NURS 103: Fundamentals of Nursing - Communication & Therapeutic
Relationships 2026 |WCU
1. A nurse is caring for a patient who is chronically ill and expresses feeling
overwhelmed. The nurse responds, ‘It sounds like you are feeling a lot of
pressure right now.’ This is an example of which therapeutic communication
technique?
A. Summarizing
B. Paraphrasing
C. Sharing observations
D. Reflecting
Answer: D
Rationale: Reflecting directs the patient’s feelings back to them, helping the patient
recognize and accept their emotions. Paraphrasing focuses on the content of the message,
whereas reflecting focuses on the underlying feelings.
2. During the orientation phase of the nurse-patient relationship, which action
should the nurse prioritize?
A. Reviewing the patient’s medical record and history.
B. Evaluating the patient’s progress toward discharge goals.
C. Implementing specific nursing interventions to achieve goals.
D. Establishing a rapport and clarifying the roles of both parties.
Answer: D
Rationale: The orientation phase is focused on setting the stage for the relationship,
establishing trust, defining roles, and set the contract for meeting. Reviewing the record
happens in the pre-interaction phase.
,3. A nurse observes a patient wringing their hands and pacing but the patient
states, ‘I am fine.’ This incongruence between verbal and non-verbal cues is best
addressed by which communication concept?
A. Proxemics
B. Pacing
C. Metacommunication
D. Interpersonal variables
Answer: C
Rationale: Metacommunication refers to all factors that influence communication,
including the relationship between verbal and non-verbal messages. Incongruence is a key
area where nurses must explore metacommunication.
4. Which statement by the nurse best demonstrates the use of empathy?
A. ‘I know exactly how you feel; my mother had the same surgery.’
B. ‘Don’t worry, the doctors here are the best in the state.’
C. ‘It must be very frustrating to lose your independence like this.’
D. ‘I am so sorry this happened to you; it’s just terrible.’
Answer: C
Rationale: Empathy is the ability to understand and accept another person’s reality
without taking on their emotions as your own. Option A is sympathy/identification, Option
C is false reassurance, and Option D is sympathy.
5. The nurse uses the SOLER acronym to facilitate active listening. What does
the ‘E’ in SOLER stand for?
A. Empathize with the client
B. Establish eye contact
C. Evaluate the message
D. Encourage the client
Answer: B
, Rationale: SOLER stands for: Sit facing the patient, Open posture, Lean toward the patient,
Eye contact, and Relax.
6. A patient is being discharged and thanks the nurse for the care. The nurse
reviews the progress made and discusses how the patient can maintain health
at home. Which phase of the therapeutic relationship is this?
A. Pre-interaction phase
B. Orientation phase
C. Working phase
D. Termination phase
Answer: D
Rationale: The termination phase occurs at the end of the relationship, focusing on
evaluating goal achievement and transitioning care back to the patient or another provider.
7. When communicating with a patient who has expressive aphasia following a
stroke, which intervention is most effective?
A. Speak louder to ensure the patient can hear clearly.
B. Use open-ended questions to encourage elaborate speech.
C. Provide a picture board or alphabet board for the patient.
D. Finish the patient’s sentences to reduce their frustration.
Answer: C
Rationale: Expressive aphasia means the patient understands but cannot easily
communicate. Communication aids like picture boards are essential. Finishing sentences
can be demeaning and inaccurate.
Relationships 2026 |WCU
1. A nurse is caring for a patient who is chronically ill and expresses feeling
overwhelmed. The nurse responds, ‘It sounds like you are feeling a lot of
pressure right now.’ This is an example of which therapeutic communication
technique?
A. Summarizing
B. Paraphrasing
C. Sharing observations
D. Reflecting
Answer: D
Rationale: Reflecting directs the patient’s feelings back to them, helping the patient
recognize and accept their emotions. Paraphrasing focuses on the content of the message,
whereas reflecting focuses on the underlying feelings.
2. During the orientation phase of the nurse-patient relationship, which action
should the nurse prioritize?
A. Reviewing the patient’s medical record and history.
B. Evaluating the patient’s progress toward discharge goals.
C. Implementing specific nursing interventions to achieve goals.
D. Establishing a rapport and clarifying the roles of both parties.
Answer: D
Rationale: The orientation phase is focused on setting the stage for the relationship,
establishing trust, defining roles, and set the contract for meeting. Reviewing the record
happens in the pre-interaction phase.
,3. A nurse observes a patient wringing their hands and pacing but the patient
states, ‘I am fine.’ This incongruence between verbal and non-verbal cues is best
addressed by which communication concept?
A. Proxemics
B. Pacing
C. Metacommunication
D. Interpersonal variables
Answer: C
Rationale: Metacommunication refers to all factors that influence communication,
including the relationship between verbal and non-verbal messages. Incongruence is a key
area where nurses must explore metacommunication.
4. Which statement by the nurse best demonstrates the use of empathy?
A. ‘I know exactly how you feel; my mother had the same surgery.’
B. ‘Don’t worry, the doctors here are the best in the state.’
C. ‘It must be very frustrating to lose your independence like this.’
D. ‘I am so sorry this happened to you; it’s just terrible.’
Answer: C
Rationale: Empathy is the ability to understand and accept another person’s reality
without taking on their emotions as your own. Option A is sympathy/identification, Option
C is false reassurance, and Option D is sympathy.
5. The nurse uses the SOLER acronym to facilitate active listening. What does
the ‘E’ in SOLER stand for?
A. Empathize with the client
B. Establish eye contact
C. Evaluate the message
D. Encourage the client
Answer: B
, Rationale: SOLER stands for: Sit facing the patient, Open posture, Lean toward the patient,
Eye contact, and Relax.
6. A patient is being discharged and thanks the nurse for the care. The nurse
reviews the progress made and discusses how the patient can maintain health
at home. Which phase of the therapeutic relationship is this?
A. Pre-interaction phase
B. Orientation phase
C. Working phase
D. Termination phase
Answer: D
Rationale: The termination phase occurs at the end of the relationship, focusing on
evaluating goal achievement and transitioning care back to the patient or another provider.
7. When communicating with a patient who has expressive aphasia following a
stroke, which intervention is most effective?
A. Speak louder to ensure the patient can hear clearly.
B. Use open-ended questions to encourage elaborate speech.
C. Provide a picture board or alphabet board for the patient.
D. Finish the patient’s sentences to reduce their frustration.
Answer: C
Rationale: Expressive aphasia means the patient understands but cannot easily
communicate. Communication aids like picture boards are essential. Finishing sentences
can be demeaning and inaccurate.
