Exam 1: Therapeutic Communication

Question 1

Communication

Answer 1

exchange of information

Question 2

Two types of communication

Answer 2

1. Verbal
2. Nonverbal

Question 3

Verbal communication content:

Answer 3

literal words spoken

Question 4

Verbal communication context:

Answer 4

Context: environment, circumstances, situation in which communication occurs

Question 5

Nonverbal communication process:

Answer 5

Process: all messages used to give meaning, context to message

Question 6

Nonverbal communication

Answer 6

Congruent or incongruent messages

Question 7

Goals of therapeutic communication

Answer 7

Establish therapeutic nurse–client relationship

Identify the most important client’s concerns; assess client’s perceptions

Facilitate client’s expression of emotions

Recognize client’s needs

Implement interventions to address client’s needs
Guide client toward acceptable solutions

Question 8

Distance zones: Intimate

Answer 8

0-18inch

Question 9

Distance zones: Personal

Answer 9

Personal (18–36 in)

Question 10

Distance zones: Social

Answer 10

Social (4–12 ft)

Question 11

Distance zones: Public

Answer 11

Public (12–25 ft)

Question 12

What distance is best for therapeutic communication?

Answer 12

Therapeutic communication: most comfortable when nurse and patient are 3 to 6 ft apart

Question 13

Touch in therapeutic communication

Answer 13

Can be possible invasion of intimate and personal space

The nurse must evaluate use of touch based on the client’s preferences, history, and needs.

Nurse may find touch supportive, client may NOT*

Question 14

Active listening in therapeutic communication

Answer 14

Active listening (concentrating exclusively on what patient says)

Question 15

Active Observation in therapeutic communication

Answer 15

Active observation (watching nonverbal actions as speaker communicates)

Question 16

Active Listening and Active Observation help the nurse with _____in therapeutic communication

Answer 16

1. Recognize the most important issue
2. Know what questions to ask
3. Objectively respond to message in a concrete manner

Question 17

Techniques for verbal communication:

Answer 17

1. Exploring, restating, reflecting, clarifying
2. Some promote discussion of feelings or concerns in more depth
3. Feedback via making an observation or presenting reality

Question 18

Nontherapeutic techniques to avoid:

Answer 18

Advising, belittling, challenging, probing, reassuring, Why questions

Question 19

Overt signals or cues

Answer 19

Overt (clear, direct statements)

Question 20

Covert signals or cues

Answer 20

Covert (vague, indirect messages)

Question 21

Nonverbal communication includes

Answer 21

Facial expression
Body language
Closed body position
Open posture
Vocal cues
Eye contact
Silence

Question 22

Spirituality in communication

Answer 22

Self-awareness of own spiritual beliefs

Need for objectivity and nonjudgmental attitude about client’s beliefs

Question 23

Cultural considerations in communication

Answer 23

Cultural assessment

Use of a translator who can retain original intent without inserting biases

Nurse must understand differences in how various cultures communicate.

Question 24

Goals for establishing a therapeutic session:

Answer 24

Establishing rapport

Actively listening

Gaining in-depth understanding of client’s perception of issue

Being empathetic

Exploring client’s thoughts and feelings

Facilitating client’s expression of thoughts and feelings

Guide client in developing problem-solving skills

Promoting client’s evaluation of solutions

Question 25

How to initiate a therapeutic communication session

Answer 25

1. Introduction 2. Establishment of contract for relationship 3. Identification of major concern

Question 26

What is involved in identification of major concern:

Answer 26

1. Nondirective role (broad openings, open-ended questions) 2. Directive role (direct yes-or-no questions; usually for clients with suicidal thoughts, in crisis, or who are out of touch with reality)

Question 27

Important tips for a good therapeutic session:

Answer 27

Asking for clarification Addressing client’s avoidance of anxiety-producing topic Guiding the client in problem-solving and change Help the client explore possibilities Client’s participation is key. Avoid inserting own beliefs Expression of positive and negative feelings/ideas in an open, honest, direct way Calm, specific, factual statements Focus on “I” statements

Question 28

What is the first step toward improving communication?

Answer 28

Awareness of own communication is the first step toward improving communication. Ask for feedback from colleagues. Examine own communication skills.