Nokea
The client stated, 'I was so upset about my sister ignoring me when I was talking about being ashamed.' Which nontherapeutic communication technique would the nurse be using if the nurse would state, 'How are your stress reduction classes going?'
- A. Changing the subject
- B. Offering advice
- C. Challenging
- D. Disapproving
Correct Answer: A
Rationale: Changing the subject to an unrelated topic dismisses the client's emotional concern, hindering therapeutic communication.
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A patient yells, 'All the nurses here are so mean. None of you really care about us!' The most therapeutic response would be,
- A. I cannot allow you to yell like that.
- B. We care about you.
- C. Oh, really?
- D. You seem very irritated.
Correct Answer: D
Rationale: Reflecting the client's feelings, like irritation, acknowledges their emotions and encourages further expression, fostering a therapeutic dialogue.
Which of the following is the best reason that many psychiatric care units have policies against clients touching one another or staff?
- A. Because some clients with mental illness have difficulty knowing when touch is or is not appropriate
- B. Because clients often perceive being touched as a threat and may attempt to protect himself or herself by striking the staff person
- C. Because it can be threatening to both the client and the nurse
- D. Because touching always leads to more touching
Correct Answer: A
Rationale: Policies against touching in psychiatric units address clients' difficulty with understanding appropriate boundaries, reducing risks of misinterpretation or escalation.
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 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.
Which of the following are nontherapeutic techniques?
- A. Silence
- B. Voicing doubt
- C. Agreeing
- D. Challenging
- E. Giving approval
- F. Accepting
Correct Answer: C,D,E
Rationale: Agreeing, challenging, and giving approval are nontherapeutic as they can imply judgment or reinforce misconceptions, unlike silence, voicing doubt, or accepting, which support therapeutic dialogue.