Nursing Chapter 8: Therapeutic Communication
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Questions and Answers

What is the purpose of the therapeutic communication technique of exploring?

  • To tell the client how to behave
  • To delve further into the subject, idea, experience, or relationship (correct)
  • To share the nurse's experiences
  • To provide advice to the client

    • Which response by the nursing instructor is best when a student nurse expresses concern about providing advice to a client?

  • Remember, clients, not nurses, are responsible for their own choices and decisions. (correct)
  • Set a goal to continue to work on this aspect of your practice.
  • It's scary to feel put on the spot by a client. Nurses don't always have the answer.
  • Just keep the client's best interests in mind and do the best that you can.

    • What does the instructor say about the appropriate use of touch when communicating with clients diagnosed with psychiatric disorders?

  • Touch is best combined with empathy when dealing with anxious clients.
  • Touch is often used when deescalating volatile client situations.
  • Touch is used to convey interest and warmth.
  • Touch carries a different meaning for different individuals. (correct)

    • Which nursing statement is a good example of the therapeutic communication technique of focusing?

    <p>You mentioned your relationship with your father. Let's discuss that further.</p> Signup and view all the answers

    What is the nurse's best response when a client expresses anger after a canceled blood test?

    <p>I see that you are upset, but I feel uncomfortable when you swear at me.</p> Signup and view all the answers

    Which nursing statement may belittle the client's feelings and concerns?

    <p>Don't worry. Everything will be alright.</p> Signup and view all the answers

    What is an appropriate initial response to a client expressing feelings of worthlessness?

    <p>You've been feeling sad and alone for some time now?</p> Signup and view all the answers

    Which nursing response illustrates nontherapeutic communication by requesting an explanation?

    <p>Can you tell me why you said that?</p> Signup and view all the answers

    Which nursing response best assesses a situation when a client describes a negative interaction with their spouse?

    <p>Describe what happened during your time with your husband.</p> Signup and view all the answers

    What is the best nursing response to a client experiencing auditory hallucinations?

    <p>I understand that the voices seem real to you, but I do not hear any voices.</p> Signup and view all the answers

    Which nursing statement is a good example of the therapeutic communication technique of offering self?

    <p>Would you like me to accompany you to your electroconvulsive therapy treatment?</p> Signup and view all the answers

    What therapeutic communication technique did the nurse employ when stating, 'You seem angry,' and how is the client demonstrating a defense mechanism?

    <p>Verbalizing the implied and the defense mechanism of denial</p> Signup and view all the answers

    Which of the following individuals are communicating a message? (Select all that apply)

    <p>A teenage boy isolating himself and playing loud music</p> Signup and view all the answers

    Which therapeutic communication technique is being used in this nurse-client interaction? Client: 'When I get angry, I get into a fistfight with my wife or I take it out on the kids.' Nurse: 'I notice that you are smiling as you talk about this physical violence.'

    <p>Making observations</p> Signup and view all the answers

    Which therapeutic communication technique is being used in this nurse-client interaction? Client: 'My father spanked me often.' Nurse: 'Your father was a harsh disciplinarian.'

    <p>Restatement</p> Signup and view all the answers

    Which therapeutic communication technique is being used in this nurse-client interaction? Client: 'When I am anxious, the only thing that calms me down is alcohol.' Nurse: 'Other than drinking, what alternatives have you explored to decrease anxiety?'

    <p>Formulating a plan of action</p> Signup and view all the answers

    Which nursing statement is an example of offering a 'general lead'?

    <p>'Yes, I see. Go on.'</p> Signup and view all the answers

    A nurse states to a client, 'Things will look better tomorrow after a good night's sleep.' This is an example of which communication technique?

    <p>The nontherapeutic technique of 'giving false reassurance'</p> Signup and view all the answers

    Which therapeutic communication technique used by the nurse is an example of a broad opening?

    <p>'What would you like to talk about?'</p> Signup and view all the answers

    Which therapeutic communication technique used by the nurse is an example of making observations?

    <p>'You appear to be talking to someone I do not see.'</p> Signup and view all the answers

    A nurse maintains an uncrossed arm and leg posture. This nonverbal behavior is reflective of which letter of the SOLER acronym for active listening?

    <p>O</p> Signup and view all the answers

    Which instructor statement is the best example of effective feedback?

    <p>'I noticed that you used the client's name in your written process recording. That is a breach of confidentiality.'</p> Signup and view all the answers

    Which communication technique has the group leader employed? 'I'm so proud of you for being assertive. You are so good!'

    <p>The nontherapeutic technique of giving approval</p> Signup and view all the answers

    What is the purpose of a nurse providing appropriate feedback?

    <p>To give the client critical information</p> Signup and view all the answers

    Which appropriate feedback should a nurse provide when a client with antisocial personality disorder experiences an angry outburst?

    <p>'During group, you raised your voice, yelled at a peer, and slammed the door.'</p> Signup and view all the answers

    Which nursing response is most appropriate for a client with dependent personality disorder asking about moving out?

    <p>'Let's discuss and explore all of your options.'</p> Signup and view all the answers

    Which nursing statement reflects the nonverbal behavior of sitting squarely, facing the client?

    <p>Sitting squarely, facing the client</p> Signup and view all the answers

    What is an example of reflection in a nurse's response?

    <p>'You're feeling guilty because you weren't able to save your children.'</p> Signup and view all the answers

    Which nursing statement best addresses a client with OCD who washes hands continually?

    <p>'Let's figure out a way for you to attend unit activities and still wash your hands.'</p> Signup and view all the answers

    Which example of a therapeutic communication technique would be effective in planning?

    <p>'We've discussed past coping skills. Let's see if these coping skills can be effective now.'</p> Signup and view all the answers

    Which nursing response is therapeutic for a client feeling bad about their mother not wanting them home?

    <p>'You feel that your mother does not want you to come back home?'</p> Signup and view all the answers

    Which communication block is exemplified by the nurse's response, 'Hang in there. Don't you think she has a lot to learn about life?'

    <p>Making stereotyped comments</p> Signup and view all the answers

    Which nursing statement is a good example of the therapeutic communication technique of giving recognition?

    <p>'I notice you are wearing a new dress and you have washed your hair.'</p> Signup and view all the answers

    Which nursing statement is an example of verbalizing the implied?

    <p>'You seem to be motivated to change your behavior.'</p> Signup and view all the answers

    Study Notes

    Therapeutic Communication Techniques

    • Making Observations: Noting a client's nonverbal cues, such as smiling while discussing violence, prompts further exploration of emotions.
    • Restatement: Repeating a client's main idea (e.g., "Your father was a harsh disciplinarian") to confirm understanding and encourage continuation of dialogue.
    • Formulating a Plan of Action: Encouraging clients to explore alternatives to maladaptive behaviors, such as asking about alternatives to alcohol for anxiety relief.
    • Offering General Leads: Statements like "Yes, I see. Go on." invite clients to share more information and promote open dialogue.
    • Giving False Reassurance: Phrases like "Things will look better tomorrow" can minimize the client's feelings and create a disconnect between nurse and client.
    • Broad Opening: Asking "What would you like to talk about?" empowers the client to direct their discussion, enhancing their involvement in the therapeutic process.
    • Verbalizing Implied Feelings: Identifying and articulating the emotional responses of clients can foster deeper understanding and address hidden concerns.

    Nonverbal Communication

    • SOLER Acronym: A framework for effective nonverbal communication:
      • S: Sitting squarely facing the client.
      • O: Open posture (uncrossed arms and legs).
      • L: Leaning slightly forward.
      • E: Establishing eye contact.
      • R: Relaxing to convey comfort and safety.

    Effective Feedback

    • Descriptive Feedback: Focused on observable behaviors, such as "During group, you raised your voice." This model helps clients understand how their actions are perceived without judgment.
    • Encouraging Exploration: Nurses should guide discussions towards evaluating options and independent decision-making, such as discussing living arrangements with clients.

    Communication Blocks

    • Giving Approval: Seeking to validate client behaviors can create dependency; hence, it is viewed as a nontherapeutic technique.
    • Stereotyped Comments: Using clichés, such as dismissive phrases, detracts from meaningful communication.

    Therapeutic Responses and Techniques

    • Reflection: Addressing feelings by saying statements like, "You're feeling guilty..." helps clients clarify emotional responses.
    • Encouraging Coping Skills: Nurses should assist clients in applying effective coping strategies from the past to current situations.
    • Exploring Client Experiences: Delving deeper into the reasons behind hospitalization or emotional states aids in comprehensive understanding and intervention.

    Understanding Client Needs

    • Distinction Between Information and Advice: Educators stress that clients are responsible for their decisions; thus, nurses should guide rather than dictate choices.
    • Touch in Communication: Nurses should approach touch with caution, acknowledging its variable significance and ensuring it is appropriate in therapeutic settings.### Touch and Empathy
    • Touch can provoke both positive and negative reactions depending on context and individuals involved.
    • Combining touch with empathy is effective for addressing anxiety in clients.

    Therapeutic Communication Techniques

    • Focusing: Directing conversation on a particular topic enhances client clarity. Example: "You mentioned your relationship with your father. Let's discuss that further."
    • Feedback: Appropriate feedback should concern behaviors the client can modify. Example: "I see that you are upset, but I feel uncomfortable when you swear at me."
    • Belittling Feelings: Statements that minimize client emotions can lead to a lack of empathy. Example: "Don't worry. Everything will be alright."
    • Reflection: Encourages clients to express and recognize feelings. Example: "You've been feeling sad and alone for some time now?"

    Communication Blocks

    • Requesting an Explanation: Asking clients to justify their feelings can intimidate them, suggesting they must defend their emotional state. Example: "Can you tell me why you said that?"
    • Exploring: In-depth discussion of specific events or situations helps clients articulate their experiences. Example: "Describe what happened during your time with your husband."

    Presenting Reality

    • Effective for clients experiencing hallucinations. It involves clarifying the nurse's observations to help clients distinguish between misperceptions and reality. Example: "I understand that the voices seem real to you, but I do not hear any voices."

    Offering Self

    • This technique increases client self-worth by showing unconditional support. Example: "Would you like me to accompany you to your electroconvulsive therapy treatment?"

    Defense Mechanisms

    • Denial: A client may refuse to acknowledge their feelings, as seen when they outright deny emotions conveyed by their actions. Example: Client says, "I'm not angry," despite showing anger through behavior.

    Nonverbal Communication

    • Nonverbal cues can communicate messages effectively, accounting for up to 90% of communication. Examples include physical actions like spanking, isolating behavior, tattoos, and written expressions.

    Client Behavior and Communication

    • Various actions and expressions are forms of communication. For instance, a mother spanking her child and a teenager isolating themselves both send strong messages about emotions and states of being.

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    Description

    Test your knowledge of therapeutic communication techniques used in nursing practices with these flashcards. This quiz will challenge you to identify techniques based on nurse-client interactions, promoting better understanding and application in real-life scenarios.

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