Question

1. Complete an NCLEX style question. Provide the rationales for your answer. The question should be a multiple-choice style question.
2. Provide one question from each area (therapeutic and non-therapeutic concepts).

Therapeutic: Providing information, Clarifying, Focusing, Paraphrasing, Validation, Asking relevant questions,

Summarizing, Self-disclosure, Confrontation, Active listening, Using silence

Non-Therapeutic: Asking personal questions, Giving personal opinions, Changing the subject, Automatic responses, False reassurance,

Asking for explanations, Approval, or disapproval, Defensive responses, Passive or aggressive responces

Answer 1

Therapeutic

1- patient with a diagnosis of major depression who has attempted suicide says to the nurse, “I should have died! I’ve always been a failure. Nothing ever goes right for me.” Which response demonstrates therapeutic communication?

• A. "You have everything to live for."
• B. "Why do you see yourself as a failure?"
• C. "Feeling like this is all part of being depressed."
• D. "You've been feeling like a failure for a while?

Ans is D

Responding to the feelings expressed by a patient is an effective therapeutic communication technique. The correct option is an example of the use of restating.

A,B,C option block patient’s experience and do not facilitate exploration of the patient’s expressed feelings. In addition, the use of the word “why” is nontherapeutic.

2 - . Question

1. When the community health nurse visits a patient at home, the patient states, “I haven’t slept the last couple of nights.” Which response by the nurse illustrates a therapeutic communication response to this patient?

   • A. "I see."
   • B. "Really?"
   • C. "You're having difficulty sleeping?"
   • D. "Sometimes, I have trouble sleeping too."

Correct Answer: C. “You’re having difficulty sleeping?”

The correct option uses the therapeutic communication technique of restatement. Although restatement is a technique that has a prompting component to it, it repeats the patient’s major theme, which assists the nurse in obtaining a more specific perception of the problem from the patient.

• Options A, B, and D: The remaining options are not therapeutic responses since none encourage the patient to expand on the problem. Offering personal experiences moves the focus away from the patient and onto the nurse.

Non therapeutics

1

A client diagnosed with dependent personality disorder states, “Do you think I should move from my parent’s house and get a job?” Which nursing response is most appropriate?

1. • A. "It would be best to do that in order to increase independence."
   • B. "Why would you want to leave a secure home?"
   • C. "Let's discuss and explore all of your options."

• D "I'm afraid you would feel very guilty leaving your parents

Correct Answer: C. “Let’s discuss and explore all of your options.”

The most appropriate response by the nurse is, “Let’s discuss and explore all of your options.” In this example, the nurse is encouraging the client to formulate ideas and decide independently the appropriate course of action.

2

A client who frequently exhibits angry outbursts is diagnosed with antisocial personality disorder. Which appropriate feedback should a nurse provide when this client experiences an angry outburst?

• A. "Why do you continue to alienate your peers by your angry outbursts?"
• B. "You accomplish nothing when you lose your temper like that."
• C. "Showing your anger in that manner is very childish and insensitive."
• D. "During group, you raised your voice, yelled at a peer, left, and slammed the door."

Correct Answer: D. “During group, you raised your voice, yelled at a peer, left, and slammed the door.”

The nurse is providing appropriate feedback when stating, “During group, you raised your voice, yelled at a peer, left, and slammed the door.” Giving appropriate feedback involves helping the client consider a modification of behavior. Feedback should give information to the client about how he or she is perceived by others. Feedback should not be evaluative in nature or be used to give advice.