NP2230 - Ch. 10

Ch. 10
Communication and Clinical Interview

Multiple Choice

Which communication techniques should the nurse use with a patient who has been identified as having difficulty expressing thoughts and feelings?

• Using emotionally charged words and gestures

• Offering opinions and avoiding periods of silence

• Asking closed-ended questions requiring “yes” or “no” answers

• Asking open-ended questions and seeking clarification

Asking open ended questions and seeking clarification

Asking open-ended questions allows the patient to freely express themselves without feeling restricted by yes or no responses, facilitating a deeper exploration of their thoughts and feelings. Seeking clarification helps ensure mutual understanding and allows the nurse to clarify any ambiguous or unclear information, promoting effective communication despite the patient's difficulty in expression.

Multiple Choice

Who determines the content and direction of the clinical interview?

• The nurse

• The patient

• The physician

• The health care team

The patient

The patient determines the content and direction of the clinical interview because their unique experiences, concerns, and goals shape the focus and flow of the conversation, ensuring it aligns with their needs and priorities.

Multiple Choice

Which of the following are two main principles that can guide the communication process during the nurse–patient interview?

• Clarity and continuity

• Personal and environmental factors

• Passive listening and cultural caution

• Interpreting and speculating on the patient’s meaning

Clarity and continuity

Clarity ensures that the nurse effectively conveys information and understands the patient's concerns, fostering mutual understanding and trust. Continuity ensures that the communication process is consistent and ongoing, promoting a supportive and therapeutic environment for the patient's care and well-being across multiple interactions.

Multiple Choice

When discussing her husband, a patient shares that “I would be better off alone. At least I would be able to come and go as I please and not have to be interrogated all the time.” What therapeutic communication technique is the nurse using when responding, “Are you saying that things would be better if you left your husband?”

• Focusing

• Restating

• Reflection

• Clarification

Clarification

The use of clarifying techniques helps both participants identify major differences in their frame of reference, giving them the opportunity to correct misperceptions before they cause any serious misunderstandings.

Multiple Choice

During a therapeutic encounter, the nurse remarks to a patient, “I noticed anger in your voice when you spoke of your father. Tell me about that.” What communication techniques is the nurse using?

• Giving information and encouraging evaluation

• Presenting reality and encouraging planning

• Clarifying and suggesting collaboration

• Reflecting and exploring

Reflecting and exploring

Reflection is a means of assisting people to better understand their own thoughts and feelings. A technique that enables the nurse to examine important ideas, experiences, or relationships more fully is exploring.

Multiple Choice

The patient is sitting with her arms crossed over her chest and her left leg rapidly moving up and down, and she has an angry expression on her face. When the nurse approaches her, she states harshly, “I’m fine! Everything’s great.” Which of the following responses would be most therapeutic?

• “Okay, but we are all here to help you, so come get one of the staff if you need to talk.”

• • “I’m glad everything is good. I am going to give you your schedule for the day and we can discuss how the groups are going.”

• “I don’t believe you. You are not being truthful with me.”

• “It looks as though you are saying one thing but feeling another. Can you tell me what may be upsetting you?”

“It looks as though you are saying one thing but feeling another. Can you tell me what may be upsetting you?”

Conflicting messages are known as double messages or mixed messages. One way a nurse can respond to verbal and non-verbal incongruity is to reflect and validate the patient’s feelings.

Multiple Select

Which of the following statements indicates a therapeutic communication technique? (Select all that apply.)

• “Why didn’t you attend group this morning?”

• “From what you have said, you have great difficulty sleeping at night.”

• “I’m really proud of you for the way you stood up to your brother when he visited today.”

• “You mentioned that you have never had friends. Tell me more about that.”

• “It sounds like you have been having a very hard time at home lately.”

• “You mentioned that you have never had friends. Tell me more about that.”

• “It sounds like you have been having a very hard time at home lately.”