1.

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 of the kids.”
Nurse: “I notice that you are smiling as you talk about this physical
violence.”

A. Encouraging comparison
B. Exploring
C. Formulating a plan of action
D. Making observations

2. 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

3. 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. Reflecting
B. Making observations
C. Formulating a plan of action
D. Giving recognition

4. Nurse Patrick 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?”

5. 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 nontherapeutic technique of “presenting reality”
D. The nontherapeutic technique of “giving false reassurance”

6. 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 occurred prior to the rape, and when did you go to the emergency
department?”
B. “What would you like to talk about?”
C. “I notice you seem uncomfortable discussing this.”
D. “How can we help you feel safe during your stay here?”
7. 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. “Please describe what you are seeing.”
C. “Why do you continually look in the corner of this room?”
D. “If you hum a tune, the voices may not be so distracting.”

8. 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

9. 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 by name on your clinical
worksheet.”
C. “Surely you didn’t do this deliberately, but you breached confidentiality by
using the client’s name.”
D. “It is disappointing that after being told, you’re still using client names on
your worksheet.”

10. 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 nontherapeutic technique of giving approval

B. The nontherapeutic technique of interpreting
C. The therapeutic technique of presenting reality
D. The therapeutic technique of making observations

11. 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

12. 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 angry outbursts?”

B. “You accomplish nothing when you lose your temper like that.”
C. “Showing your anger in that manner is very childish and insensitive.”
D. “During group, you raised your voice, yelled at a peer, left, and slammed the
door.”

13. A client diagnosed with dependent 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 you want to leave a secure home?”
C. “Let’s discuss and explore all of your options.”
D. “I’m afraid you would feel very guilty leaving your parents.”
14. 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 arms and legs crossed

15. 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 gone back in.”
B. “You’re feeling guilty because you weren’t able to save your children.”
C. “Focus on the fact that you could have lost all four of your children.”
D. “It’s best if you try not to think about what happened. Try to move on.”

16. 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 their ritualistic behaviors.”

B. “It is important for you to discontinue these ritualistic behaviors.”
C. “Why are you asking for help if you won’t participate in unit therapy?”
D. “Let’s figure out a way for you to attend unit activities and still wash your
hands.”

17. 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 what brought you to the hospital.”
C. “This new approach worked for you. Keep it up.”
D. “I notice that you seem to be responding to voices that I do not hear.”

18. 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 you talk to your mother? You may find out she doesn’t feel that
way.”
C. “Your mother seems like an understanding person. I’ll help you approach
her.”
D. “You feel that your mother does not want you to come back home?”

19. 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 an explanation
B. Belittling the client
C. Making stereotyped comments
D. Probing

20. 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 wearing a new dress and you have washed your hair.”
D. “I’m happy that you are now taking your medications. They will really help.”

Answers and Rationale

1. Answer: D. Making observations

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 with those of the nurse.

2. Answer: A. Restatement

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 understood.

3. Answer: C. Formulating a plan of action

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 choice, may serve to prevent anger or anxiety from escalating.

4. Answer: 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.
5. Answer: D. The nontherapeutic technique of “giving false
reassurance.”

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, thereby devaluing the client’s feelings.

6. Answer: B. “What would you like to talk about?”

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 the importance of the client’s role in the interaction.

7. Answer: A. “You appear to be talking to someone I do not see.”

The nurse is making an observation when stating, “You appear to be talking to

someone I do not see.” Making observations involve verbalizing what is
observed or perceived. This encourages the client to recognize specific
behaviors and make comparisons with the nurse’s perceptions.

8. Answer: B. O.

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. Open posture when interacting with the client (O).

The acronym SOLER includes:

 Option A: Sitting squarely facing the client (S).

 Option C: Leaning forward toward the client (L)
 Option D: Establishing eye contact (E).
  Option E: Relaxing (R).

9. Answer: C. “Surely you didn’t do this deliberately, but you breached

confidentiality by using the client’s name.”

The instructor’s statement, “Surely you didn’t do this deliberately, but you
breached 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 behavior. Feedback should be descriptive, specific, and directed
toward a behavior that the person has the capacity to modify and should impart
information rather than offer advice or criticize the individual.

10. Answer: A. The nontherapeutic technique of giving approval.

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 acceptance of the client.

11. Answer: D. To give the client critical information

The purpose of providing appropriate feedback is to give the client critical

information. Feedback should not be used to give advice or evaluate behaviors.

12. Answer: D. “During group, you raised your voice, yelled at a peer,
left, and slammed the door.”

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 should give information to the client about how he or she is
perceived by others. Feedback should not be evaluative in nature or be used to
give advice.
13. Answer: C. “Let’s discuss and explore all of your options.”

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.

14. Answer: C. Sitting squarely, facing the client

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), open posture when interacting with a client (O), leaning forward
toward the client (L), establishing eye contact (E), and relaxing (R).

15. Answer: B. “You’re feeling guilty because you weren’t able to save
your children.”

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 and reflects these feelings back to the client so that they may be
recognized and accepted.

16. Answer: D. “Let’s figure out a way for you to attend unit activities
and still wash your hands.”

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
attempts to work with the client to develop a plan without damaging the
therapeutic relationship or increasing the client’s anxiety.
17. Answer: A. “We’ve discussed past coping skills. Let’s see if these
coping skills can be effective now.”

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 from escalating to an unmanageable level.

18. Answer: D. “You feel that your mother does not want you to come
back home?”

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 gives him or her the chance to continue, or clarify if necessary.

19. Answer: C. Making stereotyped comments

This is an example of the nontherapeutic communication block of making

stereotyped comments. Clichés and trite expressions are meaningless in a
therapeutic nurse-client relationship.

20. Answer: C. “I notice you are wearing a new dress and you have
washed your hair.”

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.