C HAPTER 09: T HERAPEUTIC C OMMUNICATION
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. During a one-on-one interaction with the nurse, a patient frequentl y looks
nervousl y at the door. Select the best comment by the nurse regarding this
nonverbal communication.
a. I notice you keep looking toward the door.
b. This is our time together. No one is going to interrupt us.
c. It looks as if you are eager to end our discussion for today.
d. If you are uncomfortable in this room, we can move someplace else.
ANS: A
Making observations and encouraging the patient to describe
perceptions are useful ther apeutic communication techniques for this
situation. The other responses are assumptions made by the nurse.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 143 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
2. A black patient says to a white nurse, Theres no sense talking. You
wouldnt understand because you live in a white world. The nurses best
action would be to:
a. explain, Yes, I do understand. Everyone goes through the same
experiences.
, b. say, Please give an example of something you think I wouldnt
understand.
c. reassure the patient that nurses interact with people from all
cultures.
d. change the subject to one that is less emotionall y disturbing.
ANS: B
Having the patient speak in specifics rather than globall y will he lp the
nurse understand the patients perspective. This approach will help the
nurse engage the patient. Reassurance and changing the subject are no
therapeutic techniques.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 144 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
3. 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 used to raise the patients s elf-esteem, but after
3 weeks, the patients eye contact did not improve. What is the most
accurate anal ysis of this scenario?
a. The patients eye contact should have been directl y addressed by
role-playing to increase comfort with eye contact.
b. The nurse should not have independentl y embarked on assessment,
diagnosis, and planning for this patient.
c. The patients poor eye contact is indicative of anger and hostilit y
that were unaddressed.
d. The nurse should have assessed the patients culture before making
this diagnosis and plan.
, ANS: D
The amount of eye contact a person engages in is often culturall y
determined. In some cultures, eye contact is considered insolent,
whereas in others eye contact is expected. Asian Americans, including
persons from the Philippines, often prefer not to engage in direct eye
contact.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 148
TOP: Nursing Process: Evaluation MSC: Client Needs:
Psychosocial Integrity
4. When a female Mexican American patient and a female nurse sit toget her,
the patient often holds the nurses hand. The patient also links arms with
the nurse when they walk. The nurse is uncomfortable with this behavior.
Which anal ysis is most accurate?
a. The patient is accustomed to touch during conversation, as are
members of many Hispanic subcultures.
b. The patient understands that touch makes the nurse uncomfortable
and controls the relationship based on that factor.
c. The patient is afraid of being alone. When touching the nurse, the
patient is reassured and comforted.
d. The patient is trying to manipulate the nurse using nonverbal
techniques.
ANS: A
The most likel y answer is that the patients behavior is culturall y
influenced. Hispanic women frequentl y touch women they consider to
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. During a one-on-one interaction with the nurse, a patient frequentl y looks
nervousl y at the door. Select the best comment by the nurse regarding this
nonverbal communication.
a. I notice you keep looking toward the door.
b. This is our time together. No one is going to interrupt us.
c. It looks as if you are eager to end our discussion for today.
d. If you are uncomfortable in this room, we can move someplace else.
ANS: A
Making observations and encouraging the patient to describe
perceptions are useful ther apeutic communication techniques for this
situation. The other responses are assumptions made by the nurse.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 143 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
2. A black patient says to a white nurse, Theres no sense talking. You
wouldnt understand because you live in a white world. The nurses best
action would be to:
a. explain, Yes, I do understand. Everyone goes through the same
experiences.
, b. say, Please give an example of something you think I wouldnt
understand.
c. reassure the patient that nurses interact with people from all
cultures.
d. change the subject to one that is less emotionall y disturbing.
ANS: B
Having the patient speak in specifics rather than globall y will he lp the
nurse understand the patients perspective. This approach will help the
nurse engage the patient. Reassurance and changing the subject are no
therapeutic techniques.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 144 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
3. 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 used to raise the patients s elf-esteem, but after
3 weeks, the patients eye contact did not improve. What is the most
accurate anal ysis of this scenario?
a. The patients eye contact should have been directl y addressed by
role-playing to increase comfort with eye contact.
b. The nurse should not have independentl y embarked on assessment,
diagnosis, and planning for this patient.
c. The patients poor eye contact is indicative of anger and hostilit y
that were unaddressed.
d. The nurse should have assessed the patients culture before making
this diagnosis and plan.
, ANS: D
The amount of eye contact a person engages in is often culturall y
determined. In some cultures, eye contact is considered insolent,
whereas in others eye contact is expected. Asian Americans, including
persons from the Philippines, often prefer not to engage in direct eye
contact.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 148
TOP: Nursing Process: Evaluation MSC: Client Needs:
Psychosocial Integrity
4. When a female Mexican American patient and a female nurse sit toget her,
the patient often holds the nurses hand. The patient also links arms with
the nurse when they walk. The nurse is uncomfortable with this behavior.
Which anal ysis is most accurate?
a. The patient is accustomed to touch during conversation, as are
members of many Hispanic subcultures.
b. The patient understands that touch makes the nurse uncomfortable
and controls the relationship based on that factor.
c. The patient is afraid of being alone. When touching the nurse, the
patient is reassured and comforted.
d. The patient is trying to manipulate the nurse using nonverbal
techniques.
ANS: A
The most likel y answer is that the patients behavior is culturall y
influenced. Hispanic women frequentl y touch women they consider to
