A mother rescues two of her four children from a house fire. In the emergency department, she cries, “I should have gone back in to get them. I should have died, not them.” What is the nurse’s best response?
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Solution
“You’re feeling guilty because you weren’t able to save your children.”
The best response by the nurse is, “You’re experiencing feelings of guilt because you weren’t able to save your children.” This response utilizes the therapeutic communication technique of reflection which identifies a client’s emotional response and reflects these feelings back to the client so that they may be recognized and accepted.
When interviewing a client, which nonverbal behavior should a nurse employ?
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Solution
Sitting squarely, facing the client
When interviewing a client, the nurse should employ the nonverbal behavior of sitting squarely, facing the client. Facilitative skills for active listening can be identified by the acronym SOLER. SOLER includes sitting squarely facing the client (S), open posture when interacting with a client (O), leaning forward toward the client (L), establishing eye contact (E), and relaxing (R).
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?
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Solution
“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.
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?
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Solution
“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.
What is the purpose of a nurse providing appropriate feedback?
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Solution
To give the client critical information
The purpose of providing appropriate feedback is to give the client critical information. Feedback should not be used to give advice or evaluate behaviors.
After assertiveness training, a formerly passive client appropriately confronts a peer in group therapy. The group leader states, “I’m so proud of you for being assertive. You are so good!” Which communication technique has the leader employed?
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Solution
The nontherapeutic technique of giving approval.
The group leader has employed the nontherapeutic technique of giving approval. Giving approval implies that the nurse has the right to pass judgment on whether the client’s ideas or behaviors are “good” or “bad.” This creates a conditional acceptance of the client.
An instructor is correcting a nursing student’s clinical worksheet. Which instructor statement is the best example of effective feedback?
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Solution
“Surely you didn’t do this deliberately, but you breached confidentiality by using the client’s name.”
The instructor’s statement, “Surely you didn’t do this deliberately, but you breached confidentiality by using the client’s name.” is an example of effective feedback. Feedback is a method of communication to help others consider a modification of behavior. Feedback should be descriptive, specific, and directed toward a behavior that the person has the capacity to modify and should impart information rather than offer advice or criticize the individual.
A nurse maintains an uncrossed arm and leg posture. This nonverbal behavior is reflective of which letter of the SOLER acronym for active listening?
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Solution
O.
The nurse should identify that maintaining an uncrossed arm and leg posture is nonverbal behavior that reflects the “O” in the active-listening acronym SOLER. Open posture when interacting with the client (O).
A nurse is assessing a client diagnosed with schizophrenia for the presence of hallucinations. Which therapeutic communication technique used by the nurse is an example of making observations?
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Solution
“You appear to be talking to someone I do not see.”
The nurse is making an observation when stating, “You appear to be talking to someone I do not see.” Making observations involve verbalizing what is observed or perceived. This encourages the client to recognize specific behaviors and make comparisons with the nurse’s perceptions.
A client diagnosed with post-traumatic stress disorder is admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which therapeutic communication technique used by the nurse is an example of a broad opening?
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Solution
“What would you like to talk about?”
The nurse’s statement, “What would you like to talk about?” is an example of the therapeutic communication technique of giving broad openings. Using a broad opening allows the client to take the initiative in introducing the topic and emphasizes the importance of the client’s role in the interaction.