A charge nurse is conducting a class on therapeutic communication with a group of newly licensed nurses. Which of the following aspects of communication should the nurse identify as a component of verbal communication?
- A. Personal space
- B. Posture
- C. Eye contact
- D. Intonation
Correct Answer: D
Rationale: Verbal communication involves the use of words, tone, and pitch to convey messages. Intonation refers to the variation of pitch in speech, which can convey emotions, attitudes, and emphasize certain points. Therefore, intonation is a key component of verbal communication, making it the correct choice in this scenario. Choices A, B, and C are aspects of nonverbal communication. Personal space, posture, and eye contact are important nonverbal cues that contribute to effective communication, but they are not components of verbal communication.
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Gilbert, age 19, is described by his parents as a 'moody child' with an onset of odd behavior at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert's early and slow onset of what is now recognized as schizophrenia, his prognosis is considered:
- A. Favorable with medication
- B. In the relapse stage
- C. Improvable with psychosocial interventions
- D. To have a less positive outcome
Correct Answer: D
Rationale: A person like Gilbert, with an early and slow onset of schizophrenia along with severe symptoms such as loss of daily functioning and obsessions, is likely to have a less positive outcome. Early and severe symptoms are often associated with a more chronic and debilitating course of schizophrenia, which can make treatment and recovery more challenging. Therefore, Gilbert's prognosis is considered to have a less positive outcome. Choices A, B, and C are incorrect because Gilbert's condition, with its early onset and severe symptoms impacting daily life, suggests a more challenging prognosis that is less likely to be favorable with just medication or psychosocial interventions. Being in the relapse stage is not the primary concern here; the focus is on the overall outcome which is expected to be less positive given the early and severe nature of Gilbert's symptoms.
Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, 'I don't need to come see you anymore. I have found a therapy app on my phone that I love.' How should Carolina respond to this news?
- A. That sounds exciting; would you be willing to visit and show me the app?
- B. At this time, there is no real evidence that the app can replace our therapy.
- C. I am not sure that is a good idea right now; we are so close to progress.
- D. Why would you think that is a better option than meeting with me?
Correct Answer: A
Rationale: Carolina should respond with openness and curiosity to maintain a positive therapeutic relationship. By showing interest in the patient's new therapy method and inviting them to share the app, Carolina demonstrates a willingness to explore alternative approaches while also ensuring the patient feels heard and valued in their decision-making process. Choice B is incorrect because it dismisses the patient's choice without exploring it further. Choice C focuses more on Carolina's concerns rather than engaging with the patient's decision. Choice D comes off as defensive and may make the patient feel misunderstood or judged.
When orienting a new client to a mental health unit, which of the following statements should the nurse make about the unit's community meetings?
- A. "Clients gather to discuss their treatment plans together."
- B. "Staff establish a specific agenda for community meetings."
- C. "Clients meet with staff to discuss common problems."
- D. "Community meetings provide an opportunity to explore personal mental health issues."
Correct Answer: C
Rationale: During community meetings in a mental health unit, clients come together with staff to discuss common problems they may be facing. These meetings are designed to foster a sense of community and provide support and guidance to clients. Choice A is incorrect because community meetings focus on discussions beyond individual treatment plans. Choice B is incorrect as while staff may facilitate the meetings, the focus is on clients' concerns, not a predetermined agenda. Choice D is incorrect as the primary purpose of community meetings is to address shared challenges, not individual mental health issues.
A client in an acute mental health facility is being discharged and requires supervision due to a severe mental illness. The client's partner works all day but is home by late afternoon. Which of the following strategies should the nurse suggest for follow-up care?
- A. Receiving daily care from a home health aide
- B. Having a weekly visit from a nurse case worker
- C. Attending a partial hospitalization program
- D. Visiting a community mental health center on a daily basis
Correct Answer: C
Rationale: For clients requiring supervision due to severe mental illness, attending a partial hospitalization program provides structured care and support while allowing the client to return home in the evenings, making it a suitable option for follow-up care. The other choices are less appropriate: A home health aide may not provide the necessary level of care and supervision, a weekly visit from a nurse case worker may not be sufficient for the client's needs, and visiting a community mental health center on a daily basis may not offer the structured support required for someone with a severe mental illness.
In an acute mental health facility, a nurse is communicating with a client. The client states, "I can't sleep. I stay up all night." The nurse responds, "You are having difficulty sleeping?" Which of the following therapeutic communication techniques is the nurse demonstrating?
- A. Offering general leads
- B. Summarizing
- C. Focusing
- D. Restating
Correct Answer: D
Rationale: The nurse is using the restating technique, where the nurse paraphrases or repeats the main idea expressed by the client to show understanding and encourage further communication. Restating helps clarify the client's message and fosters a therapeutic relationship. Choice A, offering general leads, involves encouraging the client to continue talking with nonverbal or minimal verbal prompts. Summarizing (Choice B) involves condensing and organizing the client's message. Focusing (Choice C) involves centering the conversation on a key element or topic.