NCLEX Style Questions - Therapeutic Communication

Which therapeutic communication technique is being used in this nurse-client interaction?
Client: "When I get angry, I get into a fistfight with my wife or I take it out on the kids."
Nurse: "I notice that you are smiling as you talk about this physical v

ANS: D
The nurse is using the therapeutic communication technique of making observations when noting that the client smiles when talking about physical violence. The technique of making observations encourages the client to compare personal perceptions wi

Which therapeutic communication technique is being used in this nurse-client interaction?
Client: "My father spanked me often."
Nurse: "Your father was a harsh disciplinarian."
A. Restatement
B. Offering general leads
C. Focusing
D. Accepting

ANS: A
The nurse is using the therapeutic communication technique of restatement. Restatement involves repeating the main idea of what the client has said. The nurse uses this technique to communicate that the client's statement has been heard and underst

Which therapeutic communication technique is being used in this nurse-client interaction?
Client: "When I am anxious, the only thing that calms me down is alcohol."
Nurse: "Other than drinking, what alternatives have you explored to decrease anxiety?"
A.

ANS: C
The nurse is using the therapeutic communication technique of formulating a plan of action to help the client explore alternatives to drinking alcohol. The use of this technique, rather than direct confrontation regarding the client's poor coping c

The nurse 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 chronologi

ANS: C
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.

A nurse states to a client, "Things will look better tomorrow after a good night's sleep." This is an example of which communication technique?
A. The therapeutic technique of "giving advice"
B. The therapeutic technique of "defending"
C. The nontherapeut

ANS: D
The nurse's statement, "Things will look better tomorrow after a good night's sleep." is an example of the nontherapeutic technique of giving false reassurance. Giving false reassurance indicates to the client that there is no cause for anxiety, th

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?
A. "What occurre

ANS: B
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 th

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?
A. "You appear to be talking to someone I do not see."
B. "Ple

ANS: A
The nurse is making an observation when stating, "You appear to be talking to someone I do not see." Making observations involves verbalizing what is observed or perceived. This encourages the client to recognize specific behaviors and make compari

A nurse maintains an uncrossed arm and leg posture. This nonverbal behavior is reflective of which letter of the SOLER acronym for active listening?
A. S
B. O
C. L
D. E
E. R

ANS: B
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. The acronym SOLER includes sitting squarely facing the client (S), open posture when inte

An instructor is correcting a nursing student's clinical worksheet. Which instructor statement is the best example of effective feedback?
A. "Why did you use the client's name on your clinical worksheet?"
B. "You were very careless to refer to your client

ANS: C
The instructor's statement, "Surely you didn't do this deliberately, but you breeched 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

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?
A. The non

ANS: A
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 acceptan

What is the purpose of a nurse providing appropriate feedback?
A. To give the client good advice
B. To advise the client on appropriate behaviors
C. To evaluate the client's behavior
D. To give the client critical information

ANS: D
The purpose of providing appropriate feedback is to give the client critical information. Feedback should not be used to give advice or evaluate behaviors.

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?
A. "Why do you continue to alienate your peers by your an

ANS: D
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 sho

A client diagnosed with dependant personality disorder states, "Do you think I should move from my parent's house and get a job?" Which nursing response is most appropriate?
A. "It would be best to do that in order to increase independence."
B. "Why would

ANS: C
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.

When interviewing a client, which nonverbal behavior should a nurse employ?
A. Maintaining indirect eye contact with the client
B. Providing space by leaning back away from the client
C. Sitting squarely, facing the client
D. Maintaining open posture with

ANS: C
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

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?
A. "The smoke was too thick. You couldn't have

ANS: B
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 a

A newly admitted client diagnosed with obsessive-compulsive disorder (OCD) washes hands continually. This behavior prevents unit activity attendance. Which nursing statement best addresses this situation?
A. "Everyone diagnosed with OCD needs to control t

ANS: D
The most appropriate statement by the nurse is, "Let's figure out a way for you to attend unit activities and still wash your hands." This statement reflects the therapeutic communication technique of formulating a plan of action. The nurse attempt

Which example of a therapeutic communication technique would be effective in the planning phase of the nursing process?
A. "We've discussed past coping skills. Let's see if these coping skills can be effective now."
B. "Please tell me in your own words wh

ANS: A
This is an example of the therapeutic communication technique of formulating a plan of action. By the use of this technique, the nurse can help the client plan in advance to deal with a stressful situation which may prevent anger and/or anxiety fro

A client tells the nurse, "I feel bad because my mother does not want me to return home after I leave the hospital." Which nursing response is therapeutic?
A. "It's quite common for clients to feel that way after a lengthy hospitalization."
B. "Why don't

ANS: D
This is an example of the therapeutic communication technique of restatement. Restatement is the repeating of the main idea that the client has verbalized. This lets the client know whether or not an expressed statement has been understood and give

A client's younger daughter is ignoring curfew. The client states, "I'm afraid she will get pregnant." The nurse responds, "Hang in there. Don't you think she has a lot to learn about life?" This is an example of which communication block?
A. Requesting a

ANS: C
This is an example of the nontherapeutic communication block of making stereotyped comments. Clich�s and trite expressions are meaningless in a therapeutic nurse-client relationship.

Which nursing statement is a good example of the therapeutic communication technique of giving recognition?
A. "You did not attend group today. Can we talk about that?"
B. "I'll sit with you until it is time for your family session."
C. "I notice you are

ANS: C
This is an example of the therapeutic communication technique of giving recognition. Giving recognition acknowledges and indicates awareness. This technique is more appropriate than complimenting the client which reflects the nurse's judgment.

A client is struggling to explore and solve a problem. Which nursing statement would verbalize the implication of the client's actions?
A. "You seem to be motivated to change your behavior."
B. "How will these changes affect your family relationships?"
C.

ANS: A
This is an example of the therapeutic communication technique of verbalizing the implied. Verbalizing the implied puts into words what the client has only implied or said indirectly.

The nurse asks a newly admitted client, "What can we do to help you?" What is the purpose of this therapeutic communication technique?
A. To reframe the client's thoughts about mental health treatment
B. To put the client at ease
C. To explore a subject,

ANS: C
This is an example of the therapeutic communication technique of exploring. The purpose of using exploring is to delve further into the subject, idea, experience, or relationship. This technique is especially helpful with clients who tend to remain

A student nurse tells the instructor, "I'm concerned that when a client asks me for advice I won't have a good solution." Which should be the nursing instructor's best response?
A. "It's scary to feel put on the spot by a client. Nurses don't always have

ANS: B
Giving advice tells the client what to do or how to behave. It implies that the nurse knows what is best and that the client is incapable of any self-direction. It discourages independent thinking.

A student nurse is learning about the appropriate use of touch when communicating with clients diagnosed with psychiatric disorders. Which statement by the instructor best provides information about this aspect of therapeutic communication?
A. "Touch carr

ANS: A
Touch can elicit both negative and positive reactions, depending on the people involved and the circumstances of the interaction.

Which nursing statement is a good example of the therapeutic communication technique of focusing?
A. "Describe one of the best things that happened to you this week."
B. "I'm having a difficult time understanding what you mean."
C. "Your counseling sessio

ANS: D
This is an example of the therapeutic communication technique of focusing. Focusing takes notice of a single idea or even a single word and works especially well with a client who is moving rapidly from one thought to another.

After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been canceled. The client swears at the nurse and states, "You are incompetent!" Which is the nurse's best response?
A. "Do you believe that I was the cause of you

ANS: B
This is an example of the appropriate use of feedback. Feedback should be directed toward behavior that the client has the capacity to modify.

During a nurse-client interaction, which nursing statement may belittle the client's feelings and concerns?
A. "Don't worry. Everything will be alright."
B. "You appear uptight."
C. "I notice you have bitten your nails to the quick."
D. "You are jumping t

ANS: A
This nursing statement is an example of the nontherapeutic communication block of belittling feelings. Belittling feelings occur when the nurse misjudges the degree of the client's discomfort, thus a lack of empathy and understanding may be conveye

A client on an inpatient psychiatric unit tells the nurse, "I should have died because I am totally worthless." In order to encourage the client to continue talking about feelings, which should be the nurse's initial response?
A. "How would your family fe

ANS: C
This nursing statement is an example of the therapeutic communication technique of reflection. When reflection is used, questions and feelings are referred back to the client so that they may be recognized and accepted.

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 goo

ANS: A
This nursing statement is an example of the nontherapeutic communication block of requesting an explanation. Requesting an explanation is when the client is asked to provide the reason for thoughts, feelings, behaviors, and events. Asking "why" a c

A client states, "You won't believe what my husband said to me during visiting hours. He has no right treating me that way." Which nursing response would best assess the situation that occurred?
A. "Does your husband treat you like this very often?"
B. "W

ANS: D
This is an example of the therapeutic communication technique of exploring. The purpose of using exploring is to delve further into the subject, idea, experience, or relationship. This technique is especially helpful with clients who tend to remain

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

ANS: B
This is an example of the therapeutic communication technique of presenting reality. Presenting reality is when the client has a misperception of the environment. The nurse defines reality or indicates his or her perception of the situation for the

Which nursing statement is a good example of the therapeutic communication technique of offering self?
A. "I think it would be great if you talked about that problem during our next group session."
B. "Would you like me to accompany you to your electrocon

ANS: B
This is an example of the therapeutic communication technique of offering self. Offering self makes the nurse available on an unconditional basis, increasing client's feelings of self-worth. Professional boundaries must be maintained when using the

A client slammed a door on the unit several times. The nurse responds, "You seem angry." The client states, "I'm not angry." What therapeutic communication technique has the nurse employed and what defense mechanism is the client unconsciously demonstrati

ANS: B
This is an example of the therapeutic communication technique of verbalizing the implied. The nurse is putting into words what the client has only implied by words or actions. Denial is the refusal of the client to acknowledge the existence of a re

Which of the following individuals are communicating a message? (Select all that apply.)
A. A mother spanking her son for playing with matches
B. A teenage boy isolating himself and playing loud music
C. A biker sporting an eagle tattoo on his biceps
D. A

ANS: A, B, C, D
The nurse should determine that spanking, isolating, getting tattoos, and writing are all ways in which people communicate messages to others. It is estimated that about 70% to 90% of communication is nonverbal.