Townsend

PMHN, 10e
Chapter 7 - ETB
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Chapter 7. Therapeutic Communication

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MULTIPLE CHOICE
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1. Which therapeutic communication technique is being used in this nurse-client

interaction? abirb.com/test
Client: “When I get angry, I get into a fistfight with my partner or I take it out on the
kids.”
Nurse: “I notice that you are smiling as you talk about this physical violence.”
abirb.com/test
1. Encouraging comparison
2. Exploring
3. Formulating a plan of action
4. Making observations abirb.com/test

ANS: 4
Chapter: Chapter 7 Therapeutic Communication
abirb.com/test
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 126
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
Communication Techniques abirb.com/test
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
abirb.com/test
Concept: Communication
Difficulty: Moderate

Feedback abirb.com/test
1. This is incorrect. The nurse is using the therapeutic communication technique of
making observations by noting that the client smiles when talking about physical
violence. The technique of making observations encourages the client to compare
abirb.com/test
personal perceptions with those of the nurse. Encouraging comparison is a
therapeutic technique that involves asking the client to compare similarities and
differences in ideas, experiences, or interpersonal relationships.
2. This is incorrect. The nurse is using the therapeutic communication technique of
abirb.com/test
making observations by 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. abirb.com/test
3. This is incorrect. The nurse is using the therapeutic communication technique of
making observations by 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. Formulating aabirb.com/test
plan assists the client in
making a plan to prevent anger or anxiety from escalating.

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Townsend
PMHN, 10e
Chapter 7 - ETB
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4. This is correct. The nurse is using the therapeutic communication technique of
making observations by noting that the client smiles when talking about physical
violence. The technique of making observations encourages the client to compare
abirb.com/test
personal perceptions with those of the nurse.

CON: Communication
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2. Which therapeutic communication technique is being used in this nurse-client

abirb.com/test
interaction?
Client: “My father spanked me often.”
Nurse: “Your father was a harsh disciplinarian.”
1. Restating abirb.com/test
2. Offering general leads
3. Focusing
4. Accepting
abirb.com/test

ANS: 1
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe therapeutic and nontherapeutic verbal communication
abirb.com/test techniques.
Page: 126
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
Communication Techniques
abirb.com/test
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication abirb.com/test
Difficulty: Moderate

Feedback abirb.com/test
1. This is correct. The nurse is using the therapeutic communication technique of
restating. Restating 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. abirb.com/test

2. This is incorrect. The nurse is using the therapeutic communication technique of

restating. Restating involves repeating the main idea of what the client has said. The
nurse uses this technique to communicate that the client’s statement
abirb.com/testhas been heard
and understood. Offering general leads to the client encourages the client to
continue.
3. This is incorrect. The nurse is using the therapeutic communication technique of
abirb.com/test
restating. Restating 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. Focusing is when the nurse notices a single idea or even a single
word and works especially well with a client who is moving rapidly from one
abirb.com/test
thought to another. Focusing is not therapeutic with a client who is very anxious.

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Townsend
PMHN, 10e
Chapter 7 - ETB
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4. This is incorrect. The nurse is using the therapeutic communication technique of
restating. Restating 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. Accepting conveys an attitude of receptionabirb.com/test
and regard.

CON: Communication
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3. Which therapeutic communication technique is being used in this nurse-client

abirb.com/test
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?”
1. Reflecting abirb.com/test
2. Making observations
3. Formulating a plan of action
4. Giving recognition
abirb.com/test

ANS: 3
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe therapeutic and nontherapeutic verbal communication
abirb.com/test techniques.
Page: 126
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
Communication Techniques
abirb.com/test
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication abirb.com/test
Difficulty: Moderate

Feedback abirb.com/test
1. This is incorrect. 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 abirb.com/test
anxiety from escalating.
Reflecting involves referring questions and feelings back to the client so that they
may be recognized and accepted and so that the client may recognize that his or her
point of view has value. abirb.com/test
2. This is incorrect. 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 abirb.com/test
anxiety from escalating.
Making observations involves verbalizing what is observed or perceived and
encourages the client to recognize specific behaviors and compare perceptions with
the nurse. abirb.com/test
3. This is correct. The nurse is using the therapeutic communication technique of

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Townsend
PMHN, 10e
Chapter 7 - ETB
abirb.com/test
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.
abirb.com/test
4. This is incorrect. 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 abirb.com/test
anxiety from escalating.
Giving recognition is acknowledging and indicating the client’s awareness.

CON: Communication
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4. The nurse is interviewing a newly admitted psychiatric client. abirb.com/test

Which nursing
statement is an example of offering a general lead?
1. “Do you know why you are here?”
2. “Are you feeling depressed or anxious?”
abirb.com/test
3. “Yes, I see. Go on.”
4. “Can you chronologically order the events that led to your admission?”

ANS: 3 abirb.com/test
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 126 abirb.com/test
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
Communication Techniques
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity abirb.com/test
Cognitive Level: Application [Applying]
Concept: Communication
Difficulty: Moderate abirb.com/test

Feedback
1. This is incorrect. The question “Do you know why you are here?” is not an example
abirb.com/test
of offering a general lead. Offering a general lead encourages the client to continue
sharing information with minimal input from the nurse.
2. This is incorrect. The question “Are you feeling depressed or anxious?” is not an
example of offering a general lead. Offering a general leadabirb.com/test
encourages the client to
continue sharing information with minimal input from the nurse.
3. This is correct. The nurse’s statement is an example of the therapeutic
communication technique of a general lead. Offering a general lead encourages the
abirb.com/test
client to continue sharing information.
4. This is incorrect. The question “Can you chronologically order the events that led to
your admission?” is not an example of offering a general lead. Offering a general
lead encourages the client to continue sharing information abirb.com/test
with minimal input from
the nurse.

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Townsend
PMHN, 10e
Chapter 7 - ETB
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CON: Communication
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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? abirb.com/test
1. The nontherapeutic technique of “giving advice”
2. The therapeutic technique of “formulating a plan of action”
3. The therapeutic technique of “presenting reality”
4. The nontherapeutic technique of “giving false reassurance” abirb.com/test

ANS: 4
Chapter: Chapter 7 Therapeutic Communication abirb.com/test
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 129
Heading: Nontherapeutic Communication Techniques > Table 7–3 Nontherapeutic
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Communication Techniques
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying] abirb.com/test
Concept: Communication
Difficulty: Moderate
abirb.com/test
Feedback
1. This is incorrect. The nurse’s statement 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. Giving
abirb.com/test
advice is the nontherapeutic technique of telling the client what to do or how to
behave and implies that the nurse knows what is best and that the client is incapable
of any self-direction. abirb.com/test
2. This is incorrect. The nurse’s statement 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.
Formulating a plan of action encourages a client to identifyabirb.com/test
a plan for behavior
change.
3. This is incorrect. The nurse’s statement is an example of the nontherapeutic
technique of giving false reassurance. Giving false reassurance indicates to the client
abirb.com/test
that there is no cause for anxiety, thereby devaluing the client’s feelings. Presenting
reality is the therapeutic technique used to define reality when a client has a
misperception of the environment.
4. This is correct. The nurse’s statement is an example of the abirb.com/test
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.
abirb.com/test
CON: Communication

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Townsend
PMHN, 10e
Chapter 7 - ETB
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6. A client diagnosed with posttraumatic stress disorder is admitted to an inpatient
psychiatric unit for evaluation and medication stabilization. Which utterance made by
the nurse is an example of a broad opening?
1. “What occurred prior to the traumatic event, and when did youabirb.com/test
go to the emergency
department?”
2. “What would you like to talk about?”
3. “I notice you seem uncomfortable discussing this.”
abirb.com/test
4. “How can we help you feel safe during your stay here?”

ANS: 2
Chapter: Chapter 7 Therapeutic Communication abirb.com/test
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 126
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
abirb.com/test
Communication Techniques
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying] abirb.com/test
Concept: Communication
Difficulty: Moderate
abirb.com/test
Feedback
1. This is incorrect. The nurse’s question “What occurred prior to the traumatic event,
and when did you go to the emergency department?” is an example of the
therapeutic communication technique of placing the event abirb.com/test
in time or sequence.
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.
2. This is correct. The nurse’s question “What would you likeabirb.com/test
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.
3. This is incorrect. The nurse’s statement “I notice you seemabirb.com/test
uncomfortable discussing
this” is an example of the therapeutic communication technique of making
observations. Using a broad opening allows the client to take the initiative in
introducing the topic and emphasizes the importance of theabirb.com/test
client’s role in the
interaction.
4. This is incorrect. The nurse’s question “How can we help you feel safe during your
stay here?” is an example of the therapeutic communication technique of
formulating a plan of action. Using a broad opening allowsabirb.com/test
the client to take the
initiative in introducing the topic and emphasizes the importance of the client’s role
in the interaction.
abirb.com/test
CON: Communication

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Townsend
PMHN, 10e
Chapter 7 - ETB
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7. A nurse is assessing a client diagnosed with schizophrenia for abirb.com/test

the presence of
hallucinations. Which therapeutic communication technique used by the nurse is an
example of making observations?
1. “You appear to be talking to someone I do not see.” abirb.com/test
2. “Please describe what you are seeing.”
3. “Why do you continually look in the corner of this room?”
4. “If you hum a tune, the voices may not be so distracting.”
abirb.com/test

ANS: 1
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe therapeutic and nontherapeutic verbal communication
abirb.com/test techniques.
Page: 126
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
Communication Techniques
abirb.com/test
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication abirb.com/test
Difficulty: Moderate

Feedback
abirb.com/test
1. This is correct. 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 comparisons with the nurse’s perceptions. abirb.com/test
2. This is incorrect. The statement “Please describe what you are seeing” is an example
of offering general leads.
3. This is incorrect. The question “Why do you continually look in the corner of this
abirb.com/test
room?” is an example of the nontherapeutic technique of requesting an explanation,
which can be intimidating.
4. This is incorrect. The statement “If you hum a tune, the voices may not be so
distracting” is an example of the nontherapeutic technique abirb.com/test
of giving advice.

CON: Communication
abirb.com/test

8. A nurse maintains an uncrossed arm and leg posture. This nonverbal behavior is
abirb.com/test
reflective of which letter of the SOLER acronym for active listening?
1. S
2. O
3. L abirb.com/test
4. E

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Townsend
PMHN, 10e
Chapter 7 - ETB
abirb.com/test

ANS: 2
Chapter: Chapter 7 Therapeutic Communication
abirb.com/test
Objective: Identify components of nonverbal expression.
Page: 131
Heading: Active Listening
Integrated Processes: Nursing Process: Implementation abirb.com/test
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication
abirb.com/test
Difficulty: Easy

Feedback
1. This is incorrect. The S in the acronym SOLER stands for abirb.com/test
sitting squarely facing the
client.
2. This is correct. The nurse’s uncrossed arm and leg posture is nonverbal behavior that
reflects the O in the active-listening acronym SOLER. The acronym SOLER
abirb.com/test
includes sitting squarely facing the client (S), open posture when interacting with the
client (O), leaning forward toward the client (L), establishing eye contact (E), and
relaxing (R).
3. This is incorrect. The L in the acronym SOLER stands for abirb.com/test
leaning forward toward
the client.
4. This is incorrect. The E in the acronym SOLER stands for establishing eye contact
(E). abirb.com/test

CON: Communication

abirb.com/test

9. Which action by the nurse, who is first meeting a client, would likely send a
nonverbal message that is inappropriate for the therapeutic relationship?
abirb.com/test
1. The nurse provides eye contact intermittently during the meeting.
2. The nurse is dressed in business casual attire; a tattoo is visible.
3. The nurse offers a handshake during initial interaction with the client.
4. The nurse gives a client a strong hug at the end of the meeting.abirb.com/test

ANS: 4
Chapter: Chapter 7 Therapeutic Communication abirb.com/test
Objective: Identify components of nonverbal communication.
Page: 125
Heading: Nonverbal Communication
abirb.com/test
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication abirb.com/test
Difficulty: Moderate

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Townsend
PMHN, 10e
Chapter 7 - ETB
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Feedback
1. This is incorrect. The nurse who provides intermittent eye contact is demonstrating
abirb.com/test
interest in the client.
2. This is incorrect. The nurse is presenting oneself in a professional manner. Many
dress codes allow visible tattoos. While these may be perceived differently by
individuals, tattoos are generally acceptable. abirb.com/test
3. This is incorrect. Offering a handshake during the first meeting demonstrates a
socially polite behavior that is accepting of the client.
4. This is correct. A strong hug is typically a gesture that demonstrates
abirb.com/test
an attraction or
attachment to another person and is inappropriate for establishing a therapeutic
relationship.

CON: Communication abirb.com/test

abirb.com/test
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?
1. Giving approval abirb.com/test

2. Interpreting
3. Presenting reality
4. Making observations abirb.com/test

ANS: 1
Chapter: Chapter 7 Therapeutic Communication
abirb.com/test techniques.
Objective: Describe therapeutic and nontherapeutic verbal communication
Page: 128
Heading: Nontherapeutic Communication Techniques > Table 7–3 Nontherapeutic
Communication Techniques abirb.com/test
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication abirb.com/test

Difficulty: Moderate

Feedback abirb.com/test
1. This is correct. 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
abirb.com/test
creates a conditional acceptance of the client.
2. This is incorrect. 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
abirb.com/test
creates a conditional acceptance of the client. Interpreting is a nontherapeutic

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Townsend
PMHN, 10e
Chapter 7 - ETB
abirb.com/test
technique in which the therapist seeks to make conscious that which is unconscious,
telling the client the meaning of his or her experience.
3. This is incorrect. The group leader has employed the nontherapeutic technique of
giving approval. Giving approval implies that the nurse hasabirb.com/test
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. Presenting reality is the therapeutic
technique used to define reality when a client has a misperception of the
abirb.com/test
environment.
4. This is incorrect. The group leader has employed the nontherapeutic technique of
giving approval. Giving approval implies that the nurse has the right to pass
abirb.com/test
judgment on whether the client’s ideas or behaviors are “good” or “bad.” This
creates a conditional acceptance of the client. Making observations involves
verbalizing what is observed or perceived and encourages the client to recognize
specific behaviors and compare perceptions with the nurse.abirb.com/test

CON: Communication
abirb.com/test

11. What is the purpose of a nurse providing appropriate feedback?

1. To provide the client with good advice abirb.com/test
2. To advise the client on appropriate behaviors
3. To evaluate the client’s behavior
4. To give the client critical information abirb.com/test

ANS: 4
Chapter: Chapter 7 Therapeutic Communication
Objective: Discuss therapeutic feedback. abirb.com/test
Page: 131
Heading: Feedback
Integrated Processes: Nursing Process: Implementation abirb.com/test
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Communication
Difficulty: Easy abirb.com/test

Feedback
1. This is incorrect. The purpose of providing appropriate feedback is to give the client
abirb.com/test
critical information. Feedback should not be used to give advice.
2. This is incorrect. The purpose of providing appropriate feedback is to give the client
critical information. Feedback should not be used to evaluate behaviors.
abirb.com/test
3. This is incorrect. The purpose of providing appropriate feedback is to give the client
critical information. Feedback should not be used to evaluate behaviors.
4. This is correct. The purpose of providing appropriate feedback is to give the client
critical information. Feedback should not be used to give advice or evaluate
abirb.com/test
behaviors.

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Townsend
PMHN, 10e
Chapter 7 - ETB
abirb.com/test

CON: Communication
abirb.com/test

12. The nurse is providing therapeutic feedback to a client who exhibited an angry
outburst in a group setting. Which is appropriate for the nurse to abirb.com/test
say to the client?
1. “Why do you continue to alienate your peers by your angry outbursts?”
2. “You accomplish nothing when you lose your temper like that.”
3. “Showing your anger in that manner is very childish and insensitive.”
abirb.com/test
4. “During group, you raised your voice, yelled at a peer, and slammed the door.”

ANS: 4
Chapter: Chapter 7 Therapeutic Communication abirb.com/test
Objective: Discuss therapeutic feedback.
Page: 131
Heading: Feedback
abirb.com/test
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication abirb.com/test
Difficulty: Moderate

Feedback
abirb.com/test
1. This is incorrect. This feedback does not help the client consider how to modify
behavior. This approach will likely put the client in a defensive position and is not a
therapeutic response.
2. This is incorrect. This feedback is nontherapeutic and demonstrates
abirb.com/testjudgment. The
nurse is not allowing the client the opportunity to consider how to modify his or her
behavior.
3. This is incorrect. This is a judgmental response that does not provide the client the
abirb.com/test
opportunity to modify his or her behavior. This response is likely to alienate the
client or put the client in a defensive position, which is not therapeutic.
4. This is correct. The nurse is providing appropriate feedback when stating, “During
group, you raised your voice, yelled at a peer, and slammed abirb.com/test
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 or used to give advice.
abirb.com/test

CON: Communication
abirb.com/test

13. A client diagnosed with dependent personality disorder states, “Do you think I
should move out of my parents’ house and get a job?” Which nursing response is most
abirb.com/test
appropriate?

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Townsend
PMHN, 10e
Chapter 7 - ETB
abirb.com/test
1. “It would be best to do that to increase independence.”
2. “Why would you want to leave a secure home?”
3. “Let’s discuss and explore all of your options.”
abirb.com/test
4. “I’m afraid you would feel very guilty leaving your parents.”

ANS: 3
Chapter: Chapter 7 Therapeutic Communication abirb.com/test
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 126
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
abirb.com/test
Communication Techniques
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying] abirb.com/test
Concept: Communication
Difficulty: Moderate
abirb.com/test
Feedback
1. This is incorrect. The statement “It would be best to do that to increase
independence,” is an example of the nontherapeutic technique of advice giving.
2. This is incorrect. The question “Why would you want to leave a secure home?” is an
abirb.com/test
example of the nontherapeutic technique of requesting an explanation, which can be
intimidating.
3. This is correct. The most appropriate response by the nurseabirb.com/test
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.
4. This is incorrect. The statement “I’m afraid you would feel very guilty leaving your
abirb.com/test
parents” is an example of the nontherapeutic technique of giving advice and implies
that the nurse knows what is best and that the client is incapable of any self-
direction.
abirb.com/test
CON: Communication

abirb.com/test

14. Why is it important for the nurse to demonstrate active listening during a client
interaction?
1. The client will be able to understand the nurse’s instructions better.
abirb.com/test
2. The client will feel a sense of trust and acceptance by the nurse.
3. The client will change his or her behavior if active listening is used.
4. The client will be able to provide feedback to the nurse for improvement.
abirb.com/test

ANS: 2
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe active listening. abirb.com/test
Page: 131

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Townsend
PMHN, 10e
Chapter 7 - ETB
abirb.com/test
Heading: Active Listening
Integrated Processes: Nursing Process: Planning
Client Need: Psychosocial Integrity
abirb.com/test
Cognitive Level: Comprehension [Understanding]
Concept: Patient-Centered Care
Difficulty: Moderate
abirb.com/test
Feedback
1. This is incorrect. Active listening does not necessarily improve the client’s ability to
understand or follow the nurse’s instructions.
abirb.com/test
2. This is correct. Active listening conveys acceptance of the client and helps to
develop trust between the nurse and client.
3. This is incorrect. Active listening is a part of motivational interviewing but it is not
the entire process that would assist in changing the client’sabirb.com/test
behavior.
4. This is incorrect. Active listening does not allow for the client to give the nurse
feedback for improvement. A process recording is used for this purpose.
abirb.com/test
CON: Patient-Centered Care

abirb.com/test

15. A mother rescues two of her four children from a house fire. In an emergency
department, she cries, “I should have gone back in to get them. I should have died, not
them.” Which of the following responses by the nurse is an example of reflection?
abirb.com/test
1. “The smoke was too thick. You couldn’t have gone back in.”
2. “You’re feeling guilty because you weren’t able to save your children.”
3. “Focus on the fact that you could have lost all four of your children.”
abirb.com/test
4. “It’s best if you try not to think about what happened. Try to move on.”

ANS: 2
Chapter: Chapter 7 Therapeutic Communication abirb.com/test
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 126
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
Communication Techniques abirb.com/test

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying] abirb.com/test
Concept: Communication
Difficulty: Moderate
abirb.com/test
Feedback
1. This is incorrect. The response “The smoke was too thick. You couldn’t have gone
back in” utilizes the nontherapeutic communication technique of disagreeing, which
implies inaccuracy and provokes the need for the client to abirb.com/test
be defensive.

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Townsend
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Chapter 7 - ETB
abirb.com/test
2. This is correct. The best response by the nurse is, “You’re feeling guilty because you
weren’t able to save your children.” This response utilizes the therapeutic
communication technique of reflection, which identifies a client’s emotional
abirb.com/test
response and reflects these feelings back to the client so that they may be recognized
and accepted.
3. This is incorrect. The response “Focus on the fact that you could have lost all four of
your children” utilizes the nontherapeutic communication technique
abirb.com/testof giving
advice, which implies that the nurse knows what is best and discourages independent
thinking.
4. This is incorrect. The response “It’s best if you try not to think about what happened.
abirb.com/test
Try to move on” utilizes the nontherapeutic communication technique of giving
advice, which implies that the nurse knows what is best and discourages independent
thinking.
abirb.com/test
CON: Communication

abirb.com/test

16. A newly admitted client diagnosed with obsessive-compulsive disorder (OCD)

washes her hands continually. This behavior prevents her from attending unit activities.
Which nursing statement made to the client best addresses this situation?
abirb.com/test
1. “Everyone diagnosed with OCD needs to control their ritualistic behaviors.”
2. “It is important for you to discontinue these ritualistic behaviors.”
3. “Why are you asking for help if you won’t participate in unit therapy?”
abirb.com/test
4. “Let’s figure out a way for you to attend unit activities and still wash your hands.”

ANS: 4
Chapter: Chapter 7 Therapeutic Communication abirb.com/test
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 126
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
abirb.com/test
Communication Techniques
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying] abirb.com/test

Concept: Communication
Difficulty: Moderate
abirb.com/test
Feedback
1. This is incorrect. The statement “Everyone diagnosed with OCD needs to control
their ritualistic behaviors” reflects the nontherapeutic communication technique of
abirb.com/test
giving advice.
2. This is incorrect. The statement “It is important for you to discontinue these
ritualistic behaviors” is an example of the nontherapeutic technique of giving advice.
3. This is incorrect. The question “Why are you asking for help if you won’t participate
abirb.com/test
in unit therapy?” is an example of the nontherapeutic technique of requesting an

abirb.com/test
Townsend
PMHN, 10e
Chapter 7 - ETB
abirb.com/test
explanation, which can be intimidating.
4. This is correct. 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
abirb.com/test
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.
abirb.com/test
CON: Communication

abirb.com/test

17. Which example of a therapeutic communication technique would be most effective

in the planning phase of the nursing process?
1. “We’ve discussed past coping skills. Let’s see if these coping abirb.com/test
skills can be effective
now.”
2. “Please tell me in your own words what brought you to the hospital.”
3. “This new approach worked for you. Keep it up.”
abirb.com/test
4. “I noticed that you seem to be responding to voices that I do not hear.”

ANS: 1
Chapter: Chapter 7 Therapeutic Communication abirb.com/test
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 126
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
abirb.com/test
Communication Techniques
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying] abirb.com/test
Concept: Communication
Difficulty: Moderate
abirb.com/test
Feedback
1. This is correct. The nurse’s statement “We’ve discussed past coping skills. Let’s see
if these coping skills can be effective now” is an example of the therapeutic
communication technique of formulating a plan of action. This abirb.com/test
technique 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.
2. This is incorrect. The nurse’s statement “Please tell me in your own words what
abirb.com/test
brought you to the hospital” is an example of the therapeutic communication
technique of exploring. This technique is not most effective during the planning
phase.
abirb.com/test
3. This is incorrect. The nurse’s statement “This new approach worked for you. Keep it
up” is an example of the nontherapeutic communication technique of giving advice.
4. This is incorrect. The nurse’s statement “I noticed that you seem to be responding to
voices that I do not hear” is an example of the therapeutic communication
abirb.com/test technique
of presenting reality. This technique can help the client who has a misperception of

abirb.com/test
Townsend
PMHN, 10e
Chapter 7 - ETB
abirb.com/test
the environment but is not especially effective during the planning phase.

CON: Communication
abirb.com/test

18. A client tells the nurse, “I feel like my mother does not want abirb.com/test
me to return home after
I leave the hospital.” Which nursing response is therapeutic?
1. “It’s quite common for clients to feel that way after a lengthy hospitalization.”
2. “Why don’t you talk to your mother? You may find out she doesn’t feel that way.”
abirb.com/test
3. “Your mother seems like an understanding person. I’ll help you approach her.”
4. “You feel that your mother does not want you to come back home?”

ANS: 4 abirb.com/test
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 126
abirb.com/test
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
Communication Techniques
Integrated Processes: Caring
Client Need: Psychosocial Integrity abirb.com/test
Cognitive Level: Application [Applying]
Concept: Communication
Difficulty: Moderate
abirb.com/test

Feedback
1. This is incorrect. The nurse’s statement “It’s quite common for clients to feel that
way after a lengthy hospitalization” is an example of the nontherapeutic
abirb.com/test
communication technique of belittling or minimizing feelings.
2. This is incorrect. The nurse’s question “Why don’t you talk to your mother? You
may find out she doesn’t feel that way” is an example of the nontherapeutic
abirb.com/test
communication technique of giving advice.
3. This is incorrect. The nurse’s statement “Your mother seems like an understanding
person. I’ll help you approach her” is an example of the nontherapeutic
communication technique of giving false reassurance. abirb.com/test

4. This is correct. The nurse’s question “You feel that your mother does not want you
to come back home?” is an example of the therapeutic communication technique of
restating. Restating is the repeating of the main idea the client has verbalized and lets
abirb.com/test
the client know whether the statement has been understood and gives him or her the
chance to continue or clarify if necessary.
abirb.com/test
CON: Communication

abirb.com/test

abirb.com/test
Townsend
PMHN, 10e
Chapter 7 - ETB
abirb.com/test
19. Which feature distinguishes motivational interviewing from other therapeutic
techniques?
1. Motivational interviewing establishes a contract for change.
abirb.com/test
2. Motivational interviewing is the only patient-centered communication strategy.
3. Motivational interviewing allows the nurse to inform the client’s choices.
4. Motivational interviewing focuses on what the client wants.
abirb.com/test
ANS: 4
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe motivational interviewing as a communication strategy.
abirb.com/test
Page: 131
Heading: Motivational Interviewing
Integrated Processes: Nursing Process: Intervention
Client Need: Psychosocial Integrity abirb.com/test
Cognitive Level: Comprehension [Understanding]
Concept: Communication
Difficulty: Easy
abirb.com/test

Feedback
1. This is incorrect. Motivational interviewing does not use a contract for change in and
of itself, it focuses on the client’s motivation to change. abirb.com/test
2. This is incorrect. Motivational interviewing is one of several patient-centered
approaches.
3. This is incorrect. Motivational interviewing does not rely on the nurse informing the
abirb.com/test
client of his/her choices; it focuses on the client’s choices.
4. This is correct. Motivational interviewing promotes behavior change by focusing on
what the client wants.
abirb.com/test

CON: Communication

abirb.com/test

20. Which nursing statement is a good example of the therapeutic communication

technique of giving recognition?
1. “You did not attend group today. Can we talk about that?” abirb.com/test
2. “I’ll sit with you until it is time for your family session.”
3. “I noticed you are wearing a new dress and have washed your hair.”
4. “I’m happy that you are now taking your medications. They will really help.”
abirb.com/test

ANS: 3
Chapter: Chapter 7 Therapeutic Communication
abirb.com/test
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 126
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
Communication Techniques abirb.com/test
Integrated Processes: Nursing Process: Implementation

abirb.com/test
Townsend
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Chapter 7 - ETB
abirb.com/test
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication
abirb.com/test
Difficulty: Easy

Feedback
1. This is incorrect. The nurse’s question “You did not attendabirb.com/test
group today. Can we talk
about that?” is an example of the therapeutic communication techniques of making
observations and exploring.
2. This is incorrect. The nurse’s statement “I’ll sit with you until it is time for your
abirb.com/test
family session” is an example of the therapeutic communication technique of
offering self.
3. This is correct. This statement is an example of the therapeutic communication
technique of giving recognition. Giving recognition acknowledges and indicates
abirb.com/test
awareness. This technique is more appropriate than complimenting the client, which
reflects the nurse’s judgment.
4. This is incorrect. The nurse’s statement “I’m happy that you are now taking your
abirb.com/test
medications. They will really help” is an example of the nontherapeutic
communication technique of giving approval.

CON: Communication abirb.com/test

abirb.com/test
21. A client is trying to explore and solve a problem. Which nursing statement is an
example of verbalizing the implied?
1. “You seem to be motivated to change your behavior.”
2. “How will these changes affect your family relationships?” abirb.com/test
3. “Why don’t you make a list of the behaviors you need to change?”
4. “The team recommends that you make only one behavioral change at a time.”
abirb.com/test
ANS: 1
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 127 abirb.com/test

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques
Integrated Processes: Nursing Process: Implementation abirb.com/test
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication
abirb.com/test
Difficulty: Moderate

Feedback
abirb.com/test

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Townsend
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Chapter 7 - ETB
abirb.com/test
1. This is correct. 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.
abirb.com/test
2. This is incorrect. The nurse’s question “How will these changes affect your family
relationships?” is an example of the therapeutic communication technique of
reflecting.
3. This is incorrect. The nurse’s question “Why don’t you make a list of the behaviors
abirb.com/test
you need to change?” is not an example of verbalizing the implied. Verbalizing the
implied puts into words what the client has only implied or said indirectly.
4. This is incorrect. The nurse’s statement “The team recommends that you make only
abirb.com/test
one behavioral change at a time” is an example of the nontherapeutic communication
technique of giving advice.

CON: Communication abirb.com/test

abirb.com/test
22. The nurse says to a newly admitted client, “Tell me more about what led up to your
hospitalization.” What is the purpose of this therapeutic communication technique?
1. To reframe the client’s thoughts about mental health treatment
2. To put the client at ease abirb.com/test
3. To explore a subject, idea, experience, or relationship
4. To communicate that the nurse is listening to the conversation
abirb.com/test
ANS: 3
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 127 abirb.com/test

Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic

Communication Techniques
Integrated Processes: Nursing Process: Implementation abirb.com/test
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication
Difficulty: Moderate abirb.com/test

Feedback
1. This is incorrect. The nurse’s statement is an example of the therapeutic
abirb.com/test
communication technique of exploring. The purpose of exploring is not to reframe
the client’s thoughts about mental health treatment.
2. This is incorrect. The nurse’s statement is an example of the therapeutic
abirb.com/test
communication technique of exploring. The purpose of exploring is to facilitate the
client’s understanding of events. It is not meant to put the client at ease.

abirb.com/test

abirb.com/test
Townsend
PMHN, 10e
Chapter 7 - ETB
abirb.com/test
3. This is correct. This is an example of the therapeutic communication technique of
exploring. The purpose of exploring is to delve further into the subject, idea,
experience, or relationship. This technique is especially helpful with clients who
tend to remain on a superficial level of communication. abirb.com/test
4. This is incorrect. The nurse’s statement is an example of the therapeutic
communication technique of exploring. The purpose of exploring is not to
communicate that the nurse is listening to the conversation.abirb.com/test

CON: Communication
abirb.com/test

23. 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 would be the nursing instructor’s best
abirb.com/test
response?
1. “It’s scary to feel put on the spot by a client. Nurses don’t always have the answers.”
2. “Remember, clients, not nurses, are responsible for their own choices and decisions.”
abirb.com/test
3. “Just keep the client’s best interests in mind and do the best that you can.”
4. “Set a goal to continue to work on this aspect of your practice.”

ANS: 2 abirb.com/test
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 127 abirb.com/test
Heading: Nontherapeutic Communication Techniques > Table 7–3 Nontherapeutic
Communication Techniques
Integrated Processes: Teaching and Learning
Client Need: Psychosocial Integrity abirb.com/test
Cognitive Level: Application [Applying]
Concept: Communication
Difficulty: Moderate abirb.com/test

Feedback
1. This is incorrect. The instructor’s statement “It’s scary to feel put on the spot by a
abirb.com/test explain why
client. Nurses don’t always have the answers” does not appropriately
nurses should not use the nontherapeutic communication technique of advice giving.
2. This is correct. The instructor’s statement “Remember, clients, not nurses, are
responsible for their own choices and decisions” provides the best rationale for
abirb.com/test
advising students not to use advice giving. Advice giving is a nontherapeutic
communication technique in which the nurse tells the client what to do or how to
behave, and it implies the nurse knows what is best and that the client is incapable of
abirb.com/test
any self-direction.
3. This is incorrect. The instructor’s statement “Just keep the client’s best interests in
mind and do the best that you can” does not explain that nurses should not use the
nontherapeutic communication technique of advice giving.abirb.com/test
4. This is incorrect. The instructor’s statement “Set a goal to continue to work on this

abirb.com/test
Townsend
PMHN, 10e
Chapter 7 - ETB
abirb.com/test
aspect of your practice” does not explain that nurses should not use the
nontherapeutic communication technique of advice giving.
abirb.com/test
CON: Communication

abirb.com/test
24. A student nurse is learning about the appropriate use of touch when communicating
with clients diagnosed with psychiatric disorders. Which statement made by the
instructor best provides information about this aspect of therapeutic communication?
abirb.com/test
1. “Touch carries a different meaning for different individuals.”
2. “Touch is often used when deescalating volatile client situations.”
3. “Touch is used to convey interest and warmth.”
4. “Touch is best combined with empathy when dealing with anxious clients.”
abirb.com/test

ANS: 1
Chapter: Chapter 7 Therapeutic Communication
abirb.com/test
Objective: Identify components of nonverbal expression.
Page: 124
Heading: Nonverbal Communication > Touch
Integrated Processes: Nursing Process: Implementation abirb.com/test
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication
abirb.com/test
Difficulty: Moderate

Feedback
1. This is correct. Touch can elicit both negative and positiveabirb.com/test
reactions, depending on
the people involved and the circumstances of the interaction.
2. This is incorrect. The instructor’s statement “Touch is often used when deescalating
volatile client situations” is not accurate. Touch can elicit both negative and positive
abirb.com/test
reactions.
3. This is incorrect. The instructor’s statement “Touch is used to convey interest and
warmth” is technically true, but it is not the purpose of touch when communicating
with clients. abirb.com/test

4. This is incorrect. The instructor’s statement “Touch is best combined with empathy
when dealing with anxious clients” is not necessarily true. Touch can elicit both
negative and positive reactions, depending on the people involved and the
abirb.com/test
circumstances of the interaction.

CON: Communication
abirb.com/test

25. Which nursing statement is a good example of the therapeuticabirb.com/test

communication
technique of focusing?

abirb.com/test
Townsend
PMHN, 10e
Chapter 7 - ETB
abirb.com/test
1. “Describe one of the best things that happened to you this week.”
2. “I’m having a difficult time understanding what you mean.”
3. “Your counseling session is in 30 minutes. I’ll stay with you until then.”
abirb.com/test
4. “You mentioned your relationship with your father. Let’s discuss that further.”

ANS: 4
Chapter: Chapter 7 Therapeutic Communication abirb.com/test
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 126
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
abirb.com/test
Communication Techniques
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying] abirb.com/test
Concept: Communication
Difficulty: Easy
abirb.com/test
Feedback
1. This is incorrect. The statement “Describe one of the best things that happened to
you this week” is not an example of the therapeutic communication technique of
focusing. abirb.com/test
2. This is incorrect. The statement “I’m having a difficult time understanding what you
mean” is an example of the therapeutic communication technique of seeking
clarification and validation. abirb.com/test
3. This is incorrect. The statement “Your counseling session is in 30 minutes. I’ll stay
with you until then” is an example of the therapeutic communication technique of
offering self.
4. abirb.com/test
This is correct. The statement “You mentioned your relationship with your father.
Let’s discuss that further” 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.
abirb.com/test

CON: Communication
abirb.com/test

26. A client begins fasting at 10 p.m. for a blood test the next morning. The morning of
the test, the client finds out that it has been canceled. The client uses profanity with the
abirb.com/test
nurse and states, “You are incompetent!” Which is the nurse’s best response?
1. “Do you believe that I caused your blood test to be canceled?”
2. “I see that you are upset, but I feel uncomfortable when you swear at me.”
abirb.com/test
3. “Have you ever thought about ways to express anger appropriately?”
4. “I’ll give you some space. Let me know if you need anything.”

ANS: 2 abirb.com/test
Chapter: Chapter 7 Therapeutic Communication

abirb.com/test
Townsend
PMHN, 10e
Chapter 7 - ETB
abirb.com/test
Objective: Discuss therapeutic feedback.
Page: 124
Heading: Feedback
abirb.com/test
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication abirb.com/test
Difficulty: Moderate

Feedback
abirb.com/test
1. This is incorrect. Feedback needs to be directed at a behavior the client can modify.
2. This is correct. The feedback is specific and focuses on a behavior the client can
modify.
3. This is incorrect. The feedback needs to focus on a specificabirb.com/test
behavior. The feedback
also needs to be descriptive rather than evaluative. This statement does not
specifically address the swearing, which the client can modify.
4. This is incorrect. This statement is not specific and does not address a behavior the
abirb.com/test
client can modify.

CON: Communication
abirb.com/test

27. During a nurse-client interaction, which nursing statement may belittle the client’s
abirb.com/test
feelings and concerns?
1. “Don’t worry. Everything will be alright.”
2. “You appear uptight.”
3. “I notice you have bitten your nails to the quick.” abirb.com/test

4. “You are jumping to conclusions.”

ANS: 1 abirb.com/test
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 127
Heading: Nontherapeutic Communication Techniques > Table 7–3 abirb.com/test
Nontherapeutic
Communication Techniques
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity abirb.com/test
Cognitive Level: Application [Applying]
Concept: Communication
Difficulty: Easy
abirb.com/test

Feedback

abirb.com/test

abirb.com/test
Townsend
PMHN, 10e
Chapter 7 - ETB
abirb.com/test
1. This is correct. The nursing statement “Don’t worry. Everything will be alright” is
an example of the nontherapeutic communication block of belittling feelings.
Belittling feelings occurs when the nurse misjudges the degree of the client’s
abirb.com/test
discomfort, suggesting a lack of empathy and understanding.
2. This is incorrect. The nursing statement “You appear uptight” is not an example of
the nontherapeutic communication block of belittling feelings. Belittling feelings
occurs when the nurse misjudges the degree of the client’sabirb.com/test
discomfort, suggesting a
lack of empathy and understanding.
3. This is incorrect. The nursing statement “I notice you have bitten your nails to the
quick” is an example of the therapeutic communication technique of making
abirb.com/test
observations.
4. This is incorrect. The nursing statement “You are jumping to conclusions” is not an
example of the nontherapeutic communication block of belittling feelings. Belittling
feelings occurs when the nurse misjudges the degree of theabirb.com/test
client’s discomfort,
suggesting a lack of empathy and understanding.

CON: Communication abirb.com/test

28. A client on an inpatient psychiatric unit tells the nurse, “I should have died, because
abirb.com/test
I am totally worthless.” To encourage the client to continue talking about feelings,
which should be the nurse’s initial response?
1. “How would your family feel if you died?” abirb.com/test
2. “You feel worthless now, but that can change with time.”
3. “You’ve been feeling sad and alone for some time now?”
4. “It is great that you have come in for help.”
abirb.com/test

ANS: 3
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe therapeutic and nontherapeutic verbal communication
abirb.com/test
techniques.
Page: 126
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
Communication Techniques
Integrated Processes: Nursing Process: Implementation abirb.com/test

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]
Concept: Communication abirb.com/test
Difficulty: Moderate

Feedback
abirb.com/test
1. This is incorrect. The question “How would your family feel if you died?” is an
example of the nontherapeutic communication technique of probing.
2. This is incorrect. The statement “You feel worthless now, but that can change with
time” is an example of the nontherapeutic communication abirb.com/test
technique of belittling or
minimizing feelings.

abirb.com/test
Townsend
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Chapter 7 - ETB
abirb.com/test
3. This is correct. The question “You’ve been feeling sad and alone for some time
now?” 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
abirb.com/test
they may be recognized and accepted.
4. This is incorrect. The statement “It is great that you have come in for help” is an
example of the nontherapeutic communication technique of giving approval.
abirb.com/test
CON: Communication

abirb.com/test

29. Which nursing response is an example of the nontherapeutic communication

technique of requesting an explanation?
1. “Can you tell me why you said that?” abirb.com/test
2. “Keep your chin up. I’ll explain the procedure to you.”
3. “There is always an explanation for both good and bad behaviors.”
4. “Are you not understanding the explanation I provided?”
abirb.com/test

ANS: 1
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe therapeutic and nontherapeutic verbal communication
abirb.com/test techniques.
Page: 127
Heading: Nontherapeutic Communication Techniques > Table 7–3 Nontherapeutic
Communication Techniques abirb.com/test
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication abirb.com/test
Difficulty: Easy

Feedback abirb.com/test
1. This is correct. The question “Can you tell me why you said that?” is an example of
the nontherapeutic communication technique 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 abirb.com/test
client did something or
feels a certain way can be intimidating and implies that the client must defend his or
her behavior or feelings.
2. This is incorrect. The statement “Keep your chin up” is an abirb.com/test
example of the
nontherapeutic communication technique of making stereotyped comments. When
the nurse uses meaningless expressions, it encourages a similar response from the
client.
abirb.com/test
3. This is incorrect. The statement “There is always an explanation for both good and
bad behaviors” is an example of the nontherapeutic communication technique of
approving or disapproving, as it implies that the nurse has the right to pass judgment
on the client’s behaviors as “good” or “bad”. abirb.com/test
4. This is incorrect. The question “Are you not understanding the explanation I

abirb.com/test
Townsend
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Chapter 7 - ETB
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provided?” is not an example of the nontherapeutic communication block of
requesting an explanation.
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CON: Communication

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30. 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?
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1. “Does your husband treat you like this very often?”
2. “What do you think is your role in this relationship?”
3. “Why do you think he behaved like that?”
4. “Describe what happened during your time with your husband.”abirb.com/test

ANS: 4
Chapter: Chapter 7 Therapeutic Communication
abirb.com/test
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 126
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
Communication Techniques abirb.com/test
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
abirb.com/test
Concept: Communication
Difficulty: Moderate

Feedback abirb.com/test
1. This is incorrect. The nurse’s question “Does your husband treat you like this very
often?” is more similar to the nontherapeutic communication technique of probing.
The client may not want to answer this question. abirb.com/test
2. This is incorrect. The nurse’s question “What do you think is your role in this
relationship?” is more similar to the nontherapeutic communication technique of
probing. The client may not want to answer this question.
3. This is incorrect. The nurse’s question “Why do you think abirb.com/test
he behaved like that?” is
an example of the nontherapeutic communication technique of requesting an
explanation.
4. This is correct. The nurse’s response “Describe what happened during your time
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with your husband” is an example of the therapeutic communication technique of
exploring and is especially helpful with clients who tend to remain on a superficial
level of communication. The purpose of using exploring is to delve further into the
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subject, idea, experience, or relationship.

CON: Communication
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Townsend
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Chapter 7 - ETB
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31. Which statement reflects the therapeutic communication technique the nurse should
use when communicating with a client who is experiencing auditory hallucinations?
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1. “My sister has the same diagnosis as you, and she also hears voices.”
2. “I understand that the voices seem real to you, but I do not hear any voices.”
3. “Why not turn up the radio so that the voices are muted.”
4. “I wouldn’t worry about these voices. The medication will make them disappear.”
abirb.com/test

ANS: 2
Chapter: Chapter 7 Therapeutic Communication
abirb.com/test
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 126
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
Communication Techniques abirb.com/test
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
abirb.com/test
Concept: Communication
Difficulty: Moderate

Feedback abirb.com/test
1. This is incorrect. The nurse’s statement “My sister has the same diagnosis as you
and she also hears voices” does not present reality, which should be used when the
client has a misperception of the environment.
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2. This is correct. The nurse’s statement “I understand that the voices seem real to you,
but I do not hear any voices” is an example of presenting reality, which should be
used when the client has a misperception of the environment. Presenting reality is
when the nurse defines or indicates the nurse’s perception abirb.com/test
of the situation for the
client.
3. This is incorrect. The nurse’s statement “Why not turn up the radio so that the voices
are muted” is an example of giving advice, which is a nontherapeutic
abirb.com/test
communication technique and does not present reality.
4. This is incorrect. The nurse’s statement “I wouldn’t worry about these voices. The
medication will make them disappear” does not present reality, which should be
used when the client has a misperception of the environment.abirb.com/test

CON: Communication
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32. Which nursing response is the best example of the therapeutic communication
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technique of offering self?
1. “I think it would be great if you talked about that problem during our next group
session.”
2. “Would you like me to accompany you to your electroconvulsive therapy treatment?”
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3. “I notice that you are offering help to other peers in the milieu.”

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Townsend
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Chapter 7 - ETB
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4. “After discharge, would you like to meet me for lunch to review your outpatient
progress?”
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ANS: 2
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 126 abirb.com/test
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
Communication Techniques
Integrated Processes: Nursing Process: Implementation
abirb.com/test
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication
Difficulty: Moderate abirb.com/test

Feedback
1. This is incorrect. The statement “I think it would be great if you talked about that
abirb.com/test
problem during our next group session” is an example of the nontherapeutic
communication technique of giving advice.
2. This is correct. The question “Would you like me to accompany you to your
electroconvulsive therapy treatment?” is the best example of the therapeutic
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communication technique of offering self. Offering self makes the nurse available on
an unconditional basis, increasing the client’s feelings of self-worth. When using the
technique of offering self, the nurse must maintain professional boundaries.
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3. This is incorrect. The statement “I notice that you are offering help to other peers in
the milieu” is an example of the therapeutic communication technique of making
observations.
4. This is incorrect. The question “After discharge, would youabirb.com/test
like to meet me for
lunch to review your outpatient progress?” is not an example of the therapeutic
communication technique of offering self. Offering self makes the nurse available on
an unconditional basis. In this example, the nurse is askingabirb.com/test
to review the client’s
progress.

CON: Communication
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33. Which of the following best represents a patient-centered approach that promotes a
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change in behavior?
1. Process recordings
2. Providing guidance
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3. Motivational interviewing
4. Therapeutic communication

ANS: 3 abirb.com/test
Chapter: Chapter 7 Therapeutic Communication

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Townsend
PMHN, 10e
Chapter 7 - ETB
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Objective: Describe motivational interviewing as a communication strategy.
Page: 131
Heading: Motivational Interviewing
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Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Communication abirb.com/test
Difficulty: Easy

Feedback
abirb.com/test
1. This is incorrect. Process recordings are used as a tool by the nurse to improve
interpersonal communication techniques.
2. This is incorrect. Providing guidance, while an important part of the therapeutic
relationship, does not necessarily promote a change in behavior.
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3. This is correct. Motivational interviewing is an evidence-based, patient-centered
style of communication that promotes behavior change by guiding clients to explore
their motivation to change and the advantages and disadvantages to their decisions.
abirb.com/test
4. This is incorrect. Therapeutic communication is the foundation of a therapeutic
client-nurse relationship; however, it does not necessarily promote a change in
behavior. Therapeutic communication is a set of “procedures” used to enhance a
therapeutic relationship. abirb.com/test

CON: Communication
abirb.com/test

34. Which statement reflects the model of transactional communication?

1. Individuals use nonverbal body language to communicate. abirb.com/test
2. Individuals simultaneously perceive each other.
3. Individuals use touch as a means of social communication.
4. Individuals use facial expressions to convey feelings. abirb.com/test

ANS: 2
Chapter: Chapter 7 Therapeutic Communication
Objective: Discuss the transactional model of communication. abirb.com/test

Page: 122
Heading: What Is Communication?
Integrated Processes: Nursing Process: Assessment abirb.com/test
Client Needs: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Communication
abirb.com/test
Difficulty: Moderate

Feedback
1. This is incorrect. In the transactional model of communication, both participants
abirb.com/test
simultaneously perceive each other, listen to each other, and are mutually involved

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Townsend
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Chapter 7 - ETB
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in creating meaning in a relationship. Nonverbal communication is only one way in
which individuals can communicate.
2. This is correct. Interpersonal communication is a transaction between the sender and
the receiver. In the transactional model of communication,abirb.com/test
both participants
simultaneously perceive each other, listen to each other, and are mutually involved
in creating meaning in a relationship.
3. This is incorrect. In the transactional model of communication, both participants
abirb.com/test
simultaneously perceive each other, listen to each other, and are mutually involved
in creating meaning in a relationship. Touch is one example of nonverbal
communication.
abirb.com/test
4. This is incorrect. In the transactional model of communication, both participants
simultaneously perceive each other, listen to each other, and are mutually involved
in creating meaning in a relationship. The use of facial expressions to convey
feelings is one example of communication. abirb.com/test

CON: Communication
abirb.com/test

35. The nurse observes a client sitting alone and crying after a group therapy session.
The nurse sits in the chair nearest to the client and states, “I see you are crying. I’d like
abirb.com/test
to sit with you for a few minutes.” Which communication technique is the nurse using?
1. Making an observation
2. Offering a general lead abirb.com/test
3. Presenting reality
4. Silence

ANS: 1 abirb.com/test

Chapter: Chapter 7 Therapeutic Communication

Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 126 abirb.com/test
Heading: Therapeutic Communication Techniques > Table 7–2 Therapeutic
Communication Techniques
Integrated Processes: Nursing Process: Implementation
Client Needs: Psychosocial Integrity abirb.com/test

Cognitive Level: Analysis [Analyzing]

Concept: Communication
Difficulty: Moderate abirb.com/test

Feedback
1. This is correct. The nurse is using the therapeutic technique of making an
abirb.com/test
observation by verbalizing and acknowledging that the client is crying. This assists
the client to recognize feelings and behaviors.
2. This is incorrect. Offering a general lead is used during a therapeutic conversation to
encourage the client to continue. This is not an example ofabirb.com/test
offering a general lead.
3. This is incorrect. The nurse presents reality when a client has a misperception of the

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Townsend
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Chapter 7 - ETB
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environment. This is not an example of presenting reality.
4. This is incorrect. The nurse uses silence to give the client the opportunity to collect
and organize thoughts, to think through a point, or to consider introducing a topic of
greater concern than the one being discussed. The nurse is abirb.com/test
not demonstrating silence.

CON: Communication
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36. A client tells the nurse, “I have nothing left to enjoy in life. My children are grown
abirb.com/test
and married.” The nurse replies, “I’m sure you are looking forward to having
grandchildren.” Which communication technique is this considered?
1. Giving advice
2. Reflecting abirb.com/test
3. Using denial
4. Verbalizing the implied
abirb.com/test
ANS: 3
Chapter: Chapter 7 Therapeutic Communication
Objective: Describe therapeutic and nontherapeutic verbal communication techniques.
Page: 127 abirb.com/test
Heading: Nontherapeutic Communication Techniques > Table 7–3 Nontherapeutic
Communication Techniques
Integrated Processes: Nursing Process: Implementation abirb.com/test
Client Needs: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Communication
Difficulty: Moderate abirb.com/test

Feedback
1. This is incorrect. The nurse is using the nontherapeutic communication
abirb.com/test
technique of
denial. Giving advice is the nontherapeutic technique of telling the client what to do
or how to behave and implies that the nurse knows what is best and that the client is
incapable of any self-direction.
2. abirb.com/test
This is incorrect. The nurse is using the nontherapeutic communication technique of
denial. Reflecting is the therapeutic communication technique in which the nurse
refers questions and feelings back to the client so they may be recognized and
accepted. abirb.com/test
3. This is correct. The nurse is using the nontherapeutic communication technique of
denial. Denying that a problem exists blocks discussion with the client and avoids
helping the client identify and explore areas of difficulty.
abirb.com/test
4. This is incorrect. The nurse is using the nontherapeutic communication technique of
denial. Verbalizing the implied is the therapeutic communication technique in which
the nurse puts into words what the client has only implied or said indirectly and
clarifies that which is implicit rather than explicit. abirb.com/test

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Townsend
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Chapter 7 - ETB
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CON: Communication

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MULTIPLE RESPONSE

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37. Which individuals are communicating a message? Select all that apply.
1. A parent spanking her child for playing with matches
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2. A teenager isolating himself and playing loud music
3. A biker sporting an eagle tattoo on a bicep
4. A teenager writing, “No one understands me”
5. A parent checking for new e-mail on a regular basis abirb.com/test

ANS: 1, 2, 3, 4
Chapter: Chapter 7 Therapeutic Communication
abirb.com/test
Objective: Discuss the transactional model of communication.
Page: 122
Heading: What Is Communication?
Integrated Processes: Nursing Process: Assessment abirb.com/test
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication
abirb.com/test
Difficulty: Easy

Feedback
1. This is correct. Spanking is a way of communicating a message. Approximately 70%
abirb.com/test
to 90% of communication is nonverbal.
2. This is correct. Isolating oneself is a way of communicating a message.
Approximately 70% to 90% of communication is nonverbal. abirb.com/test
3. This is correct. Getting a tattoo is a way of communicating a message.
Approximately 70% to 90% of communication is nonverbal.
4. This is correct. Writing is a way of communicating a message to others.
Approximately 70% to 90% of communication is nonverbal. abirb.com/test

5. This is incorrect. Communication is a transaction between a sender and a receiver in

which both participants simultaneously perceive each other, listen to each other, and
are mutually involved in creating meaning in a relationship. Checking e-mail does
abirb.com/test
not involve an interaction between a sender and a receiver.

CON: Communication
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38. Which preexisting conditions influence the outcome of communication?

abirb.com/test Select all
that apply.

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Townsend
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Chapter 7 - ETB
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1. Gender
2. Distance
3. Eye contact
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4. Values
5. Paralanguage

ANS: 1, 2, 4 abirb.com/test
Chapter: Chapter 7 Therapeutic Communication
Objective: Identify types of preexisting conditions that influence the outcome of the
communication process.
abirb.com/test
Page: 123
Heading: The Impact of Preexisting Conditions
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity abirb.com/test
Cognitive Level: Knowledge [Remembering]
Concept: Communication
Difficulty: Easy
abirb.com/test

Feedback
1. This is correct. Gender is a preexisting condition that influences the manner in which
individuals communicate. Most cultures have gender signals that are recognized as
abirb.com/test
either masculine or feminine and provide a basis for distinguishing between
members of each gender.
2. This is correct. Territoriality, density, and distance are aspects of the preexisting
abirb.com/test
condition of the environment in which the transaction takes place.
3. This is incorrect. Eye contact is a type of nonverbal communication.
4. This is correct. Values, attitudes, and beliefs are preexisting conditions that impact
communication. One’s value system may be communicated abirb.com/test
with behaviors that are
more symbolic in nature.
5. This is incorrect. Paralanguage is a type of nonverbal communication.
abirb.com/test
CON: Communication

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39. Which nursing statements demonstrate useful feedback? Select all that apply.
1. “Hitting the wall yesterday was not the best way to express your anger.”
2. “The hospital has a support group on Tuesdays for those who want to quit smoking.”
abirb.com/test
3. “It appears you want to sit near the nurses’ station when the morning meeting starts.”
4. “Your behavior has been unacceptable since you were admitted to this unit.”
5. “I noticed you participated in group more this afternoon than this morning.”
abirb.com/test

ANS: 2, 3, 5
Chapter: Chapter 7 Therapeutic Communication
Objective: Discuss therapeutic feedback. abirb.com/test
Page: 131

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Townsend
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Chapter 7 - ETB
abirb.com/test
Heading: Feedback
Integrated Processes: Nursing Process: Implementation
Client Needs: Psychosocial Integrity
abirb.com/test
Cognitive Level: Analysis [Analyzing]
Concept: Communication
Difficulty: Moderate
abirb.com/test
Feedback
1. This is incorrect. This is an example of delayed-response feedback, which is not
useful to the client. Feedback is most useful when given at the earliest appropriate
abirb.com/test
opportunity following the specific behavior.
2. This is correct. Feedback is useful when it encourages self-sufficiency and imparts
information rather than offering advice.
3. This is correct. Useful feedback should be directed towardabirb.com/test
a behavior the client has
the capacity to modify. In this situation, the nurse can explore the reason the client
sits near the nurse’s station and assist the client to modify the behavior when
appropriate. abirb.com/test
4. This is incorrect. Useful feedback should be specific rather than general.
5. This is correct. Useful feedback should be directed toward behavior that the client
has the capacity to modify and is specific. This statement is directed toward a
abirb.com/test
specific behavior the client can modify (participating in group).

CON: Communication
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