1. The nurse observes a client pacing in the hall. Which 8.

Which 8. A patient is sitting with arms crossed over their chest, their left
statement by the nurse may help the client recognize his anxiety? leg is rapidly moving up and down, and there is an angry expression on
A. “I guess you’re worried about something, aren’t you? their face. When approached by the nurse, the patient states harshly,
B. “Can I get you some medication to help calm you?” “I’m fine! Everything’s great.” Which statement related to communication
C. “Have you been pacing for a long time?”D. “I notice that you’re should the nurse focus on when working with this patient?
pacing. How are you feeling?” A. Verbal communication is always more accurate than nonverbal
communication.
B. Verbal communication is more straightforward, whereas nonverbal
2. A male client tells the nurse he was involved in a car accident communication does not portray what a person is thinking.
while he was intoxicated. What would be the most therapeutic response C. Nonverbal and verbal communication may be different; nurses must
from nurse Julia? pay attention to the nonverbal communication being presented to get an
A. “Why didn’t you get someone else to drive you?” accurate message.
B. “Tell me how you feel about the accident.” D. Nonverbal communication is about 10% of all communication, and
C. “You should know better than to drink and drive.” verbal communication is about 90%.
D. “I recommend that you attend an Alcoholics Anonymous meeting.”
9. During the termination phase of the nurse-patient relationship
with a dependent patient, the nurse evaluates the effectiveness of coping
3. A client diagnosed with depression attempted suicide says to techniques learned by:
the nurse, “I should have died. I’ve always been a failure. Nothing ever a. Role playing with the patient in order to practice being assertive
goes right for me.” Which response by the nurse demonstrates b. Asking the patient to define the difference between being assertive
therapeutic communication? and being aggressive.
A. “You have everything to live for.” c. Discussing how her father effectively used both assertiveness and
B. “Why do you see yourself as a failure?” aggressiveness to control her
C. “Feeling like this is all part of being depressed.” d. Asking, “When you used assertiveness to deal with your father during
D. “You’ve been feeling like a failure for a while?” his visit, how did it work?”

4. A client experiencing disturbed thought processes believes

that his food is being poisoned. Which communication technique should 10. A patient indicates that he is about to share information about
the nurse use to encourage the client to eat? his illness that is shocking and embarrassing. Which nursing intervention
A. Using open-ended questions and silence has priority in this situation in facilitating the communication process?
B. Sharing personal preference regarding food choices a. Reassuring the patient that talking will be therapeutic
C. Documenting reasons why the client does not want to eat b. Assuring the patient the information will be kept confidential
D. Offering opinions about the necessity of adequate nutrition c. Responding to the patient’s information in an accepting manner
d. Providing the patient with a private place for the discussion to occur
5. A client diagnosed with terminal cancer says to the nurse, “I’m
going to die, and I wish my family would stop hoping for a cure! I get so
angry when they carry on like this. After all, I’m the one who’s dying.” 11. Which statement indicates that a novice nurse understands the
Which response by the nurse is therapeutic? purpose of therapeutic communication? “My goal for communication with
A. “Have you shared your feelings with your family?” any patient is to:
B. “I think we should talk more about your anger with your family.” a. maintain relationships.”
C. “You’re feeling angry that your family continues to hope for you to be b. mutually share information.”
cured?” c. promote growth and change.”
D. “You are probably very depressed, which is understandable with such d. offer advice and make suggestions.”
a diagnosis.”

6. A client reports having thoughts of being followed by foreign 12. Which nursing response would indicate an empathetic
agents who are after his secret papers. Which response by the nurse is approach to a patient who is depressed over recent losses in her life?
most appropriate when responding to the client’s disturbed thought a. “Losing a job isn’t always a bad thing.”
process? b. “I lost my parents last year and still feel sad.”
A. “I don’t see any foreign agents.” c. “Please tell me more about what you are feeling.”
B. “I think these thoughts are frightening to you.” d. “Let’s not focus on what’s sad but rather what is good about life.”
C. “I don’t know what you mean.”D
. “I’d like you to come to the group with me right now.”

7. A patient is presenting with behaviors that indicate anger. 13. What is the purpose of a nurse providing appropriate
When approached, the patient states harshly, “I’m fine! Everything’s feedback?
great.” Which response should the nurse provide to the patient?
A. “Okay, but we are all here to help you, so come get one of the staff if A. To give the client good advice
you need to talk.” B. To advise the client on appropriate behaviors
B. “I’m glad everything is good. I am going to give you your schedule for C. To evaluate the client's behavior
the day, and we can discuss how the groups are going.” D. To give the client critical information
C. “I don’t believe you. You are not truthful with me.”
D. “It looks as though you are saying one thing but feeling another. Can 14. Which example of a therapeutic communication technique
you tell me what may be upsetting you?” would be effective in the planning phase of the nursing process?
A. "We've discussed past coping skills. Let's see if these coping skills
can be effective now." 21. A client slammed a door on the unit several times. The nurse
B. "Please tell me in your own words what brought you to the hospital." responds, “You seem angry.” The client states, “I’m not angry.” What
C. "This new approach worked for you. Keep it up." therapeutic communication technique has the nurse employed and what
D. "I notice that you seem to be responding to voices that I do not hear." defense mechanism is the client unconsciously demonstrating?

15. A client tells the nurse, “I feel bad because my mother does A. Making observations and the defense mechanism of suppression
not want me to return home after I leave the hospital.” Which nursing B. Verbalizing the implied and the defense mechanism of denial
response is therapeutic? C. Reflection and the defense mechanism of projection
D. Encouraging descriptions of perceptions and the defense
A. "It's quite common for clients to feel that way after a lengthy mechanism of displacement
hospitalization."
B. "Why don't you talk to your mother? You may find out she doesn't feel 22. The nurse is interviewing a newly admitted psychiatric client.
that way." Which nursing statement is an example of offering a general lead?
C. "Your mother seems like an understanding person. I'll help you
approach her." A. "Do you know why you are here?"
D. "You feel that your mother does not want you to come back home?" B. "Are you feeling depressed or anxious?"
C. "Can you chronologically order the events that led to your
16. Which nursing statement is a good example of the therapeutic admission?"
communication technique of giving recognition? D. "Yes, I see. Go on."

A. "You did not attend group today. Can we talk about that?"
B. "I'll sit with you until it is time for your family session." 23. The nurse uses a variety of therapeutic communication skills
C. "I notice you are wearing a new dress and you have washed your when working with
hair." patients. Which of the following is a therapeutic goal that can be
D. "I'm happy that you are now taking your medications. They will really accomplished through the use of therapeutic communication skills?
help." A) Inform the patient of priority problems
B) Assess the patient's perception of a problem
17. The nurse asks a newly admitted client, “What can we do to C) Assist the patient to control emotions
help you?” What is the purpose of this therapeutic communication D)Provide the patient with a plan of action
technique?
24. Which one of the following goals of therapeutic
A. To reframe the client's thoughts about mental health treatment communication would the nurse strive
B. To put the client at ease to attain first?
C. To explore a subject, idea, experience, or relationship A)Facilitate the client's expression of emotions.
D. To communicate that the nurse is listening to the conversation B)Establish a therapeutic nurseñclient relationship.
C)Teach the client and family necessary self-care skills.
D)Implement interventions designed to address the client's needs.
18. Which nursing statement is a good example of the therapeutic
communication technique of focusing? 25. The nurse asks the patient what he would like to talk about.
This is an example of
A. "Describe one of the best things that happened to you this week." A) broad opening.
B. "I'm having a difficult time understanding what you mean." B) encouraging expression.
C. "Your counseling session is in 30 minutes. I'll stay with you until C) focusing.
then." D) offering self.
D. "You mentioned your relationship with your father. Let's discuss
that further." 26. A patient says, Its' been so long since I've been with my
family. Which statement by the nurse is an example of restating?
19. During a nurse-client interaction, which nursing statement may A) You say you haven't seen your family in a while.
belittle the client’s feelings and concerns? B) Tell me when you last saw your family.
C) Go on. Tell me more.
A. Don't worry. Everything will be alright." D) When was the last time you saw your family?
B. "You appear uptight."
C. "I notice you have bitten your nails to the quick." 27. The patient expresses frustration that the doctor does not
D. "You are jumping to conclusions." spend enough time with the patient when making rounds. The nurse
replies, The doctors are very busy. What can I help you with? The nurse
20. Which nursing statement is a good example of the therapeutic incorporated which nontherapeutic technique in this
communication technique of offering self? response?
A) Belittling
A. "I think it would be great if you talked about that problem during our B) Defending
next group session." C) Disagreeing
B. "Would you like me to accompany you to your electroconvulsive D) Introducing an unrelated topic
therapy treatment?"
C. "I notice that you are offering help to other peers in the milieu." 28. A patient asks the nurse what she should do about her
D. "After discharge, would you like to meet me for lunch to review your cheating husband. The nurse replies, You should divorce him. You
outpatient progress?"
deserve better than that. The nurse used which communication B) investigate the source of nonverbal behavior.
technique? C) validate the client's feelings.
A) Giving information D) validate the meaning of the nonverbal behavior.
B) Verbalizing the implied
C) Giving advice 36. Which of the following is the best reason that many psychiatric
D) Agreeing care units have policies against clients touching one another or staff?
A) Because some clients with mental illness have difficulty knowing
29. The nurse asks the client what that experience was like. when touch is
Which communication skill is the nurse using? or is not appropriate
A) Encouraging expression B) Because clients often perceive being touched as a threat and may
B) Encouraging description of perceptions attempt to
C) Exploring protect himself or herself by striking the staff person
D) Requesting an explanation C) Because it can be threatening to both the client and the nurse
D) Because touching always leads to more touching
30. Which of the following statements would be an empathetic
response in a client interaction? 37. A client has been making sexual comments when
A) You must have been embarrassed when your father yelled at you in communicating with the nurse. The
the grocery store. nurse wants to spend some time talking to the patient while respecting
B) You really should find your own housing and get out of the situation the patient's right to privacy. Which setting would be the most
with your appropriate setting for the nurse to talk with the client?
father. A) In the patient's room when the patient's roommate is present and 3
C) Well, it sounds like your father has difficulty controlling his temper. feet away
D) Why do you think your father chose that time and place to yell at you? B) At the nurse's station when other clients and visitors are less than 4
feet away
31. The nurse says to the client, You become very anxious when C) In an interview room in a remote section of the unit with the nurse 1
we start talking about your drinking. Which of the following techniques is foot away
the nurse using? from the patient
A) Confronting behavior D) In a quiet corner of the dayroom at least 4 feet away from others
B) Making an observation
C) Translating into feelings 38. The nurse asks the patient, What was it like for you when you
D) Verbalizing the implied first knew you had no place to go? The patient looks down and pauses
32. The nurse is sitting down with a patient to begin a for quite some time. Which action by
conversation. Which of the following positions should the nurse take to the nurse is most therapeutic?
convey acceptance of the patient? A) Change the subject to something the patient will discuss
A) Leaning forward with arms on the table sitting directly across for the B) Encourage the patient to express any unpleasant feelings
patient C) Apologize for asking such a personal question
B) Turned slightly to the side of the patients with arms folded across the D) Sit quietly until the patient responds
chest
C) Leaning back in the chair next to the patient with legs crossed at the 39. A patient states, Right before I got here I was doing alright.
knees My job was going well, my wife and I were happy, and we just moved
D) Sitting upright facing the patient with both feet on the floor into a new apartment. The nurse responds, You said you and your wife
were happy. Tell me more about that. This is an example
33. A patient states, I feel fine. It's a good day. The nurse notes the of which therapeutic technique?
patient looking away, and a decreasing pitch in his voice while speaking. A) Encouraging comparison
Which of the following is the most therapeutic response by the nurse? B) General lead
A) I'm glad you are feeling good today. C) Restating
B) I'm not sure I believe you. D) Exploring
C) Tell me what is good about today.
D) You say you feel fine, but you don't really sound fine. 40. A patient yells, All the nurses here are so mean. None of you
really care about us! The most therapeutic response would be,
34. Which of the following statements about verbal and nonverbal A) I cannot allow you to yell like that.
communication skills is B) We care about you.
accurate? C) Oh, really?
A) One third of meaning is transmitted nonverbally and two thirds is D) You seem very irritated.
communicated verbally.
B) Nonverbal communication is as important, if not more than, verbal
communication.
C) Verbal communication is most important because it is what the patient
says.
D) Verbal communication involves the unconscious mind.

35. The nurse must be alert to the nonverbal expressions of the

client. Because the meaning
attached to nonverbal behavior is subjective, it is important for the nurse
to
A) increase the client's awareness of nonverbal behavior.