Question 1

While taking the history of a patient, the nurse states, I see you havent eaten anything. Which therapeutic communication technique is the nurse exhibiting through this statement?

Accepted Answer

Answer reason: The nurse is simply stating a factual observation without judgment or interpretation. This encourages the patient to respond and explore their feelings or situation, making it a therapeutic communication technique.

Question 2

A 65-year-old Catholic Hispanic-Latino client with prostate cancer adamantly refuses pain medication because he believes that suffering is part of life and that his life is in God's hands. The BEST action for the nurse to take is to?

Accepted Answer

Answer reason: Asking the client if he would like to talk with a priest acknowledges his beliefs, supports his coping style, and opens communication without pressuring him to change his decision. It uses a patient-centered, respectful approach that encourages further expression.

Question 3

Lack of verbal communication for therapeutic use is which technique?

Accepted Answer

Answer reason: Silence is a therapeutic communication technique that allows the patient time to think, process emotions, and formulate responses without feeling pressured, encouraging deeper expression.

Question 4

An unlicensed assistive personnel (UAP) is being observed by the nurse talking to a client who is hearing impaired. The nurse should intervene if the UAP performs which action during communication with the client?

Accepted Answer

Answer reason: When communicating with a hearing-impaired client, the caregiver should face the client and speak clearly at a normal tone; speaking directly into the impaired ear distorts sound and reduces clarity.

Question 5

A verbally abusive client becomes angry when informed he cannot go to the cafeteria. What is the nurse’s most effective approach in this situation?

Accepted Answer

Answer reason: Offering an alternative that respects the client’s needs while maintaining safety demonstrates therapeutic communication and de-escalation. It reduces confrontation and upholds the client’s dignity without reinforcing inappropriate behavior.

Question 6

The family of a client tells the admitting nurse that they value the practice of Chinese medicine. The nurse must understand that, for this family, the PRIORITY goal is to?

Accepted Answer

Answer reason: Traditional Chinese medicine views health as a balance between yin and yang; restoring this balance is the primary goal.

Question 7

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

Accepted Answer

Answer reason: This uses reality orientation and validation without reinforcing the hallucination content.

Question 8

What type of interview is most appropriate when a nurse admits a client to a clinic?

Accepted Answer

Answer reason: During admission, the nurse must obtain specific baseline data efficiently; a directive interview uses structured, focused questions to collect necessary information.

Question 9

The nurse is preparing to take a toddler's blood pressure for the first time. Which of the following actions should the nurse do first?

Accepted Answer

Answer reason: Toddlers cooperate best when their anxiety is reduced by letting them explore and handle equipment. Detailed explanations are not effective at this age.

Question 10

Presenting alternative ideas for clients' consideration relative to problem-solving is what type of therapeutic communication?

Accepted Answer

Answer reason: Offering alternative ideas to aid problem-solving is the therapeutic technique of suggestion (presenting alternatives) without imposing advice.

Question 11

Which nursing statement is a good example of the therapeutic communication technique of focusing?

Accepted Answer

Answer reason: Focusing directs the conversation to a specific topic the patient has mentioned. Option D narrows attention to the relationship with the father and invites deeper exploration, exemplifying the focusing technique.

Question 12

A young adult seeks treatment in an outpatient mental health center. The client tells the nurse that he is a government official being followed by spies. On further questioning, he reveals that his warnings must be heeded to prevent nuclear war. What is the most therapeutic approach by the nurse?

Accepted Answer

Answer reason: The client is exhibiting grandiose delusions. The most therapeutic response is to listen without reinforcing or arguing about the delusion. Probing for more details would validate the delusion; confrontation can increase defensiveness; and contacting agencies is inappropriate.

Question 13

A newly admitted client diagnosed with obsessive-compulsive disorder (OCD) continually washes their hands. This behavior prevents attendance at unit activities. Which nursing statement best addresses this situation?

Accepted Answer

Answer reason: This response is collaborative and therapeutic, acknowledging the client's compulsion while problem-solving to facilitate participation in activities. The other options are judgmental, confrontational, or demanding immediate cessation, which are not effective with OCD.

Question 14

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?

Accepted Answer

Answer reason: In mental health settings, the use of touch must be individualized and cautious because clients may perceive it differently based on their history, culture, and psychiatric condition.

Question 15

A client refuses the medication prescribed for him because he prefers his own herbal preparation. What is the first action the nurse should take?

Accepted Answer

Answer reason: The nurse first assesses the reason for refusal and explores the client’s beliefs through open communication before taking further action.

Question 16

Which therapeutic communication technique is being used in this nurse–client interaction? Client: "When I get angry, I get into a fistfight with my wife, or I take it out on the kids." Nurse: "I notice that you are smiling as you talk about this physical violence."?

Accepted Answer

Answer reason: The nurse states an objective perception of the client's behavior (smiling) to increase awareness; this is the therapeutic technique of making observations.

Question 17

A client with considerable pain asks the nurse's opinion regarding acupuncture as a drug-free method for alleviating pain. The nurse responds, "I'd forget about it, as those weird non-Western treatments can be scary." The nurse's response is an example?

Accepted Answer

Answer reason: The statement judges non-Western practices as inferior based on the nurse’s own cultural standards, which is ethnocentrism. Discrimination involves actions, prejudice is a preconceived belief, and cultural insensitivity is broader and less precise.

Question 18

The CT scan and biopsy results are indicative of metastases to the lungs. When communicating difficult news such as this, you should?

Accepted Answer

Answer reason: Sensitive information such as a cancer diagnosis must be discussed privately to protect confidentiality and provide emotional support. Privacy allows the client to process the information and express emotions safely.

Question 19

A nurse is assessing a client diagnosed with schizophrenia for the presence of hallucinations. Which therapeutic communication technique used by the nurse is an example of making observations?

Accepted Answer

Answer reason: Making observations involves verbalizing what the nurse perceives to encourage the client to acknowledge or discuss it. Stating "You appear to be talking to someone I do not see" names the observed behavior without judgment. B encourages description of perceptions; C is a non-therapeutic "why" question; and D offers a suggestion.

Question 20

The client's younger daughter is ignoring the 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?

Accepted Answer

Answer reason: The nurse uses clichéd, nonindividualized statements (e.g., "Hang in there"), which constitute stereotyped comments that block therapeutic communication by minimizing and deflecting the client’s concern. They do not request an explanation, belittle, or probe.

Question 21

A 22-year-old with stage I Hodgkin's disease is admitted to the oncology unit for radiation therapy. During the initial assessment, the client tells you, "Sometimes I am afraid of dying." Which response is most appropriate at this time?

Accepted Answer

Answer reason: Exploring the client's feelings is the therapeutic response; the other options give reassurance, generalize, or shift to medication rather than addressing the expressed fear.

Question 22

An 8-year-old client is admitted to the child mental health unit for evaluation. Following his mother's departure, the client cries and refuses his dinner. The best approach by the nurse is to?

Accepted Answer

Answer reason: Play reduces separation anxiety and provides a developmentally appropriate avenue for communication and coping. The other options are punitive or manipulative and do not address the child's emotional needs.

Question 23

A client with paranoid delusions stares at the nurse for several days. The client suddenly walks up to the nurse and shouts, "You think you're so perfect and pure and good." An appropriate response for the nurse is?

Accepted Answer

Answer reason: The best therapeutic response is to identify and reflect the client's feeling in a calm, matter-of-fact way. Stating "You are angry right now" acknowledges the emotion without arguing, defending, or probing.

Question 24

Which of the following therapeutic communication skills is most likely to encourage a depressed client to vent feelings?

Accepted Answer

Answer reason: Silence and active listening are core therapeutic communication techniques that encourage clients to express and explore their feelings. Direct confrontation increases defensiveness, reality orientation targets confusion, and projective identification is a defense mechanism, not a communication skill.

Question 25

A client with bipolar disorder is reluctant to take lithium (Lithane) as prescribed. The most therapeutic response by the nurse to his refusal is?

Accepted Answer

Answer reason: Open-ended, nonjudgmental exploration encourages the client to verbalize concerns and builds trust; it is the most therapeutic approach. The other options are coercive or avoidant of the issue.

Question 26

What is the most appropriate nursing action when a child finds a suspicious item in a parent's drawer and expresses fear?

Accepted Answer

Answer reason: The priority is to acknowledge the child's feelings, provide reassurance, and use therapeutic communication to explore concerns and ensure emotional safety. Ignoring, confronting the parent immediately, or removing the item without discussion do not address the child's fear and may harm trust.

Question 27

Which is a nontherapeutic communication technique?

Accepted Answer

Answer reason: Sympathy conveys pity and shifts the focus to the nurse’s feelings, which hinders patient-centered communication. Focusing, clarifying, and summarizing are therapeutic techniques that facilitate understanding.

Question 28

A patient with pulmonary emboli complains of pain, dyspnea, and a fear of dying. Which of the following interventions would most likely help reduce the patient's anxiety level?

Accepted Answer

Answer reason: Therapeutic communication—listening to and acknowledging the patient’s fears—directly reduces anxiety. Oxygen and analgesics treat physiological problems but do not address the patient’s emotional distress as effectively.

Question 29

A client with terminal lung cancer is admitted to the unit. A family member asks the nurse, "How much longer will it be?" Which response by the nurse is most appropriate?

Accepted Answer

Answer reason: This open-ended response acknowledges uncertainty while inviting the family member to express feelings and concerns.

Question 30

One week after the discharge of a postpartum client, the client's husband calls and says, “Is it normal for my wife to cry at the drop of a hat?” The nurse's best initial response would be:

Accepted Answer

Answer reason: This open-ended question encourages discussion and assessment without minimizing the client’s experience or assigning blame.

Question 31

Which of the following is an example of appropriate behavior when conducting a client interview?

Accepted Answer

Answer reason: Active listening and nonverbal presence encourage trust and openness during data collection.

Question 32

A client newly diagnosed with epilepsy tells the nurse, "If I keep having seizures, I'm scared my husband will feel differently toward me." Which response by the nurse would be most appropriate?

Accepted Answer

Answer reason: Option B reflects and clarifies the client’s feelings, encouraging further discussion. The other options minimize, give false reassurance, or change the subject.

Question 33

Maintaining eye contact and receptive nonverbal communication describes which therapeutic communication technique?

Accepted Answer

Answer reason: Eye contact and receptive nonverbal cues are elements of active therapeutic listening, which conveys attention and understanding.

Question 34

The transferring nurse reports that the patient with chronic lung disease has a 30-plus-year history of tobacco use. The nurse used to smoke a pack of cigarettes a day at one time and worked very hard to quit smoking. She immediately thinks to herself, "I know I tend to feel negatively about people who use tobacco, especially when they have a serious lung condition; I figure if I can stop smoking, they should be able to. I must remember how physically and psychologically difficult that is, and be very careful not to be judgmental of this patient." This best illustrates?

Accepted Answer

Answer reason: The nurse recognizes her own biases about tobacco use and intentionally avoids judgment to provide therapeutic, patient-centered care—an example of self-awareness or self-knowledge.

Question 35

A nurse responds therapeutically to a patient with AIDS when he expresses feelings of depression and fear of death by saying, "Are you afraid of dying?" What type of therapeutic technique is used?

Accepted Answer

Answer reason: The prompt "Are you afraid of dying?" invites a yes/no response, which makes it a closed-ended question rather than an open-ended, leading, or mirroring one.

Question 36

Which of the following is appropriate for a depressed patient?

Accepted Answer

Answer reason: Depressed patients often have slowed thinking and speech. Therapeutic use of silence conveys presence and allows the time needed to respond without pressure, making it the most appropriate option among those listed.

Question 37

Which of the following is NOT an element of communication?

Accepted Answer

Answer reason: Core elements of the communication process include sender, receiver, message, channel, and feedback; attention is not considered a distinct element.

Question 38

A client with depression states, "I feel so worthless." Which response by the nurse is most therapeutic?

Accepted Answer

Answer reason: Option B uses therapeutic communication by reflecting feelings and inviting the client to share more, which validates emotions and promotes expression. A offers false reassurance, C minimizes the client’s feelings, and D inappropriately redirects.

Question 39

A postpartum mother is unwilling to allow the father to participate in the newborn's care, although he is interested in doing so. She states, "I am afraid the baby will be confused about who the mother is. Raising the baby is for mothers, not fathers." The nurse's best initial intervention is to?

Accepted Answer

Answer reason: Initial nursing action is to assess and use therapeutic communication by encouraging the mother to express feelings and concerns. Planning classes or discussing sharing duties comes later; talking to the father to accept her decision bypasses the mother’s concerns.

Question 40

A client was admitted to the psychiatric unit after complaining to her friends and family that neighbors have bugged her home in order to hear all of her business. She remains aloof from other clients, paces the floor, and believes that the hospital is a house of torture. Nursing interventions for the client should appropriately be directed toward?

Accepted Answer

Answer reason: Paranoid, suspicious clients require establishment of trust and a therapeutic alliance as the priority. Avoid arguing or trying to convince; group activities can heighten anxiety, and isolation is not indicated.

Question 41

How should a nurse caring for an elderly client with expressive and receptive aphasia communicate with the client?

Accepted Answer

Answer reason: Aphasia affects language, not hearing. Visual augmentative tools like picture boards best facilitate understanding and expression. Speaking loudly is unnecessary; gestures or slow speech may help but are less reliable alone.

Question 42

While communicating with a hearing-impaired patient?

Accepted Answer

Answer reason: Facing the patient supports lip-reading and visual cues, improving understanding. Shouting or using a high-pitched voice distorts sound, and repeating verbatim is less effective than clear, direct communication.

Question 43

A female client with the diagnosis of Crohn disease tells the nurse that her boyfriend dates other women. She believes that this behavior causes an increase in her symptoms. What should the nurse do first when counseling this client?

Accepted Answer

Answer reason: First use therapeutic communication that focuses on the client’s feelings and self-concept. Exploring her attitudes and perceptions comes before involving others or giving advice.

Question 44

An example of non therapeutic communication techniques?

Accepted Answer

Answer reason: Belittling is a non-therapeutic communication technique that dismisses the patient’s feelings. Validating, reflecting, and listening are therapeutic techniques.

Question 45

A client with Guillain-Barre syndrome has ascending paralysis and is intubated and receiving mechanical ventilation. Which strategy should the nurse incorporate in the plan of care to help the client cope with this illness?

Accepted Answer

Answer reason: Coping with acute paralysis and ventilatory support is improved by clear information, reassurance/positive feedback, and relaxation techniques. Active ROM is not feasible with severe paralysis, and restricting visitors or routine sedation does not therapeutically enhance coping.

Question 46

Which statement is not true regarding personal space?

Accepted Answer

Answer reason: Personal space typically ranges from about 18 inches to 4 feet and does not usually involve physical contact; physical contact is characteristic of intimate space. Personal space is an area a person claims as their own, is generally not threatening, and is appropriate for interviews.

Question 47

Personal barriers in effective communication do not include?

Accepted Answer

Answer reason: Language barriers are semantic/linguistic, not personal. Impatience and age are individual (person-related) factors, while rumors typically stem from interpersonal dynamics.

Question 48

"When I have a stressful day at work and when my boss 'is on my case all day' I go home and take my frustrations out on my children," says the client receiving therapy at a mental health clinic to the nurse. What is the appropriate nursing response to the client?

Accepted Answer

Answer reason: Option 1 uses therapeutic communication by inviting the client to explore and problem-solve alternative coping strategies without judgment or advice. Options 2 and 3 are leading/why questions, and option 4 gives advice and limits choices.

Question 49

Which nursing intervention should be included in the plan of care for a client experiencing fear and anxiety following a myocardial infarction?

Accepted Answer

Answer reason: Providing calm, factual information helps reduce fear and anxiety after MI. Detailed explanations can overwhelm in the acute phase, limiting family support is counterproductive, and anxiolytics require a provider order and are not the first-line nursing intervention.

Question 50

Which intervention would the nurse not consider in establishing a therapeutic relationship with a 17-year-old female with self-admitted opioid addiction?

Accepted Answer

Answer reason: Therapeutic relationships are collaborative and noncoercive. Mandating attendance is controlling and undermines autonomy, whereas discussing substance use, exploring stress-management alternatives, and assessing for comorbid disorders are appropriate therapeutic interventions.

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