T1 - Communication Lecture (Josh)

Question 1

Which type of communication is most honest: verbal or nonverbal?

Answer 1

Nonverbal is more honest

Question 2

—– communication is the use of gestures, expressions, behaviors (body language).

Answer 2

Nonverbal

Question 3

If non-verbal cues are not consistent with the verbal message, it will most likely be the —- message that is received.

Answer 3

non-verbal

Question 4

What is the most therapeutic posture/position that a nurse can take?

Answer 4

The most therapeutic posture and positioning is for the nurse to assume the same position and level as the patient.

ex: sit in chair so she can be eye level w/ patient

Question 5

What is the most critical communication strategy?

Answer 5

active listening

Question 6

What is active listening?

Answer 6

being attentive to what the patient is saying verbally and non-verbally

Question 7

SOLER Listening (helps us remember the nonverbal behaviors that are associated w/ active listening):

Answer 7

S- Sit squarely facing the patient
O- Observe an open posture
L- Lean fwd toward client
E- Establish eye contact
R- Relax

Question 8

What is therapeutic communication?

Answer 8

verbal and nonverbal techniques that focus on the care receiver’s needs and advance the promotion of healing and change.

It is nonjudgmental, discourages defensiveness, and promotes trust thus enhancing the nurse-client relationship.

Question 9

The nurse can use a — — — to initiate the discussion and follow the patient to determine what will be discussed.

Answer 9

broad opening statement

ex: “Tell me what you are thinking”

Question 10

—– —— allows the patient to introduce the topic and emphasizes the patient’s role in the interaction.

Answer 10

Broad Openings

Question 11

—- —- also leave the direction of the conversation to the patient.

Answer 11

General Leads

ex: ‘Yes, go on.’ or ‘And after that?’

Question 12

‘I noticed that you made your bed today’ is an example of….

Answer 12

giving recognition

Question 13

Patient: ‘Do you think I should quit my new job?’

Client: ‘Do you think you should quit your new job?’

Answer 13

Reflecting

• be careful b/c overuse can annoy the client

Question 14

To translate words into feelings, the nurse needs to —–

Answer 14

desymbolize

ex:
Client: ‘I’m a lost puppy’

nurse: ‘You must be feeling very lonely right now.’

Question 15

Is it ok to interrupt a conversation to clarify what was said to increase understanding?

Answer 15

yes

Question 16

Rephrasing the patient’s words to highlight an underlying message to clarify statements.

Answer 16

Verbalizing the Implied

• The nurse should be careful and only verbalize what the patient has clearly suggested.

Question 17

—- allows the nurse and client to view events in perspective to each other.

Answer 17

Placing the event in time or place

Question 18

—- is used w/ patients experiencing hallucinations.

Answer 18

Encouraging Descriptions or Perceptions

ex: ‘What are the voices telling you to do?’

Question 19

“I understand that you hear voices, but I do not hear them.”

… is an example of —–

Answer 19

Presenting Reality

• The intent is to introduce a different line of thought for the patient, NOT to convince the patient that they are wrong

Question 20

Delving further into a subject, idea, experience, or relationship; helpful with patients who stay on a superficial level of communication.

Answer 20

Exploring

• refrain from probing/prying when using this technique

Question 21

This technique permits the patient to become aware that others may not perceive or draw the same conclusion

*This technique is often used with clients experiencing delusional thinking.

Answer 21

Voicing Doubt

Question 22

Giving Reassurance is —- communication.

Answer 22

nontherapeutic

ex: ‘Everything will be alright’

Question 23

Why is ‘approving’ or ‘disapproving’ non-therapeutic?

Answer 23

implies that the nurse has the right to pass judgment on whether the patient’s ideas or behaviors are ‘good’ or ‘bad’

Question 24

Agreeing/Disagreeing is —– communication.

Answer 24

non-therapeutic

ex: ‘I agree with you’

Question 25

—- —- imposes the nurse’s opinions and solutions on the patient, rather than helping the patient arrive at the own decision.

Answer 25

Giving Advice

• non-therapeutic b/c it discourages independent thinking

Question 26

Diff. between Probing and Exploring.

Answer 26

Probing (non-therapeutic) is persistent questioning to answers client doesn’t want to give

Exploring (therapeutic) is delving deeper into a topic client is talking about superficially

Question 27

“Why do you think the other kids don’t like you?”

… is an example of —-

Answer 27

Requesting an Explanation (non-therapeutic)

• Asking the patient to provide the reasons for thoughts, feelings, behavior, and events.

Question 28

Why is this non-therapeutic?

“What makes you say mean things to your sister?”

Answer 28

attributes the source of thoughts, feelings, and behavior to others or to outside influences;

rather than accepting responsibility it encourages blame

Question 29

Why is this non-therapeutic?

“I know just how you feel. Everyone gets depressed at times.”

Answer 29

Belittling Feelings:

devalues the client’s feelings, implying that their discomfort is unimportant or insignificant

Question 30

It is — — to hear that others are or have been in similar situations (ex: miscarriage)

Answer 30

no relief

Question 31

Using social clichés leads the patient to reply in a like manner, thus keeping the conversation at a superficial level.

Answer 31

Making Stereotyped Comments (non-therapeutic)

ex: “Isn’t it a beautiful day?”
- these types of statements keep a distance b/t the nurse and the patient

Question 32

Pt: “I’m nothing.”

Nurse: “Of course you’re something. Everybody is somebody.”

Answer 32

Denial (non-therapeutic)

• denies that a problem exists
• this blocks discussion w/ the patient and avoids helping the patient identify and their areas of difficulty

Question 33

Nurse Nancy is interviewing a newly admitted psychiatric client. Which nursing statement is an example of offering a “general lead”?

a) “Do you know why you are here?”
b) Are you feeling depressed or anxious?”
c) “Yes, I see. Go on.”
d) “Can you chronologically order the events that led to your admission?”

Answer 33

c) “Yes, I see. Go on.”

The nurse’s statement, “Yes, I see. Go on.” is an example of the therapeutic communication technique of a general lead. Offering a general lead encourages the client to continue sharing information.

Question 34

When interviewing a client, which nonverbal behavior should a nurse employ?

a) Maintaining indirect eye contact with client
b) Leaning back away from the client
c) Open posture, facing the client
d) Sitting with arms and legs crossed

Answer 34

c) Open posture, facing the client

SOLER

• sit squarely
• open posture
• leaning fwd
• eye contact
• relaxing

Question 35

Which therapeutic communication technique should the nurse use when communicating with a client who is experiencing auditory hallucinations?

a) “My sister has the same diagnosis as you and she also hears voices.”.
b) “I understand that the voices seem real to you, but I do not hear any voices.”
c) “Why don’t we turn up the radio so the voices are muted.”
d) “I wouldn’t worry about those voices. The medications will make them go away soon.”

Answer 35

b) “I understand that the voices seem real to you, but I do not hear any voices.”
- This is an example of the therapeutic communication technique of presenting reality. Presenting reality is when the client has a mis-perception of the environment.

The nurse defines reality or indicates his or her perception of the situation for the client.

Question 36

Which nursing response is an example of the nontherapeutic communication block of requesting an explanation?

a) “Can you tell me why you said that?”
b) “Keep your chin up. I’ll explain the procedure to you.”
c) “There is always an explanation for both good and bad behaviors.”
d) “Are you not understanding the explanation I’m providing?”

Answer 36

a) “Can you tell me why you said that?”

Requesting an explanation is when the client is asked to provide the reason for thoughts, feelings, behaviors, and events.

Asking “why” a client did something or fells a certain way can be very intimidating and implies that the client must defend his or her behavior or feelings

Question 37

A client’s teenage son is ignoring curfew. The client states, “I’m afraid he is going to get into trouble.” The nurse responds, “Hang in there. Don’t you think he is smarter than that?” This is an example of which communication block?

a) Requesting an explanation
b) Belittling the client’s feelings
c) Making stereotyped comments
d) Probing to clarify

Answer 37

b) Belittling the client’s feelings
- This is an example of non-therapeutic communication block of making belittling comments. This causes the client to feel insignificant or unimportant.