Therapeutic Techniques in Nursing

Questions and Answers

Which of these options are correct therapeutic communication techniques? (Select all that apply)

Why did you do that?

I'll stay with you a while. (correct)

Tell me more about that situation. (correct)

I notice you are pacing a lot. (correct)

Let's talk about something else.

Which of these options demonstrate nontherapeutic techniques in communication? (Select all that apply)

I'll stay with you a while.

Let's talk about something else. (correct)

I notice you are pacing a lot.

Why did you do that? (correct)

Tell me more about that situation.

What is the significance of making observations in therapeutic communication?

Making observations helps to establish a connection and convey empathy towards the patient's feelings.

A patient says to the nurse, 'I dreamed I was stoned. When I woke up, I felt emotionally drained, as though I hadn't rested well.' Which response should the nurse use to clarify the patient's comment?

Can you give me an example of what you mean by 'stoned'? Signup and view all the answers

A patient diagnosed with schizophrenia tells the nurse, 'The Central Intelligence Agency is monitoring us through the fluorescent lights in this room. The CIA is everywhere, so be careful what you say.' Which response by the nurse is most therapeutic?

It sounds like you're concerned about your privacy. Signup and view all the answers

The patient says, 'My marriage is just great. My spouse and I always agree.' The nurse observes the patient's foot moving continuously. The conclusion the nurse can draw is that the patient's communication is:

Incongruous. Signup and view all the answers

A nurse interacts with a newly hospitalized patient. Select the nurse's comment that applies the communication technique of 'offering self.'

I'd like to sit with you for a while to help you get comfortable talking to me. Signup and view all the answers

Which technique will best communicate to a patient that the nurse is interested in listening?

Restating a feeling or thought the patient has expressed. Signup and view all the answers

A patient discloses several concerns and associated feelings. If the nurse wants to seek clarification, which comment would be appropriate?

Am I correct in understanding that... Signup and view all the answers

A patient tells the nurse, 'I don't think I'll ever get out of here.' Select the nurse's most therapeutic response.

You don't think you're making progress? Signup and view all the answers

Documentation in a patient's chart shows, 'Throughout a 5-minute interaction, patient fidgeted and tapped left foot, periodically covered face with hands, and looked under chair while stating, 'I enjoy spending time with you.' Which analysis is most accurate?

The patient's verbal and nonverbal messages are incongruent. Signup and view all the answers

While talking with a patient diagnosed with major depressive disorder, a nurse notices the patient is unable to maintain eye contact. Which aspect of communication has the nurse assessed?

Nonverbal communication Signup and view all the answers

During the first interview with a parent whose child died in a car accident, the nurse feels empathic and reaches out to take the patient's hand. Select the correct analysis of the nurse's behavior.

The gesture is premature. The patient's cultural and individual interpretation of touch is unknown. Signup and view all the answers

During a one-on-one interaction with the nurse, a patient frequently looks nervously at the door. Select the best comment by the nurse regarding this nonverbal communication.

I notice you keep looking toward the door. Signup and view all the answers

A black patient says to a white nurse, 'There's no sense talking about how I feel. You wouldn't understand because you live in a white world.' The nurse's best action would be to:

Say, 'Please give an example of something you think I wouldn't understand.' Signup and view all the answers

A Filipino American patient had a nursing diagnosis of situational low self-esteem related to poor social skills as evidenced by lack of eye contact. Interventions were applied to increase the patient's self-esteem, but after 3 weeks, the patient's eye contact did not improve. What is the most accurate analysis of this scenario?

The nurse should have assessed the patient's culture before making this diagnosis and plan. Signup and view all the answers

When a female Mexican American patient and a female nurse sit together, the patient often holds the nurse's hand. The patient also links arms with the nurse when they walk. The nurse is uncomfortable with this behavior. Which analysis is most accurate?

The patient is accustomed to touch during conversation, as are members of many Hispanic subcultures. Signup and view all the answers

A Puerto Rican American patient uses dramatic body language when describing emotional discomfort. Which analysis most likely explains the patient's behavior?

The patient belongs to a culture in which dramatic body language is the norm. Signup and view all the answers

During an interview, a patient attempts to shift the focus from self to the nurse by asking personal questions. The nurse should respond by saying:

The time we spend together is to discuss your concerns. Signup and view all the answers

Which principle should guide the nurse in determining the extent of silence to use during patient interview sessions?

Silence can provide meaningful moments for reflection. Signup and view all the answers

A patient is having difficulty making a decision. The nurse has mixed feelings about whether to provide advice. Which principle usually applies?

Giving advice is rarely helpful. Signup and view all the answers

A school age child tells the school nurse, 'Other kids call me mean names and will not sit with me at lunch. Nobody likes me.' Select the nurse's most therapeutic response.

Tell me more about how you feel. Signup and view all the answers

A patient with acute depression states, 'God is punishing me for my past sins.' What is the nurse's most therapeutic response?

You sound very upset about this. Signup and view all the answers

A patient cries as the nurse explores the patient's feelings about the death of a close friend. The patient sobs, 'I shouldn't be crying like this. It happened a long time ago.' Which responses by the nurse facilitate communication? (Select all that apply.)

Crying is a way of expressing the hurt you are experiencing. Signup and view all the answers

Which benefits are most associated with use of telehealth technologies? (Select all that apply.)

Cost savings for patients Signup and view all the answers

Which comments by a nurse demonstrate use of therapeutic communication techniques? (Select all that apply.)

I'm glad you were able to tell me how you felt about your loss. Signup and view all the answers

Study Notes

Therapeutic Communication Techniques

Clarification is important for understanding patient statements, as demonstrated by asking for definitions of terms like "stoned."
Reflecting patients' concerns, such as privacy, promotes engagement and reassurance without challenging their beliefs.
Incongruous messages occur when verbal and nonverbal cues conflict, indicating anxiety despite positive verbal communication.
"Offering self" fosters trust through presence and emotional support; effective engagement is crucial during initial interactions.
Active listening techniques like restating feelings validate patient communication and enhance understanding.
Seeking clarification can strengthen mutual understanding, using phrases like "Am I correct in understanding that…".

Patient Responses and Nurse Interventions

Nurses should gently address feelings of helplessness in patients, reframing statements about lack of progress into questions for deeper exploration.
Nonverbal communication is key; eye contact and body language relay significant emotional states and concerns.
Touch must be approached cautiously, as individual and cultural interpretations greatly vary; comfortable boundaries should be assessed first.
Patients who direct focus away from their emotions need gentle steering back towards their own feelings or concerns.

Cultural Competence in Communication

Culturally influenced behaviors, such as touch among Hispanic patients or varying norms of eye contact, highlight the need for cultural assessment in nursing.
Dramatic body language in some cultures is normative and should be understood in context rather than misinterpreted as attention-seeking.
Nurses should be aware of patient backgrounds to provide appropriate, empathetic responses without making assumptions.

Silence and Decision Making

Silence in conversations can facilitate reflection; it provides pauses to process information rather than detrimental withdrawal.
Giving advice may lead to dependency and diminish a patient's sense of autonomy, hindering their decision-making process.

Engaging Young Patients

Encouraging children to share feelings, especially in situations of bullying or loneliness, validates their experiences and enhances therapeutic relationships.
Responses to emotional distress, such as crying over loss, should reflect empathy and acknowledgment of their feelings.

Telehealth Considerations

Telehealth offers significant benefits including cost savings, better care management, and improved access to healthcare services, especially for rural patients.
Relationships through telehealth may not develop as quickly, highlighting a need for balanced expectations regarding patient rapport.

Examples of Therapeutic Communication

Statements that encourage patient sharing, such as "Tell me more about that situation" or acknowledging behaviors like pacing, create open communication channels.
Avoiding nontherapeutic techniques like minimizing feelings or changing subjects ensures focused, supportive nurse-patient dialogue.

These principles in therapeutic communication are vital for building trust, understanding cultural variations, and facilitating emotional expression while promoting patient autonomy.

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Description

This quiz focuses on the use of therapeutic techniques in nursing interactions with patients diagnosed with mental illnesses. It highlights the importance of making observations and showing empathy while avoiding non-therapeutic approaches. Test your understanding of which responses foster better patient communication.