Therapeutic Communication

Feel free to use these questions elsewhere, but please credit me by linking back to this site. Answer key with rationales found below.

  1.  The nurse is caring for a thirty year old female patient who lives on her own and is recovering from a comminuted fracture of her left tibia. The client states, “I hate that I can’t get up and walk by myself to go to the bathroom!” The nurse uses the therapeutic response of sharing empathy by saying:
    1. “Don’t worry, you’ll be up and walking before you know it.”
    2. “Keep your chin up!”
    3. “It must be frustrating to have been so independent and suddenly have to depend on other people to care for you”
    4. “I’m sorry this happened to you.”
  2. The nurse witnesses a patient exhibiting facial grimacing. When asked to rate their current pain level, the patient states, “Oh, I’m fine right now.” What is the nurse’s best response?
    1. Document that the patient reports he is not in any pain
    2. “You say that you feel fine, but you’re grimacing like you’re in pain.”
    3. “It’s not good to hide your pain from me like that.”
    4. “Why do you say you’re fine when you’re grimacing like that?”
  3. The daughter of an elderly patient tells the hospice nurse “I want to cry every time I visit my mother.” The best response by the nurse is:
    1. “You feel sad that your mother will die soon.”
    2. “You should stay strong for her.”
    3. “I felt that way when my mother was in hospice care.”
    4. “Let’s talk about something else instead.”

—–

1. Option 3 is correct. In showing empathy, the nurse should demonstrate understanding of the patient’s feelings. Option 1 is false reassurance and belittles the patient’s concerns. Option 2 demonstrates the use of a cliche, which is meaningless in the nurse-patient relationship. Option 4 demonstrates sympathy, which focuses more on the nurse’s feelings than the patient’s concerns.

2. Option 2 is correct. The nurse is demonstrating the therapeutic technique of confrontation by helping the patient be more aware of his inconsistency. Option 1 is incorrect because the patient is communicating he is in pain through nonverbal cues. Option 3 is incorrect because the nurse is demonstrating disapproval. Option 4 is incorrect because the nurse is requesting an explanation.

3. Option 1 is correct. It shows the therapeutic communication technique of reflecting, giving the family member back their feelings and ideas. Option 2 is a cliche and non-therapeutic. Option 3 focuses on the nurse, not the family member. Option 4 changes the subject and does not address the family member’s feelings.

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