Therapeutic Communication Practice Test 13
Therapeutic Communication NCLEX Practice Test
Therapeutic Communication is a key topic within the NCLEX test plan, located under Psychosocial Integrity → Coping and Adaptation → Therapeutic Communication. This section enhances empathy, active listening, and professional boundaries to strengthen nurse-patient trust. Each test contains 50 questions designed to mirror the difficulty and variety of the real exam.
This is the 13th part of the Therapeutic Communication series. To explore all practice tests under this topic, use the “Back to Main Topic” button at the end of the page.
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In the Therapeutic Communication Study Cards section, shared by real NCLEX candidates, you’ll find concise summaries and high-yield insights related to the most tested concepts. It’s a perfect space to reinforce challenging topics and sharpen your recall through quick, focused repetitions. Short, powerful, and repeatable!
Therapeutic Communication Practice Test 13
The nurse is providing care for a patient diagnosed with laryngeal cancer who is receiving radiation therapy. The patient tells the nurse that he is experiencing hoarseness and difficulty with speaking. What is the nurse’s best response?
- “Let’s elevate the head of your bed and see if that helps.”
- “Your voice should improve in 6 to 8 weeks after completion of the radiation.”
- “Sometimes patients also experience dry mouth and difficulty with swallowing.”
- “I will call your health care provider and let him know about this.”
Explanation: Answer reason: Radiation to the larynx commonly causes mucosal inflammation and edema that can lead to transient hoarseness and impaired phonation. The most therapeutic response is to provide clear, accurate anticipatory guidance that normalizes the symptom and sets an expected recovery timeframe, which reduces anxiety and supports coping. Elevating the head of the bed is not a targeted intervention for radiation-related vocal cord irritation and does not address the patient’s concern. Notifying the provider is usually reserved for red flags (e.g., progressive airway compromise, stridor, severe dysphagia/aspiration), not uncomplicated expected side effects.
The parent of a child diagnosed with attention-deficit hyperactivity disorder (ADHD), predominantly inattentive type, says to the nurse, "I hate the idea of my child taking a drug that's a stimulant. How will I know that the methylphenidate is even working?" Which is the best response by the nurse?
- "Methylphenidate is generally a safe and effective drug for children with ADHD."
- "Methylphenidate will increase the levels of neurotransmitters in your child's brain."
- "You should see your child's school grades improve."
- "Your child should be able to more easily complete school assignments and other tasks."
Explanation: Answer reason: " Stimulants used for ADHD are evaluated by observable functional improvements in attention, task initiation, and task completion across settings. This response gives the parent a concrete, behavior-based outcome to monitor, which is more clinically meaningful than a general reassurance or a mechanism-of-action statement. Grades can be influenced by many variables (teaching style, workload, learning disorders, home environment) and may lag behind symptom improvement, making it an unreliable early indicator. Describing improved ability to complete assignments directly reflects the target symptom domain for predominantly inattentive ADHD and supports appropriate parental expectations.
The nurse is providing care to a client experiencing posttraumatic stress disorder following a terrorist attack at the client's place of worship. What is the priority nursing action?
- Acknowledge the client's feelings of anger
- Assess the client's support system
- Encourage the client to talk about the trauma
- Offer the client a PRN sleep medication
Explanation: Answer reason: Reflecting and acknowledging emotions helps reduce anxiety, builds trust, and supports emotional regulation without pushing disclosure. Prematurely focusing on retelling the event can intensify distress and trigger re-experiencing symptoms. Assessment of supports and addressing sleep may be appropriate next steps, but they follow initial validation and rapport-building.
A mother is to undergo a breast biopsy. She tells the nurse, “If I lose my breast, I know my husband will no longer find me attractive.” Which of the following responses by the nurse would be MOST appropriate?
- “You don’t know if you are going to lose your breast. They are just doing the biopsy now.”
- “You should focus on your children. They are young and they need you.”
- “You seem to be concerned that your relationship with your husband might change.”
- “Why don’t you wait and see what your husband’s reaction is before you get upset.”
Explanation: Answer reason: ” This uses therapeutic communication by reflecting and validating the client’s stated fear, which encourages further expression and assessment of coping. It focuses on the client’s feelings and meaning (body image and relationship concerns) without minimizing or offering false reassurance. It keeps the conversation client-centered and opens the door to explore supports and potential counseling needs. A common pitfall is giving advice or redirecting (e.g., focusing on children), which can shut down communication and increase distress.
A client who is newly diagnosed with paranoid schizophrenia tells the nurse, “The aliens are telling me that I’m defective and need to be eliminated.” Which of the following responses by the nurse is most appropriate initially?
- “I know those voices are real to you, but I don’t hear them.”
- “You are having hallucinations as a result of your illness.”
- “I want you to agree to tell staff when you hear these voices.”
- “Your medications will help control these voices you are hearing.”
Explanation: Answer reason: Therapeutic communication with hallucinations prioritizes acknowledging the client’s experience and feelings while presenting reality without arguing or reinforcing the delusion. This response validates the distress and builds rapport, and it also gently orients to reality by stating the nurse does not perceive the voices. Telling the client they are hallucinating can feel confrontational or dismissive early in the interaction and may increase paranoia. Discussing medication effects or making agreements to report voices can be helpful later, but the initial priority is establishing trust and reality-based support.
A client who has had three episodes of recurrent endogenous depression within the past 2 years states to the nurse, “I want to know why I’m so depressed.” Which of the following statements by the nurse is most helpful?
- “I know you’ll get better with the right medication.”
- “Let’s discuss possible reasons underlying your depression.”
- “Your depression is most likely caused by a brain chemical imbalance.”
- “Members of your family seem very supportive of you.”
Explanation: Answer reason: Therapeutic communication focuses on exploring the client’s feelings and perceptions with open-ended, collaborative statements that invite discussion. This response acknowledges the client’s question and encourages deeper exploration of contributing factors (biologic, psychosocial, situational) without making assumptions. Promising improvement with medication can give false reassurance and shuts down exploration, and attributing depression solely to “chemical imbalance” is an unverified, overly simplistic explanation that may invalidate the client’s experience. Commenting on family support may be positive but does not directly address the client’s expressed need to understand their depression.
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