Question 1

The nurse tells a patient, "I noticed that you frowned when we discussed your relationship with your family." Which communication technique is the nurse using?

Accepted Answer

A)   Clarifying
B)   Interpreting
C)   Giving information
D)   Making observations D

Question 2

A patient states, "I'm tired of all these therapy sessions. It's just too much for me." Using supportive confrontation, the nurse should reply:

Accepted Answer

A)   "It will get better if you just keep trying."
B)   "You are doing fine. Don't be so hard on yourself."
C)   "Tell me more about how the therapy sessions are too much."
D)   "I know you find this difficult, but I believe you can get through it." D

Question 3

A patient says to the nurse, "I dreamed I could not breathe and was being attacked. When I woke up, I felt emotionally drained, as though I hadn't rested well." Which comment would be appropriate if the nurse seeks to interpret?

Accepted Answer

A)   "It sounds as though you were uncomfortable with the content of your dream."
B)   "So you are saying that you were not able to breathe and felt in danger?"
C)   "I understand. Thank you for telling me about your bad dream."
D)   "So, you feel as though you had a poor night's sleep?" A

Question 4

When observing and interpreting a patient's nonverbal communication, which nursing consideration is important?

Accepted Answer

A)   Patients are usually aware of their nonverbal cues.
B)   Verbal responses are more important than nonverbal cues.
C)   Nonverbal cues have obvious meaning and are easily interpreted.
D)   Nonverbal cues provide significant information but must be validated.

Question 5

Effective use of the nursing process is dependent on communication that:

Accepted Answer

A)   is structured and goal-directed.
B)   meets the needs of both patient and nurse.
C)   is spontaneous and affords mutual self-disclosure.
D)   fosters emotional distance between patient and nurse.

Question 6

A patient is withdrawn, suspicious, and maintains physical distance from staff and other patients. Which intervention demonstrates appropriate use of touch with this patient?

Accepted Answer

A)   Refraining from touch
B)   Patting the patient's arm when fear is expressed
C)   Reaching out to shake the patient's hand as an initial greeting
D)   Placing an arm around the patient's shoulders while walking down the hall

Question 7

What is the best analysis of this described nurse-patient interaction?
Patient: I get discouraged when I realize I've been struggling with my problems for over a year.
Nurse: Yes you have, but many people take even longer to resolve their issues. You shouldn't be so hard on yourself.

Accepted Answer

A)   The nurse has responded ineffectively to the patient's concerns.
B)   The patient is expressing lack of willingness to collaborate with the nurse.
C)   The patient is offering the opportunity for the nurse to revise the plan of care.
D)   The nurse is using techniques that are consistent with the evaluation step of the nursing process.

Question 8

A patient has difficulty expressing anger appropriately. The nurse encourages the patient to set realistic goals by stating:

Accepted Answer

A)   "You seem to have problems expressing anger in a nonaggressive way."
B)   "I thought you sounded angry when I told you it was time for group."
C)   "What do you think needs to change about how you express anger?"
D)   "What bothers you about your actions when you get angry?"

Question 9

A nurse realizes that the comment just made to a patient was inconsiderate. Select the nurse's most therapeutic statement in this situation.

Accepted Answer

A)   "How do you feel about what I just said?"
B)   "See, even nurses say stupid things sometimes."
C)   "Sorry about that. Let's continue where we left off."
D)   "That was an insensitive remark. I'm sorry if it hurt you."

Question 10

A newly admitted patient asks the nurse, "Can you hear those people laughing at me? They are making fun of me." Select the nurse's best response.

Accepted Answer

A)   "You are mistaken. No one is laughing at you."
B)   "I know the sound of laughter is real to you, but I don't hear it."
C)   "Your mind is playing tricks on you, making you think you hear laughter."
D)   "When people are mentally ill, they often experience things that others cannot relate to."

Question 11

During a one-on-one interaction with the nurse, a patient frequently looks nervously at the door. Select the best comment by the nurse to this nonverbal cue.

Accepted Answer

A)   "I notice you keep looking toward the door."
B)   "This is our time together. No one is going to interrupt us."
C)   "It looks as if you are eager to end our discussion for today."
D)   "If you are uncomfortable in this room, we can move someplace else."

Question 12

A patient diagnosed with schizophrenia, paranoid type, frequently gets up and walks away during interactions with a nurse. The nurse can best increase the patient's comfort level by:

Accepted Answer

A)   arranging the chairs side by side, about 2 feet apart.
B)   sitting at eye level across the table from the patient.
C)   standing a few feet away from where the patient sits.
D)   talking in the patient's room with the door closed.

Question 13

A patient scheduled to attend various group sessions complains, "I'm really mad about having to attend all those groups. No one else spends all day in a circle in a little room." Select the nurse's best response.

Accepted Answer

A)   "Why are you upset?"
B)   "I can hear that you are upset. Let's talk about it."
C)   "Just go along with the plan, even if you do not agree."
D)   "The groups are carefully planned by staff to benefit patients."

Question 14

A common mistake nurses make when developing therapeutic communication techniques is:

Accepted Answer

A)   using too many different techniques during an interaction.
B)   allowing patients to become too anxious before responding.
C)   giving advice rather than encouraging patients to solve problems.
D)   focusing on what patients say rather than on communication techniques.

Question 15

A patient's plan of care includes this nursing diagnosis: Impaired verbal communication related to lack of assertiveness skills. To include the patient in prioritizing this problem, the nurse should say:

Accepted Answer

A)   "Who are the people with whom you are most passive?"
B)   "How important is it for you to become more assertive?"
C)   "Let's look at how we can address this problem together."
D)   "Are you interested in attending the assertiveness class?"

Question 16

During an interview with a depressed patient, the nurse sits with folded arms and fidgets when long silences occur. When the patient expresses hopelessness about getting better, the nurse replies, "You will feel better when your medication takes effect." This interaction:

Accepted Answer

A)   shows therapeutic use of limit-setting.
B)   is minimally therapeutic but effective.
C)   evidences therapeutic use of self.
D)   is nontherapeutic and ineffective.

Question 17

Which skill is most important for a nurse preparing to work in the psychiatric setting?

Accepted Answer

A)   Helpful transference
B)   Sympathetic listening
C)   Supportive confrontation
D)   Therapeutic communication

Question 18

A patient says to the nurse, "My family was mean to me when they visited today. They have no right to treat me like that." Select the nurse's best initial response.

Accepted Answer

A)   "Why do you think they were mean?"
B)   "Perhaps you overreacted to what they said."
C)   "How do you feel about your family treating you that way?"
D)   "Describe what happened when your family visited you today."

Question 19

A nurse wants to provide opportunities for a patient to try out new, more assertive behaviors. Which technique should the nurse use?

Accepted Answer

A)   Clarifying
B)   Role-playing
C)   Giving feedback
D)   Encouraging evaluation

Question 20

Which techniques are therapeutic when interacting with a patient? Select all that apply.

Accepted Answer

A)   Avoiding direct questions
B)   Validating and clarifying
C)   Using empathy sparingly
D)   Assuming an attending posture
E)   Maintaining constant eye contact

Exam 8: Learning to Communicate Professionally