C HAPTER 09: T HERAPEUTIC C OMMUNICATION
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. During a one-on-one interaction with the nurse, a client frequentl y looks
nervousl y at the door. What is 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 client to describe perceptions
are useful therapeutic communication te chniques for this situation. The
other responses are assumptions made by the nurse.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Psychosocial Integrit y
2. A client of color says to a Caucasian nurse, “There’s no sense talking
about how I feel. You wouldn’t understand because you live in a white
world.” What is the nurse’s best action ?
, a. Explain, “Yes, I do understand. Everyone goes through the same
experiences.”
b. Say, “Please give an example of so mething you think I wouldn’t
understand.”
c. Reassure the client that nurses interact with people from all
cultures.
d. Change the subject to one that is less emotionall y disturbing.
ANS: B
Having the client speak in specifics rather than globall y will help the
nurse understand the client’s perspective. This approach will help the
nurse engage the client. Reassurance and changing the subject are not
therapeutic techniques.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Psychosocial Integrit y
3. A newl y immigrated client had a nursing diagnosis of situational low self -
esteem related to poor social skills as evidenced by lack of eye contact.
Interventions were applied to increase the client’s self -esteem but after 3
weeks, the client’s eye contact did not improve. What is the most accurate
anal ysis of this scenario?
a. The client’s eye contact should have been directl y addressed by role
playing to increase comfort with eye contact.
b. The nurse should not have in dependentl y embarked on assessment,
diagnosis, and planning for this client.
c. The client’s poor eye contact is indicative of anger and hostility
that were unaddressed.
, d. The nurse should have assessed the client’s 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.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) TOP:
Nursing Process: Evaluation MSC: Client Needs: Psychosocial
Integrit y
4. When a specific client and the nurse sit together, the client often holds the
nurse’s hand. The client also links arms with the nurse when they walk.
The nurse is uncomfortable with this behavior. Wh ich anal ysis is most
accurate?
a. The client is accustomed to touch during conversation, as are
members of many ethnic subcultures.
b. The client understands that touch makes the nurse uncomfortable
and controls the relationship based on that factor.
c. The client is afraid of being alone. When touching the nurse, the
client is reassured and comforted.
d. The client is trying to manipulate the nurse using nonverbal
techniques.
ANS: A
The most likel y answer is that the client’s behavior is culturall y
influenced.
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. During a one-on-one interaction with the nurse, a client frequentl y looks
nervousl y at the door. What is 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 client to describe perceptions
are useful therapeutic communication te chniques for this situation. The
other responses are assumptions made by the nurse.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Psychosocial Integrit y
2. A client of color says to a Caucasian nurse, “There’s no sense talking
about how I feel. You wouldn’t understand because you live in a white
world.” What is the nurse’s best action ?
, a. Explain, “Yes, I do understand. Everyone goes through the same
experiences.”
b. Say, “Please give an example of so mething you think I wouldn’t
understand.”
c. Reassure the client that nurses interact with people from all
cultures.
d. Change the subject to one that is less emotionall y disturbing.
ANS: B
Having the client speak in specifics rather than globall y will help the
nurse understand the client’s perspective. This approach will help the
nurse engage the client. Reassurance and changing the subject are not
therapeutic techniques.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Psychosocial Integrit y
3. A newl y immigrated client had a nursing diagnosis of situational low self -
esteem related to poor social skills as evidenced by lack of eye contact.
Interventions were applied to increase the client’s self -esteem but after 3
weeks, the client’s eye contact did not improve. What is the most accurate
anal ysis of this scenario?
a. The client’s eye contact should have been directl y addressed by role
playing to increase comfort with eye contact.
b. The nurse should not have in dependentl y embarked on assessment,
diagnosis, and planning for this client.
c. The client’s poor eye contact is indicative of anger and hostility
that were unaddressed.
, d. The nurse should have assessed the client’s 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.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) TOP:
Nursing Process: Evaluation MSC: Client Needs: Psychosocial
Integrit y
4. When a specific client and the nurse sit together, the client often holds the
nurse’s hand. The client also links arms with the nurse when they walk.
The nurse is uncomfortable with this behavior. Wh ich anal ysis is most
accurate?
a. The client is accustomed to touch during conversation, as are
members of many ethnic subcultures.
b. The client understands that touch makes the nurse uncomfortable
and controls the relationship based on that factor.
c. The client is afraid of being alone. When touching the nurse, the
client is reassured and comforted.
d. The client is trying to manipulate the nurse using nonverbal
techniques.
ANS: A
The most likel y answer is that the client’s behavior is culturall y
influenced.
