A male client with a diagnosis of schizophrenia begins to have hallucinations during a conversation with the nurse; this prevents him from receiving the message that the nurse is trying to communicate to him. According to Ruesch’s theory of communication, this unsuccessful interaction is called _____ communication.
Disturbed
Nontherapeutic
Blocked
Therapeutic
The theorist Eric Berne theorized that an individual’s three ego states of parent, child, and adult make up one’s:
Conscience
Personality
Thought processes
Ability to communicate
The nursing student is assigned a client to interview and is asked to practice the therapeutic communication technique of sharing perceptions. Which statement made by the student nurse best describes this technique?
“I noticed that you pace the halls, and you have a tense look on your face. I sense that you are anxious about something.”
“Can you tell me more about how you feel when you are arguing with your daughter?”
“I would like to talk with you about your plan of care.”
“Tell me if I understand you correctly.”
The nurse is talking with a male client regarding his recent relapse of alcohol addiction. The client alludes to the fact that he started to drink again after a fight with his wife. The nurse uses clarification to ensure an accurate understanding of the client. Which statement is the best example of clarification?
“You said that the fight you had with your wife caused you to start drinking again?”
“Let’s discuss what made you feel the need to drink.”
“Could you tell me again when and what happened that you feel caused you to start drinking again?”
“Tell me what your childhood was like.”
A female client discusses her feelings of jealousy regarding the relationship between her mother and her daughter. The nurse responds in a nontherapeutic way by making a statement that is defensive and challenging. Which statement is the best example of a defensive and challenging nontherapeutic response?
“Tell me more about the feelings you have regarding their relationship.”
“I think that you should tell them how you feel.”
“Let’s not talk about that right now.”
“Don’t you think that you should be thankful that your daughter has a good relationship with her grandmother?”
A female client has been attending group therapy for support regarding an abusive relationship with her husband. The client voices concern about her 10-year-old daughter growing up in this environment but states that she just can’t find the strength to leave her husband. The nurse responds by using the nontherapeutic technique of reassuring. Which statement is the best example of this nontherapeutic technique?
“I can’t believe that you would want your daughter to grow up in this environment.”
“I understand your concern. Let me give you some information on our local council for domestic abuse.”
“I’m sure it won’t be that bad to be out on your own. I know you can do it.”
“I think you should not think about leaving and should just do it.”
Therapeutic communication techniques support effective communication between the client and the nurse. Which group of therapeutic techniques is most likely to be effective when one is conversing with a client?
Broad openings, restating, and advising
Clarification, focusing, and confrontation
Listening, silence, and reflection
Humor, informing, and reassuring
While the nurse is talking with a female client, the client becomes silent for several seconds. Which is the nurse’s best response?
To interpret this action as an indication that the client is finished with the conversation
To ask the client a question so the interaction can continue
To remain silent and be attentive to the client’s nonverbal communication
To tell the client that help can be more effective if she shares her feelings
A client who usually is very active in her therapy group tells the nurse that she really does “not feel well today” and would “rather not attend the group therapy session.” Which is the nurse’s most appropriate response?
“You don’t feel like attending the group therapy today?”
“I will just stay with you for a while.”
“It’s okay to skip a session every once in a while.”
“Why don’t you want to attend group therapy?”
The nurse is talking with a male client with a diagnosis of schizophrenia who often experiences auditory hallucinations. For this communication to be most effective, the nurse should:
Sit with the client and encourage him to not verbalize.
Do most of the talking.
Discuss several different topics to keep the client’s attention.
Use simple, concrete language.
The nurse’s ability to interpret communication effectively in the mental health setting depends mostly on:
How well the client communicates
The nurse’s relationship with the client
The nurse’s understanding of mental health disorders
The nurse’s ability to listen to and observe the client’s verbal and nonverbal messages
Which nurse response is the best example of the therapeutic principle of respect?
“I’m interested in what you have to say.”
“Describe how you are feeling for me.”
“I hear how worried you are about your future and can imagine how you feel.”
“You signed a contract stating that you would let me know when you have those thoughts.”
A female client is being discharged from an inpatient mental health unit after receiving treatment for bipolar disorder. She has responded well to treatment but voices concern about going home and maintaining balance in her life. The client would benefit most by a response from the nurse that conveyed the therapeutic communication principle of:
Permission
Respect
Interest
Protection
A nurse has just graduated from nursing school and has been hired on a mental health unit. The nurse wants to practice good communication skills with clients but knows that a mistake made by many new nurses in trying to communicate effectively involves:
Focusing
Parroting
Restating
Clarifying
A client has difficulty in communicating as a result of his illness. He displays a rapid, confusing delivery of speech patterns. Which term best describes this difficulty in communicating?
Aphasia
Dyslexia
Speech cluttering
Incongruent communications
When practicing therapeutic communication with a client, the nurse demonstrates which of the following listening skills?
Finishing the client’s sentences to indicate listening
Not clarifying messages to avoid interrupting
Avoiding taking notes to detract from listening
Changing the environment to decrease distractions
The nurse asks a client how she is feeling, and the client provides a detailed description of everything she is experiencing.This is an example of:
Echolalia
Circumstantiality
Neologism
Perseveration
The client tells the nurse that she believes there is no improvement in her manic episodes. Her clothing matches, and her makeup is more subdued. She sits quietly in the chair during the session. What does this indicate?
Verbal communication takes priority.
Verbal communication is not congruent with nonverbal communication.
Nonverbal communication indicates the client is lying.
Nonverbal communication should take priority.
When the adolescent client is asked about the magazine she is reading, she responds, “It’s an article about my favorite movie star. Did you see all the stars out last night? I used to be afraid of the dark at night." Which speech pattern is this an example of?
Flight of ideas
Loose association
Which elements must be present for communication to occur? (Select all that apply.)
Feedback
Transmission
Sender
Clarification
Receiver
Context
Which interventions assist the nurse to effectively communicate with clients from other cultures? (Select all that apply.)
The nurse adapts his or her behavior to accommodate the difference in communication styles.
The nurse identifies and clarifies confusion during the interaction.
The nurse recognizes the difference between communication styles and assists the client to change to the nurse’s communication style.
The nurse uses a limited number of slang terms when communicating with the client.
Which nurse responses could block effective communication with a client? (Select all that apply.)
“This is what I think you should say...”
“Don’t stress over it. Everything will turn out fine.”
“Why did you do that?”
“Most people in your circumstance...”
In order to be therapeutic when communicating with a client living in a homeless shelter, it is important to apply which techniques? (Select all that apply.)
Show acceptance and respect.
Avoid clarifying terms.
Use medical terminology to avoid talking down.
Consider the client’s environment.
Assess client’s pattern of verbal and nonverbal communication.
Communication is the transferring between people of information, including ideas, beliefs, feelings, and attitudes.
During the process of communication, a chain of events occurs as soon as the message is sent. Steps in this chain include transmission, perception, and evaluation. Place these steps in proper chronological order. (Separate letters by a comma and space as follows: A, B, C.)
A,C,B
C,A,B
A,B,C
B,C,A
