Nokea
A patient states, 'I feel fine. It's a good day.' The nurse notes the patient looking away, and a decreasing pitch in his voice while speaking. Which of the following is the most therapeutic response by the nurse?
- A. I'm glad you are feeling good today.
- B. I'm not sure I believe you.
- C. Tell me what is good about today.
- D. You say you feel fine, but you don't really sound fine.
Correct Answer: D
Rationale: Verbalizing the implied by noting the incongruence between the client's words and nonverbal cues encourages clarification and deeper discussion, making it the most therapeutic response.
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A client is fearful and reluctant to talk. Which of the following techniques is most effective when trying to engage the client in interaction?
- A. Broad opening
- B. Focusing
- C. Giving information
- D. Silence
Correct Answer: A
Rationale: Broad openings allow a fearful client to choose what to discuss, reducing pressure and encouraging interaction, unlike focusing or silence which may intimidate.
The nurse asks the patient, 'What was it like for you when you first knew you had no place to go?' The patient looks down and pauses for quite some time. Which action by the nurse is most therapeutic?
- A. Change the subject to something the patient will discuss
- B. Encourage the patient to express any unpleasant feelings
- C. Apologize for asking such a personal question
- D. Sit quietly until the patient responds
Correct Answer: D
Rationale: Silence allows the patient time to process and respond, respecting their pace, unlike changing the subject or apologizing, which may disrupt therapeutic engagement.
A nurse has invited a patient to sit down and have a conversation. The patient takes the first seat. The nurse pulls up another chair to sit with the patient. Approximately how far from the patient should the nurse place her chair?
- A. 1 to 2 feet
- B. 3 to 4 feet
- C. 6 to 8 feet
- D. 8 to 10 feet
Correct Answer: B
Rationale: A distance of 3 to 6 feet is optimal for therapeutic communication, balancing comfort and professionalism, unlike closer intimate or farther social distances.
The nurse uses a variety of therapeutic communication skills when working with patients. Which of the following is a therapeutic goal that can be accomplished through the use of therapeutic communication skills?
- A. Inform the patient of priority problems
- B. Assess the patient's perception of a problem
- C. Assist the patient to control emotions
- D. Provide the patient with a plan of action
Correct Answer: B
Rationale: Therapeutic communication aims to understand the client's perspective, including assessing their perception of a problem, to facilitate emotional expression and collaborative planning, rather than imposing priorities or solutions.
A patient remarks, 'You know, it's the same thing every time.' The nurse should respond by stating,
- A. I understand
- B. I'm sure everyone is doing their best.
- C. I'm not sure what you mean. Please explain.
- D. It's the same thing every time?
Correct Answer: C
Rationale: Consensual validation seeks mutual understanding by clarifying ambiguous statements, ensuring both nurse and client share the same meaning.