Question 1

Which intervention promotes mindful listening in any health care setting?

Accepted Answer

2. Mindful listening is best accomplished when removing environmental distractions, such as turning off the television before interviewing a patient. Offering patients a choice to drink when taking medication and encouraging the family to step outside before assessing the patient are examples of conveying respect, not mindful listening. Telling the patient to get off the phone is not a therapeutic intervention.

Question 2

The nurse is learning about active listening techniques that will improve nurse-patient relationships. What is active listening's influence on communication?

Accepted Answer

3. Active listening offers a way to hear, observe, and understand what patients communicate. Seeking clarification, another therapeutic communication technique, offers a way to seek information or clarification of the patient's thoughts or ideas. Showing acceptance, another therapeutic communication technique, acknowledges the nurse's interest in a nonjudgmental attitude. Open-ended questioning, also a therapeutic communication technique, facilitates spontaneous responses and interactive conversation.

Question 3

During a group session, a patient expresses anger at the nurse. The nurse sits tensely with arms and legs crossed while verbally agreeing that the patient's point of view is correct. What message is being sent by the nurse?

Accepted Answer

3. The nurse's nonverbal communication is incongruent with the verbal message; the nurse's closed body position conflicts with the open verbal statements. Because nonverbal cues help individuals judge the reliability of verbal messages, any incongruence between the nurse's verbal and nonverbal communication may confuse the patient. Tolerance, compassion, and empathy are positive messages that are typically expressed by using open body language.

Question 4

The nurse is meeting with a patient and says, "I would love to hear how you are feeling today." While the patient speaks, the nurse yawns, looks at her watch, and folds her arms over her chest. What do the nurse's words and actions best indicate?

Accepted Answer

3. The nurse's verbal message is incongruent with her nonverbal communication because her statement indicates interest while her nonverbal communication indicates disinterest. Meta-communication refers to those involved in the communication and the context of the communication, but not the content of the communication. There is insufficient information to determine if the nurse is bored, in part because of the mixed message she is sending.

Question 5

The psychiatric-mental health nurse is learning about various tools that can be used to help the nurse establish a therapeutic nurse-patient relationship. The nurse learns that taping offers what advantage to establishing a therapeutic relationship?

Accepted Answer

2. Communication habits and mannerism can be identified using the method of taping, offering the nurse greater awareness of both verbal and nonverbal communication skills. The technique of process recording, not taping, offers a way for feedback to be provided on communication skills and dynamics when direct, not indirect, observation is not an option. Taping does not allow communication habits and mannerisms to be memorized.

Question 6

The novice nurse is learning about the barriers to communication within the therapeutic nurse-patient relationship and the various types of communication that block the therapeutic relationship. What will the nurse recognize as a barrier to the therapeutic relationship?

Accepted Answer

1. Giving advice is a barrier to therapeutic communication because it involves the nurse identifying his or her own personal thoughts, experiences, or views and placing them above or projecting them onto the patient's situation or concerns. Giving information, seeking clarification, and voicing doubt are all therapeutic communication techniques.

Question 7

A patient tells the nurse, "I don't think I can deal with feeling so sad much longer." What is the nurse's best response?

Accepted Answer

3. The nurse is using the therapeutic communication technique of encouraging the patient to explore feelings when asking the patient to talk about the feelings of sadness. Asking the patient if he is sad is therapeutic; however, the better response is to encourage the patient to explore his feelings about being sad to facilitate developing insight. Restating would prompt a closed-ended response by focusing on the content (sad), as opposed to focusing on the behavior or feelings (sadness). Asking about the patient's history provides the patient with an opportunity to shift the focus from the feelings to providing information about the patient's family and is not the best response. Suggesting that everyone has sad times discounts the patient's feelings.

Question 8

The novice nurse is attempting to incorporate both verbal and nonverbal communication to her practice. What does the nurse recognize as the best definition of the purpose of verbal communication?

Accepted Answer

3. Argyle hypothesized that verbal communication or spoken words communicate information about external events, whereas nonverbal communication functions to establish and maintain relationships. Interactions and internal events are not part of the definition of the purpose of verbal communication.

Question 9

A novice nurse is learning about various tools that nurses may use to aid in therapeutic communication in the nurse-patient relationship. What does the nurse recognize as true regarding the concept of process recording?

Accepted Answer

4. The process recording is a written record, not audio record, of an interaction between two or more individuals. The purpose of the process recording is to reflect on and evaluate the dynamics of a specific interaction and to provide a sample of interaction for consideration in supervision or consultation with others. The process recording does not provide a guideline for therapeutic care.

Question 10

The psychiatric-mental health nurse wishes to build upon the professional skill of using therapeutic communication during the nurse-patient relationship. Using the acronym RULE, which action by the nurse will best demonstrate active listening?

Accepted Answer

3. With the acronym RULE, 'L' means listen. The best way the nurse can actively listen to the patient is by conveying empathy, or the ability to feel another person's feelings. Conveying sympathy is conveying pity for an individual, which is not active listening. While accepting and validating the patient are both important tasks for the nurse to achieve, these are therapeutic techniques themselves, not examples of active listening.

Question 11

What is the purpose of the nurse using nonverbal communication in a therapeutic relationship with a patient?

Accepted Answer

1. Nonverbal messages should enhance, not detract from, verbal messages. Nonverbal communication is used to clarify or accentuate verbal messages, not to avoid their use. Nonverbal communication is not used to terminate a therapeutic relationship.

Question 12

The nurse is caring for a patient who has been diagnosed with postpartum depression. The patient tells the nurse, "I can't seem to get out of bed and take care of my baby." Which responses by the nurse best demonstrate therapeutic communication? Select all that apply.

Accepted Answer

1. Various techniques are used to demonstrate therapeutic communication. Asking the patient, "Would I be correct in saying that you are sleeping more than usual?" is seeking clarification, and is a therapeutic communication technique. Telling the patient, "It sounds like you are having a hard time" is a statement that uses the therapeutic communication technique of affirming. Asking the patient, "Have you felt like this before, after the birth of your oldest child?" is using the therapeutic communication technique of encouraging comparison. Telling the patient, "The baby blues are normal for every woman after birth" is using social responding, which is nontherapeutic. Telling the patient, "I had this condition after my son's birth. It is best to seek help from family members" is giving advice, which is a barrier to communication.
3. Various techniques are used to demonstrate therapeutic communication. Asking the patient, "Would I be correct in saying that you are sleeping more than usual?" is seeking clarification, and is a therapeutic communication technique. Telling the patient, "It sounds like you are having a hard time" is a statement that uses the therapeutic communication technique of affirming. Asking the patient, "Have you felt like this before, after the birth of your oldest child?" is using the therapeutic communication technique of encouraging comparison. Telling the patient, "The baby blues are normal for every woman after birth" is using social responding, which is nontherapeutic. Telling the patient, "I had this condition after my son's birth. It is best to seek help from family members" is giving advice, which is a barrier to communication.
4. Various techniques are used to demonstrate therapeutic communication. Asking the patient, "Would I be correct in saying that you are sleeping more than usual?" is seeking clarification, and is a therapeutic communication technique. Telling the patient, "It sounds like you are having a hard time" is a statement that uses the therapeutic communication technique of affirming. Asking the patient, "Have you felt like this before, after the birth of your oldest child?" is using the therapeutic communication technique of encouraging comparison. Telling the patient, "The baby blues are normal for every woman after birth" is using social responding, which is nontherapeutic. Telling the patient, "I had this condition after my son's birth. It is best to seek help from family members" is giving advice, which is a barrier to communication.

Question 13

A psychiatric-mental health nurse is learning about effective ways to clarify patient's responses. What is the best example of clarifying a patient's verbal response?

Accepted Answer

4. Asking if the patient thinks the medicine is helping is an example of clarifying, which is therapeutic. "See, the medicine does work" communicates a lack of trust and is not therapeutic. "I knew it would work for you; it just takes time" and "Everything seems to work out eventually" are examples of making stereotypical comments and do not provide the patient with a sense that the nurse is listening.

Question 14

While reviewing therapeutic communication techniques, a nursing student reviews statements and actions that are nontherapeutic. Which statement best represents nontherapeutic communication?

Accepted Answer

1. Therapeutic communication skills are used to foster the nurse-patient relationship in the psychiatric-mental health setting. Asking the patient, "Why do you think you will never get well?" is an example of requesting an explanation, which is not therapeutic and requires the patient to defend his or her actions. Asking how the patient feels about being discharged, what happened when medication was discontinued, or concerns about the patient's living situation are examples of therapeutic communication.

Question 15

Which intervention demonstrates the nurse's sensitivity toward the teen who is admitted with a diagnosis of depression?

Accepted Answer

1. Listening to the patient's feelings helps to communicate the patient's value and is part of demonstrating sensitivity to the patient. Closed-ended questions limit the quality of the patient's responses, minimizing opportunity for the patient to explore feelings or to develop insight. Avoiding the use of silence does not decrease anxiety, but is often a response to anxiety.

Question 16

A nurse tells the patient that meeting new people sometimes makes the nurse feel anxious. What is the nurse demonstrating by acknowledging feelings to the patient?

Accepted Answer

3. The active component of genuineness requires an individual to be honest with another; an example of this is the nurse acknowledging feelings of anxiety to a client. Sympathy is a feeling of care or concern toward the patient, not an acknowledgment of how one feels. Empathy is the ability to feel the experience of others, not an acknowledgment of feelings. Superficiality indicates concern for one's self only and is not apparent in this scenario.

Quiz 8: The Nurse-Patient Relationship and Therapeutic Communication