not to think about what happened. Try to move on." The best response by the nurse is, "You're experiencing feelings of guilt 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 that they may be recognized and accepted. A newly admitted client diagnosed with obsessive-compulsive disorder (OCD) washes hands continually. This behavior prevents unit activity attendance. Which nursing statement best addresses this situation? A "Everyone diagnosed with OCD needs to control their ritualistic behaviors." B "It is important for you to discontinue these ritualistic behaviors." C "Why are you asking for help if you won't participate in unit therapy?" D "Let's figure out a way for you to attend unit activities and still wash your hands." 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 formulating a plan 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. Which example of a therapeutic communication technique would be effective in the planning phase of the nursing process? A "We've discussed past coping skills. Let's see if these coping skills can be effective now." B "Please tell me in your own words what brought you to the hospital." C "This new approach worked for you. Keep it up." D "I notice that you seem to be responding to voices that I do not hear." This is an example of the therapeutic communication technique of formulating a plan of action. By the use of this technique, the nurse 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. A client tells the nurse, "I feel bad because my mother does not want me to return home after I leave the hospital." Which nursing response is therapeutic? A "It's quite common for clients to feel that way after a lengthy hospitalization." B "Why don't you talk to your mother? You may find out she doesn't feel that way." C "Your mother seems like an understanding person. I'll help you approach her." D "You feel that your mother does not want you to come back home?" This is an example of the therapeutic communication technique of restatement. Restatement is the repeating of the main idea that the client has verbalized. This lets the client know whether or not an expressed statement has been understood and gives him or her the chance to continue, or clarify if necessary. A client's younger daughter is ignoring curfew. The client states, "I'm afraid she will get pregnant." The nurse responds, "Hang in there. Don't you think she has a lot to learn about life?" This is an example of which communication block? A Requesting an explanation B Belittling the client C Making stereotyped comments D Probing This is an example of the nontherapeutic communication block of making stereotyped comments. Clichés and trite expressions are meaningless in a therapeutic nurse-client relationship. Which nursing statement is a good example of the therapeutic communication technique of giving recognition? A "You did not attend group today. Can we talk about that?" B "I'll sit with you until it is time for your family session." C "I notice you are wearing a new dress and you have washed your hair." D "I'm happy that you are now taking your medications. They will really help." This is an example of the therapeutic communication technique of giving recognition. Giving recognition acknowledges and indicates awareness. This technique is more appropriate than complimenting the client which reflects the nurse's judgment. A client is struggling to explore and solve a problem. Which nursing statement would verbalize the implication of the client's actions? A "You seem to be motivated to change your behavior." B "How will these changes affect your family relationships?" C "Why don't you make a list of the behaviors you need to change." D "The team recommends that you make only one behavioral change at a time." 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. The nurse asks a newly admitted client, "What can we do to help you?" What is the purpose of this therapeutic communication technique? A To reframe the client's thoughts about mental health treatment B To put the client at ease C To explore a subject, idea, experience, or relationship D To communicate that the nurse is listening to the conversation This is an example of the therapeutic communication technique of exploring. The purpose of using 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. 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 should be the nursing instructor's best response? A "It's scary to feel put on the spot by a client. Nurses don't always have the answer." B "Remember, clients, not nurses, are responsible for their own choices and decisions." C "Just keep the client's best interests in mind and do the best that you can." D "Set a goal to continue to work on this aspect of your practice." Giving advice tells the client what to do or how to behave. It implies that the nurse knows what is best and that the client is incapable of any self-direction. It discourages independent thinking. A student nurse is learning about the appropriate use of touch when communicating with clients diagnosed with psychiatric disorders. Which statement by the instructor best provides information about this aspect of therapeutic communication? A "Touch carries a different meaning for different individuals." B "Touch is often used when deescalating volatile client situations." C "Touch is used to convey interest and warmth." D "Touch is best combined with empathy when dealing with anxious clients." Touch can elicit both negative and positive reactions, depending on the people involved and the circumstances of the interaction. Which nursing statement is a good example of the therapeutic communication technique of focusing? A "Describe one of the best things that happened to you this week." B "I'm having a difficult time understanding what you mean." [Show Less]