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A nurse responds to a patient?s statement with silence based on the rationale that this technique is used primarily to do which of the following?
- A. Allow the nurse to determine an appropriate response
- B. Permit the patient to gather his or her thoughts
- C. Encourage self-reflection by the nurse
- D. Demonstrate passive listening
Correct Answer: B
Rationale: Silence in therapeutic communication allows the patient to gather thoughts, process emotions, or continue speaking, promoting deeper exploration. It?s not primarily for the nurse?s response planning, self-reflection, or passive listening, which is nontherapeutic.
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A group of students are reviewing the process of verbal communication. The students demonstrate understanding of the information when they identify which of the following as the first component of the process?
- A. Formulation of an idea
- B. Message encoding
- C. Transmission of message
- D. Message reception
Correct Answer: A
Rationale: Verbal communication begins with formulating an idea, which is then encoded, transmitted, and received. Formulation is the initial step where the speaker conceptualizes the message.
While providing care to a patient with a mental disorder, the patient asks the nurse, 'Does mental illness run in your family?' Which response by the nurse would be most inappropriate?
- A. Mental illnesses do run in families, and I?ve had a lot of experience caring for people with mental illness.
- B. It sounds like you are concerned that there may be a family connection to your current problem?
- C. Yes, it does. I have a sister who was diagnosed several years ago with severe major depression.
- D. Mental illness can be family related. Let?s focus the discussion on you and how you?re doing today.
Correct Answer: C
Rationale: Self-disclosure, especially personal details like a family member?s mental illness, is inappropriate in therapeutic communication unless it directly benefits the patient. Option C risks shifting focus to the nurse. Other responses redirect to the patient?s concerns or provide general information, maintaining therapeutic focus.
During an interview, a patient tells the nurse that he was recently let go from his job. As the interaction continues, the patient states, 'I was really overqualified for that position anyway. It was definitely below my area of expertise.' The nurse interprets this information as reflecting which of the following?
- A. Denial
- B. Intellectualization
- C. Projection
- D. Passive aggression
Correct Answer: B
Rationale: Intellectualization involves using rational explanations to avoid emotional distress. The patient?s statement minimizes the job loss by focusing on being overqualified, distancing from the emotional impact. Denial avoids the reality, projection attributes feelings to others, and passive aggression expresses hostility indirectly.
A patient is talking to the nurse about the recent death of her grandmother. She is obviously very sad, and a tear rolls down her cheek as she talks. The nurse remembers how she felt when her own grandmother died the previous summer. The nurse puts her hand on the patient?s shoulder and says, 'This must be very difficult for you.' The nurse is demonstrating empathy based on which of the following?
- A. The response comment reflects an attempt to communicate understanding of patient?s feelings.
- B. The nurse?s response and use of reassuring touch reinforce the nurse?s concern for the patient.
- C. The nurse demonstrates understanding of how the patient feels because of her own grandmother?s death.
- D. The nurse?s statement expresses compassion and kindness toward the patient.
Correct Answer: A
Rationale: Empathy involves understanding and communicating the patient?s feelings. The nurse?s statement and touch reflect an attempt to convey understanding of the patient?s grief, aligning with empathy. Option C describes countertransference, and options B and D describe compassion but not the specific mechanism of empathy.
When engaged in a nontherapeutic relationship, which of the following would the nurse identify as occurring first?
- A. Failure to recognize the patient as a person with a need
- B. Patient avoiding the nurse
- C. The nurse being perceived as rude
- D. Patient feeling hopeless and frustrated
Correct Answer: A
Rationale: A nontherapeutic relationship begins with the nurse?s failure to recognize the patient?s individual needs, undermining trust and rapport. This precedes patient avoidance, perceptions of rudeness, or feelings of hopelessness, which are outcomes of the initial failure.