Therapeutic Communication for Nurses
Chapter Exam Questions
Course Introduction
Therapeutic Communication for Nurses focuses on the foundational strategies and skills required for effective nurse-patient interactions that foster healing and well-being. This course explores various communication techniques, including active listening, empathy, verbal and nonverbal cues, and culturally sensitive approaches to address the diverse needs of patients. Emphasis is placed on establishing trust, managing difficult conversations, and using therapeutic communication to navigate challenging healthcare situations. Students will engage in practical exercises and role-plays to develop their ability to build rapport, support patient autonomy, and promote positive health outcomes through compassionate and ethical communication.
Recommended Textbook
Interpersonal Relationships Professional Communication Skills for Nurses 7th Edition by Arnold
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Chapter 1: Theory Based Perspectives and Contemporary Dynamics
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Q1) The identification phase of the nurse-client relationship
A) sets the stage for the rest of the relationship.
B) correlates with the assessment phase of the nursing process.
C) focuses on therapeutic goals to enhance client and family well-being.
D) uses community resources to help resolve health care issues.
Answer: C
Q2) A young mother tells the nurse,"I'm worried because my son needs a blood transfusion.I don't know what to do,because blood transfusions cause AIDS." Which central nursing construct is represented in this situation?
A) Environment
B) Caring
C) Health
D) Person
Answer: D
Q3) Which of the following statements about communication theory is true?
A) Primates are able to learn new languages to share ideas and feelings.
B) Concepts include only verbal communication.
C) Perceptions are clarified through feedback.
D) Past experience does not influence communication.
Answer: C
Page 3
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Chapter 2: Professional Guides for Nursing Communication
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Q1) When evaluating the client's progress toward goal achievement,the nurse should ask which of the following questions?
A) "Did the client tell the truth?"
B) "Were the goals realistic?"
C) "Did the physician diagnose the client's condition correctly?"
D) "Was the length of stay too short?"
Answer: B
Q2) In regard to informed consent,which of the following statements is true?
A) Only legally incompetent adults can give consent.
B) Only parents can give consent for minor children.
C) It is not required that the client be told about costs and alternatives to treatment.
D) Consent must be voluntary.
Answer: D
Q3) The plan of care serves as the structural framework for A) maintaining confidentiality.
B) attaining self-actualization.
C) maintaining therapeutic communication.
D) providing safe, high-quality care.
Answer: D
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Page 4
Chapter 3: Clinical Judgment and Ethical Decision Making
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Q1) Which of the following describes the first step in acquisition of a value?
A) There must be pride in and happiness with the choice.
B) The value must be acted upon in a pattern of behavior consistent with the choice.
C) The value should be the result of conscious choice.
D) The value must be chosen after careful consideration of each alternative.
Answer: C
Q2) Which of the following personality characteristics is a barrier to critical thinking?
A) Accepting change
B) Being open minded
C) Stereotyping
D) Going with the flow
Answer: C
Q3) The student nurse can best learn the steps in critical thinking through A) reading journals.
B) classroom instruction.
C) repeated practice.
D) developing a mnemonic.
Answer: C
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Chapter 4: Clarity and Safety in Communication
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Q1) A nurse manager is teaching a group of nurses about client safety.The nurse manager teaches the nurses that safety is defined as "avoidance,prevention,and amelioration of adverse outcomes or injuries stemming from the process of health care itself." What is the source of this definition?
A) Hippocratic oath
B) National Patient Safety Foundation
C) American Association of Colleges of Nursing
D) American Nurses Association's Code of Ethics
Q2) When calling a physician,the nurse tells the physician her name,what unit and what hospital she is calling from,the client's name,and that the client is having trouble breathing.The nurse is demonstrating which step in the SBAR format for communicating with a client's physician?
A) Situation
B) Assessment
C) Background
D) Recommendation
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Chapter 5: Developing Therapeutic Communication Skills
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Q1) When therapeutically communicating with a client who has just found out he is HIVpositive,the nurse should focus on
A) professional needs.
B) an unlimited time frame for communication.
C) verbal communication only between the client and the nurse.
D) achieving identified health-related goals.
Q2) Which of the following is true in relation to the use of humor?
A) Humor is most effective when building rapport.
B) Humor should focus on the client's personal characteristics.
C) Humor and laughter have healing purposes.
D) Humor should dominate the situation.
Q3) As the nurse communicates with a client,the feedback provided by the nurse should be
A) descriptive, general, and content focused.
B) client focused and evaluative.
C) well-timed and general.
D) specific and focused on observed behavior.
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Chapter 6: Variation in Communication Styles
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Q1) An adult client responds to questions inappropriately.The nurse should do which of the following?
A) Assume that the client is depressed and seek further information.
B) Ask other staff members whether the client is sick.
C) Leave the client alone for now and return to reassess.
D) Observe the client's nonverbal behavior.
Q2) Social cognitive competency refers to
A) the ability to use verbal and nonverbal interventions.
B) understanding the relationships between the roles of the sender and receiver.
C) the ability to interpret message content within interactions from the point of view of each participant.
D) interpreting emotional content by observing body language.
Q3) When communicating about a client with a health care provider from another culture,the nurse states,"The client stopped taking his medications last week when he fell off the wagon." The health care provider looks at the nurse blankly.This is an example of A) connotation.
B) information processing.
C) time span between messages.
D) nonverbal cultural variations.
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Page 8
Chapter 7: Intercultural Communication
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Q1) When performing a newborn bath demonstration for the mother of a Native American infant,the nurse should
A) maintain constant eye contact with the mother.
B) anticipate answering many of the mother's questions.
C) ask the mother to stand next to the nurse.
D) deliver verbal instructions in a story-telling format.
Q2) Which of the following is a true statement in relation to the concept of poverty?
A) Poverty affects only a small segment of the population.
B) Poor people expect others to work with them in making things better.
C) Communication strategies that empower the poor to take small steps toward dependence are most effective.
D) Lack of essential resources is associated with political and personal powerlessness.
Q3) Cultural competence
A) involves a lack of acceptance of cultural differences in others.
B) requires self-awareness of one's own cultural values.
C) is a nonessential skill set required for health care providers.
D) begins with developing knowledge and acceptance of cultural differences in others.
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Chapter 8: Therapeutic Communication in Groups
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Q1) Which of the following describes group think?
A) A member of a corporate executive committee states, "You could be making a big mistake."
B) Members of a corporate executive committee fail to inform the chairperson that some middle managers do not support the decision.
C) A corporate executive committee cancels a press conference in light of poor market survey results.
D) Members demonstrate a willingness to take interpersonal risks
Q2) During a support group meeting,a group member makes several sexually provocative remarks toward the group leader.The best response by the group leader is, A) "What do you think your fellow group member is trying to tell us?"
B) "I want to discuss your sexually provocative remarks privately after this meeting."
C) "Our group work is of the highest priority; please align your remarks with the group purpose."
D) "I don't appreciate what you are saying, you are excused from the group."
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Chapter 9: Self Concept in Professional Interpersonal
Relationships
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Q1) An older adult client is admitted to the hospital with terminal cancer.The client expresses acceptance of impending death and states,"I am very satisfied with the life I had." The nurse recognizes the client is in Erikson's stage of psychosocial development known as which of the following?
A) Integrity vs. Despair
B) Autonomy vs. Shame and Doubt
C) Intimacy vs. Isolation
D) Identity vs. Identity Diffusion
Q2) To adequately meet the spiritual needs of clients,the nurse should first
A) learn to be considerate and sensitive.
B) distinguish between his or her own spiritual needs and those of the client.
C) meet the client's spiritual needs.
D) offer to pray and read the bible with the client.
Q3) A client states,"I am an obese,compulsive person." The nurse demonstrates how to conduct a perceptual check when stating which of the following?
A) "Can you tell me more about this?"
B) "Is it difficult for you to be this way?"
C) "I wouldn't worry about being very neat."
D) "It is okay to be this way; you are not hurting anyone."
Page 11
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Chapter 10: Developing Therapeutic Relationships
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Sample Questions
Q1) Self-disclosure by the nurse refers to the intentional revealing of personal experiences or feelings that are similar to or different from those of the client.The purpose of self-disclosure is to
A) deepen trust, to be a role model of self-disclosure as a beneficial mode of communicating.
B) to find out how the client would like to be.
C) to determine how things would be if the problems were solved.
D) to work toward resolution of the client's self-care needs.
Q2) The student nurse has finished her rotation on the outpatient psychiatric unit.Her client,who was diagnosed with borderline personality disorder,suddenly displays superficial scratches to both forearms.Which of the following is a nursing diagnosis for the client related to losses and endings in the nurse-client relationship?
A) Noncompliance about impending termination of nurse-client relationship
B) Knowledge deficit about impending termination of nurse-client relationship
C) Self-care deficit related to impending termination of nurse-client relationship
D) Anxiety related to impending termination of nurse-client relationship
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Chapter 11: Bridges and Barriers in Therapeutic Relationships
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Q1) Stereotypes are learned during A) exposure to early education.
B) childhood and reinforced by life experiences.
C) limited contact with other cultures.
D) uncomfortable experiences with culturally diverse clients.
Q2) In order to reduce clinical bias in nursing practice,the nurse should
A) memorize beliefs held by different cultures.
B) generalize beliefs based on ethnic membership.
C) develop a nonjudgmental, neutral attitude.
D) recognize that individuals of the same religion share the same characteristics.
Q3) Which of the following describes caring?
A) It is difficult to demonstrate professionally.
B) It is an ethical responsibility.
C) It is an intuitive process.
D) It is not influenced by past experience.
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Chapter 12: Communicating With Families
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Q1) When interviewing the family of a client newly diagnosed with Alzheimer disease,the nurse's primary goal is to help the family members sort out their personal fears and identify family strengths through the use of A) interventive questioning.
B) genogram.
C) ecomap.
D) offering commendations.
Q2) When caring for clients,it is important for the nurse to understand that A) treatment plans should be tailored around personal family goals.
B) meaningful involvement in the client's care will be consistent among family members.
C) the nurse should listen to only immediate family members when considering implications for family involvement.
D) individual family members have different perspectives.
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Chapter 13: Resolving Conflicts Between Nurse and Client
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Q1) A client states to the nurse in a hostile voice,"I am sick of being poked at and stuck with needles.Go away and leave me alone." Which of the following is the best statement by the nurse?
A) "I am not surprised that you wish to be left alone."
B) "I'm so sorry you are feeling so upset."
C) "You feel vulnerable and depressed as a result of all these treatments."
D) "Okay, I will go away."
Q2) The initial interpersonal strategy to help the client reduce strong emotion to a workable level involves
A) talking the emotion through with someone.
B) providing a neutral, accepting, interpersonal environment.
C) taking action that might help the client come to terms with the emotional consequences.
D) obtaining more information.
Q3) Which of the following best describes the goal of assertiveness?
A) Offering responses that contain "you" statements
B) Indirect communication
C) Standing up for one's personal rights
D) Ignoring the rights of others
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Chapter 14: Communicating to Encourage Health Literacy,
health Promotion, and Prevention of Disease
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Q1) A client who overeats and is overweight is admitted to the hospital for shortness of breath.Which of the following statements by the nurse reflects Bandura's social theory?
A) "Your cardiac studies reveal an enlarged heart. This is a sign of cardiac problems."
B) "I know you love to eat, but your current lifestyle is not conducive to good health."
C) "Can you remember what it was like to get up and go to work every day? Your buddies miss you."
D) "If you were to lose weight, you would no longer experience shortness of breath. Just think about how much better you would feel to breathe normally."
Q2) The nurse is caring for an older adult client who is newly diagnosed with diabetes and has a low literacy level.Which of the following guidelines for teaching low-literacy clients should the nurse use when working with this client?
A) Teach the largest amount possible in each teaching session.
B) Sequence key behavior information last when teaching the client.
C) Use symbols and images with which the client is familiar.
D) Use words that are abstract and provide teaching in long sentences.
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Chapter 15: Health Teaching and Coaching
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Q1) A client requires health teaching for exercises related to an arthritic shoulder.During an assessment,the client tells the nurse she is a kinetic learner.What teaching resource should the nurse recommend to this client?
A) Reading a book about arthritis
B) Watching an exercise video
C) Performing water aerobics
D) Listening to an exercise audiotape
Q2) The nurse is preparing teaching material for a class of diabetic clients.The most important aspect when preparing a presentation with slides for group teaching is
A) the inclusion of greater than five items per slide.
B) use of large font so all participants can see from a distance.
C) use of slides as the primary content for the presentation.
D) having the presenter face the slides, not the audience.
Q3) Which of the following is an effective teaching objective? The client will be able to A) ambulate short distances around the nursing unit.
B) learn subcutaneous self-administration of insulin.
C) understand diabetes and its lifestyle implications.
D) perform foot care correctly after three teaching sessions.
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Chapter 16: Empowerment-Oriented Communication
Strategies to Reduce Stress
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Q1) Which of the following is true in relation to stress?
A) Men and women respond to stress in the same fashion.
B) Culture does not affect the stress experience.
C) Stress is always a negative experience.
D) Stress can have protective and adaptive functions.
Q2) A client who has been diagnosed with cancer asks the nurse,"If I take the chemotherapy,will I be cured,or am I going to die anyway?" The nurse's best response is
A) "Tell me what prompted your question."
B) "I don't think you should have chemotherapy; it will harm you more than help you."
C) "Let's not talk about dying; I'm sure you will be cured."
D) "I really don't think you should worry about such things; it isn't something you can control."
Q3) A three-stage progressive pattern of nonspecific physiologic responses known as alarm,resistance,and exhaustion is based on
A) Cannon's scientific physiologic response theory.
B) Selye's General Adaptation Syndrome.
C) Holmes and Rahe's stimuli stress model.
D) Lazarus and Folkman's transactional model of stress.
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Chapter 17: Communicating With Clients Experiencing
Communication Deficits
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Q1) When communicating with a client diagnosed with a serious mental disorder,it is important for the nurse to recognize which of the following?
A) Clients with mental disorders never have intact sensory channels
B) Clients with a 'flat affect' are easier to understand
C) Clients with mental disorders are always very talkative
D) Clients with mental disorders may suffer from social isolation and impaired coping
Q2) The nurse is caring for a client who is hearing-impaired and legally blind in his right eye.The client has just returned from cataract surgery on his left eye.The nurse recognizes that
A) the client's arm should be held when walking.
B) verbal speech is useless in this situation.
C) signals should be developed to indicate changes in pace or direction while walking.
D) the client should be discouraged from reading lips.
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Chapter 18: Communicating With Children
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Q1) When caring for a preschooler,the nurse understands that this child tends to interpret language in a literal way and that the child will not ask for clarification,leading to a misunderstanding of messages.The nurse recognizes a preschooler is in which of Piaget's cognitive stages of development?
A) Concrete operations
B) Formal operations
C) Preoperational
D) Sensorimotor
Q2) When assessing a child's reaction to illness,it is important for the nurse to A) observe the interaction between parent and child.
B) recognize that chronological age matches cognitive level.
C) realize that children are more comfortable with female health care providers.
D) recognize that the child's behavior will be age appropriate.
Q3) In mastering QSEN competency of patient-centered care,effective tools need to be A) cognitive, developmentally appropriate, and educational.
B) cultural, educational, interpersonal, and societal.
C) attitudinal, cognitive, and developmentally appropriate.
D) attitudinal, cultural, and developmentally appropriate.
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Chapter 19: Communicating With Older Adults
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Q1) The nurse is caring for an older adult client who has been diagnosed with dementia.The nurse recognizes which of the following as true in relation to the use of touch with this client?
A) Clients with dementia can ask for touch.
B) Clients with dementia can create touch for themselves.
C) Clients with dementia can become more anchored in the present time, space, and humanity when touched.
D) Clients with dementia can tell the nurse about the meaning of touch.
Q2) The nurse has just completed a care plan on a visually impaired client.Which of the following interventions is most appropriate for this client?
A) Stand away from the client when communicating to not obstruct the view of the immediate environment.
B) Provide the client with reading material that has all capital letters.
C) Verbally explain all written information while discouraging the client from asking questions.
D) Ensure the client's room has bright lighting with no glare.
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Chapter 20: Communicating With Clients in Crisis
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Q1) The nurse is caring for an older adult client who has recently lost his job,is experiencing a major physical illness,and lives alone.The client states,"I sometimes wish I wasn't here." When working with this client,the nurse recognizes that
A) an increase in the client's energy level indicates the client is coping better.
B) older adult clients have a lower rate of suicide.
C) the client should be assessed for imminent danger of doing harm to self.
D) when the client begins giving away possessions, it is a positive sign.
Q2) A client enters the emergency department.When performing the initial admission assessment,the nurse recognizes which client behavior as an indicator that the client may become violent?
A) Coherent speech
B) Flat affect
C) A relaxed posture
D) Confusion
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Chapter 21: Communicating With Clients and Families at the End of Life
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Q1) Which of the following is an inappropriate intervention for communicating with terminally ill clients?
A) Allowing the client to lead discussions about the future
B) Offering automatic responses and trite reassurances
C) Respecting the individual's pattern of communication
D) Maintaining a sense of calm
Q2) Which of the following statements is true about grief?
A) Grief always occurs immediately after a loss.
B) Support for a grieving client includes closed communication.
C) Recurring, wavelike feelings of sadness and loss are common feelings in a client who is grieving.
D) It is normal for grief to be exaggerated.
Q3) The nurse is caring for a client who has just experienced the death of her mother.The nurse best demonstrates support for the client by
A) sitting quietly with the client and not discussing the loss.
B) reminding the client that her mother lived a long life.
C) changing the subject so the client won't get upset.
D) offering spiritual support for the client and family.
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Chapter 22: Role Relationships and Interprofessional Communication
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Q1) A novice nurse decides to attend a diabetes workshop after a client was admitted to the unit with an insulin pump that the nurse was not familiar with.This is an example of A) role performance.
B) client advocacy.
C) collaboration.
D) professional self-awareness.
Q2) Essential components of interprofessional professionalism are clear communication,caring,professional ethics,and A) aesthetics.
B) altruism.
C) justice.
D) truth.
Q3) When documenting nursing care in the client's chart,the nurse does so accurately and honestly.The nurse is demonstrating which essential value of professionalism in nursing?
A) Altruism
B) Integrity
C) Human dignity
D) Asepsis
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Chapter 23: Communicating With Other Health
Professionals
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Q1) The charge nurse is working on a unit where a nurse is frequently late for work.The charge nurse addresses the behavior by telling the nurse,"It is necessary for you to be here on time from now on." This is an example of what type of constructive criticism?
A) Expressing sympathy
B) Describing the behavior
C) Stating expectations
D) Listing consequences
Q2) The charge nurse is working with a group of staff nurses on a hospital unit.When delegating to the staff nurses,the charge nurse determines that there is conflict among the group.The charge nurse should
A) wait for the staff nurses to discuss the problems that are related to the conflict.
B) perform simultaneous activities when listening to the staff nurses.
C) present the staff nurses with documented data that is irrelevant to the conflict.
D) briefly summarize when providing the staff nurses with feedback.
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Chapter 24: Communicating for Continuity of Care
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Q1) The nurse demonstrates understanding of continuity of care (COC)when doing which of the following?
A) Providing care in an untimely manner
B) Utilizing management plans that are inconsistent
C) Encouraging a longitudinal construct in health care
D) Demonstrating inflexibility when managing the client's care
Q2) To build relational continuity with each client,the nurse strives for
A) the use of data to tailor current treatment and care to each client's evidenced needs.
B) accurate record sharing and technology to allow real-time communication exchanges between providers and with clients in remote sites.
C) a consistent, coherent care management approach that can be flexibly adjusted as client needs change.
D) a therapeutic relationship with a practitioner that spans more than one episode of care and leads, in the practitioner, to a sense of clinical responsibility and an accumulated knowledge of the client's personal and medical circumstances
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Chapter 25: Documentation in an Electronic Era
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Q1) The nurse recognizes which of the following as a true statement about a nursing classification system?
A) It provides a standard language for nursing care.
B) It promotes visibility and defines professional practice of nursing contributions to client care.
C) It lacks standardized terminologies that promote best practices within nursing.
D) It has not been thoroughly incorporated into many agencies' electronic clinical records.
E) It provides a common language for nursing care.
Q2) All of the following are true about electronic records except A) they are portable.
B) they are less durable than paper charting.
C) they are easily transferable.
D) they are more durable than paper charting.
Q3) Which of the following is a disadvantage of computerized charting?
A) Ability to aggregate data
B) Improved access to health record
C) Standardized charting
D) Preset activities that can be coded
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Chapter 26: Communicating at the Point of Care:
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Q1) A nursing instructor educates a student nurse about standards of effective communication.The nursing instructor recognizes that additional teaching is warranted when the student nurse lists which of the following as a standard of effective communication?
A) Clear
B) Timely
C) Lengthy
D) Complete
Q2) When working on a hospital unit,the nurse uses a cellular telephone as an aid to giving client care.When using a cellular telephone,the nurse recognizes that a barrier to this type of technology is
A) cellular telephones lead to less productivity.
B) cellular telephones can lead to a higher rate of hospital errors.
C) some hospitals prohibit using cellular telephones.
D) cellular telephones complicate information retrieval at the point of care.
Q3) Which of the following best describes a laptop computer?
A) It is less powerful than a tablet.
B) It should not be taken into a client's home.
C) It is used to chart and transmit a client's care.
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D) It does not allow for information to be transmitted in a wireless fashion.
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