Chapter 10: Communication and the Therapeutic Relationship

Format: Multiple Choice

Client Needs: Psychosocial Integrity

Cognitive Level: Apply

Integrated Process: Communication/Documentation

Objective: 4

Page and Header: 119, Box 10.2 Principles of Therapeutic Communication

1. When engaged in therapeutic communication with a client who has been diagnosed with a mental disorder, which is the most important principle for a nurse to keep in mind?

A) The nurse should self-disclose when indicated.

B) The client is the primary focus of the interaction.

C) The nurse should have an empathetic relationship with the client.

D) The client’s conversations should be recorded.

Page and Header: 122, Table 10.2. Verbal Communication Techniques

2. A hospitalized client diagnosed with depression asks a nurse, “Should I go home this weekend?” Which response by the nurse uses the technique of reflection?

A) “Should you go home for the weekend?”

B) “Home means what to you?”

C) “It sounds as if you don’t want to go home this weekend.”

D) “I doubt that you really should go home this weekend.”

Page and Header: 122, Table 10.2. Verbal Communication Techniques

3. A client who is hospitalized with a diagnosis of depression tells a nurse, “I don’t want to take the medication because I’m afraid I’ll become suicidal.” Which response by the nurse would be most appropriate?

A) “Have you ever thought about hurting yourself?”

B) “It’s important that you take this medication.”

C) “I agree with you. I wouldn’t want to take this medication either.”

D) “Another client took that medication and felt better.”

Page and Header: 124–125, Rapport

4. A psychiatric client is talking to the nurse about the reasons for being hospitalized. The client describes things about a personal relationship that are uncomfortable and asks the nurse, “Should I break up with my partner?” Which response by the nurse would be most effective in building rapport between the client and nurse?

A) “Of course you should; I would never stay with a partner who didn’t make me happy.”

B) “Yes, I think you should pursue a new relationship to help you move on.”

C) “It sounds like you’re beginning to be uncomfortable in this relationship.”

D) “You need to focus on yourself rather than the relationship right now.”

Page and Header: 125–126, Personal Boundaries

5. A nurse engaged in an interaction with a client recognizes body space zones. Which would the nurse identify as the individual’s personal zone?

A) Beginning at the boundary of the intimate zone and ending at the social zone

B) Extending outward from the border to the public zone

C) Surrounding and protecting an individual from others, especially outsiders

D) The most distant boundary that can be used for recognizing intruders

Page and Header: 132, Orientation Phase

6. A nurse is in the orientation phase of the nurse–client relationship with a client diagnosed with a mental disorder. When interviewing the client during this first encounter, which information about the client would be most important for the nurse to obtain?

A) Known allergies

B) Recent hospitalizations

C) Perception of the problem

D) Family history

Page and Header: 133, Resolution Phase

7. During the termination process, a client brings up resolved problems and presents them as new issues to work toward. The nurse interprets the client’s action as indicating what?

A) Anger that the nurse is abandoning the client

B) A need for additional therapy

C) Unhappiness that the therapy was ineffective

D) An attempt to prolong the nurse–client relationship

Page and Header: 133, Nontherapeutic Relationships

8. When engaged in a nontherapeutic relationship, what would a nurse identify as occurring first?

A) Failure to recognize the client as a person with a need

B) The client avoiding the nurse

C) The nurse being perceived as rude

D) The client feeling hopeless and frustrated

Page and Header: 120, Limiting Self-Disclosure

9. When providing care to a client diagnosed with a mental disorder, the client asks the nurse, “Does mental illness run in your family?” Which response by the nurse would be nontherapeutic?

A) “Mental illnesses do run in families, and I’ve had a lot of experience caring for people with mental illness.”

B) “It sounds like you are concerned that there may be a family connection to your current problem?”

C) “Yes, it does. I have a sister who was diagnosed several years ago with severe major depression.”

D) “Mental illness can be family related. Let’s focus the discussion on you and how you’re doing today.”

Page and Header: 118, Self-Awareness

10. A nursing instructor is describing the nurse–client relationship to a group of nursing students. Which would the instructor emphasize as crucial for establishing and maintaining the relationship?

A) Rapport

B) Empathy

C) Self-awareness

D) Values

Page and Header: 119, Verbal Communication

11. A group of students is reviewing the process of verbal communication. The students demonstrate understanding of the information when they identify which as the first component of the process?

A) Formulation of an idea

B) Message encoding

C) Message transmission

D) Message reception

Page and Header: 123, Silence

12. A nurse responds to a client’s statement with silence based on the rationale that this technique is used for what primary purpose?

A) To allow the nurse to determine an appropriate response

B) To permit the client to gather the client’s thoughts

C) To encourage self-reflection by the nurse

D) To demonstrate passive listening

Page and Header: 119–120, Nonverbal Communication

13. When communicating with a client, which would a nurse use to convey positive body language?

A) Sitting erect with back against the chair

B) Crossing the arms over the chest

C) Sitting at the client’s eye level

D) Keeping the feet flat on the floor with the legs crossed

Page and Header: 127–128, Table 10.4. Specific Defense Mechanisms and Coping Styles

14. During an interview, a client tells the nurse about a recent job loss. As the interaction continues, the client states, “I was really overqualified for that position anyway. It was definitely below my area of expertise.” The nurse interprets this information as a reflection of what?

A) Denial

B) Intellectualization

C) Projection

D) Passive aggression

Page and Header: 126, Defense Mechanisms

15. An instructor is educating a nursing student on defense mechanisms. The instructor determines that the education was successful when the student makes which statement?

A) “Most defense mechanisms are considered to be maladaptive, regardless of the situation.”

B) “Defense mechanisms help mediate a person’s response to emotional conflicts and external stressors.”

C) “Use of defense mechanisms indicates that a person’s mental state is dysfunctional.”

D) “Persistent use of defense mechanisms commonly enhances a person’s quality of life.”

Page and Header: 119, Verbal Communication

16. A group of nursing students is role playing situations to practice using therapeutic communication techniques. What would the students identify as verbal communication?

A) Emotion underlying the words

B) Gestures

C) Body language

D) Expressions

Page and Header: 122, Table 10.2. Verbal Communication Techniques

17. A psychiatric–mental health nurse is preparing a review class on therapeutic and nontherapeutic techniques of communication. The nurse demonstrates understanding of the information by selecting which techniques to demonstrate as therapeutic? Select all that apply.

A) Confrontation

B) Open-ended statements

C) Reflection

D) Reassurance

E) Agreement

F) Challenges

Page and Header: 131, Table 10.7. Phases of the Nurse–Patient Relationship

18. A nurse is engaged in a therapeutic nurse–client relationship. The relationship is in the working phase. What does this involve? Select all that apply.

A) Beginning to identify a need

B) Testing new ways for problem solving

C) Testing the relationship

D) Discussing problems related to needs

E) Examining personal issues

Page and Header: 120–121, Active Listening

19. A psychiatric–mental health nurse is engaging in active listening with a client. Which technique would the nurse most likely use? Select all that apply.

A) Changing the subject to gather more information

B) Responding indirectly to statements

C) Using open-ended statements

D) Concentrating fully on what the client says

E) Allowing the client to talk as the client wishes