Therapeutic Communication
Help Questions
NCLEX-PN › Therapeutic Communication
In a pre-op holding area, a 60-year-old client scheduled for cataract surgery says, "I’m scared I’ll wake up blind." The client is trembling and repeatedly asks the same question. The LPN/VN is within scope to provide support and notify the RN as needed. Which technique should the nurse use to facilitate discussion?
Say, "Tell me what you’re most afraid might happen after surgery."
Say, "Let’s not talk about that—think positive thoughts."
Ask, "Are you ready to go back now?"
Say, "There’s no reason to be scared; the surgeon is the best."
Explanation
This question tests therapeutic communication skills in nursing. The key technique being tested is using open-ended questions to facilitate discussion of fears. The correct answer, choice B, effectively uses this by encouraging the client to specify fears, which helps process anxiety. Choice A is closed and pressure-inducing, choice C offers false reassurance, and choice D avoids the topic. Therapeutic communication is important in pre-op settings to alleviate fears and improve outcomes. It also supports emotional preparation for procedures. A transferable strategy is to probe gently with 'Tell me what you're most afraid...' to uncover specific concerns.
In an outpatient imaging center, a 28-year-old client who is the first in their family to navigate healthcare is scheduled for an MRI with contrast. The client says, "I’m claustrophobic. I can’t do this." The client is visibly anxious. Which statement by the nurse demonstrates therapeutic communication?
It’s just a machine—there’s nothing to be afraid of.
You have to do it; otherwise the provider can’t diagnose you.
Tell me what has helped you in the past when you felt claustrophobic.
Do you want me to just get this over with quickly?
Explanation
This question tests therapeutic communication skills in nursing. The key technique being tested is exploring past coping strategies. The correct answer, choice B, effectively uses this by seeking client input on management, empowering them. Choice A pressures, choice C minimizes, and choice D rushes without regard. Therapeutic communication is essential in imaging to reduce procedure-related anxiety. It also improves completion rates for diagnostics. A transferable strategy is to ask 'Tell me what has helped you in the past...' to build on client strengths.
On an orthopedic unit, a 70-year-old client scheduled for a hip replacement says, "I’m afraid I won’t wake up from anesthesia." The client reports poor sleep and keeps asking for reassurance. Which technique should the nurse use to facilitate discussion?
Ask, "Do you want to cancel the surgery?"
Say, "What questions do you have about anesthesia, and what are you most concerned about?"
Say, "Anesthesia is safe—don’t think about it."
Say, "When I had surgery, I woke up right away."
Explanation
This question tests therapeutic communication skills in nursing. The key technique being tested is using open-ended questions to facilitate discussion. The correct answer, choice A, effectively uses this by assessing concerns directly, encouraging expression. Choice B minimizes, choice C pressures, and choice D shares inappropriately. Therapeutic communication is key in orthopedic pre-op care to address fears and improve recovery. It also reduces insomnia-related anxiety. A transferable strategy is to combine questions like 'What questions do you have... and what are you most concerned about...' for thorough exploration.
In a primary care office, a 45-year-old client has just been told they have high cholesterol. The client says, "My father had a heart attack at my age—so I’m doomed." The client appears tense and catastrophizing. Which statement by the nurse demonstrates therapeutic communication?
What does your father’s experience make you think might happen to you, and what questions do you have about your results?
You’re overreacting; lots of people have high cholesterol.
You need to stop eating fried foods and start exercising every day.
Let me read you all the numbers and guidelines so you understand the lab report.
Explanation
This question tests therapeutic communication skills in nursing. The key technique being tested is assessing perceptions and inviting questions. The correct answer, choice B, effectively uses this by linking family history to personal fears and clarifying, which corrects catastrophizing. Choice A dismisses, choice C prescribes without input, and choice D overwhelms with data. Therapeutic communication is vital for lifestyle-related diagnoses to motivate change. It also prevents unnecessary worry through education. A transferable strategy is to explore thoughts with 'What does... make you think... and what questions do you have...' to address misconceptions.
At a community clinic, a 31-year-old client who recently immigrated and prefers simple, concrete language has just been told they have hypertension. The client says, "I feel fine. I don’t think I need pills." The LPN/VN is reinforcing teaching. What is the best way for the nurse to address the client's concern?
You’re wrong—high blood pressure is serious, so you must take the medication.
Don’t worry; you can stop the pills once your pressure is normal.
What do you think high blood pressure means for your health, and what worries you about taking medicine?
Here is a list of all antihypertensive drug classes and their side effects.
Explanation
This question tests therapeutic communication skills in nursing. The key technique being tested is exploring beliefs and concerns through open-ended questions. The correct answer, choice C, effectively uses this by assessing perceptions and worries, allowing for culturally sensitive teaching. Choice A is argumentative, choice B gives false advice, and choice D provides overwhelming information. Therapeutic communication is essential for clients with language preferences as it ensures understanding and adherence. It also builds trust in diverse populations. A transferable strategy is to inquire about beliefs with 'What do you think... and what worries you...' to tailor responses.
In a pre-procedure area, a 48-year-old client scheduled for a bronchoscopy says, "I feel like I can’t breathe just thinking about it." The client is breathing rapidly and repeatedly asks to leave. The LPN/VN is providing support while the RN is notified. Which statement by the nurse demonstrates therapeutic communication?
Do you want to cancel the procedure?
It’s quick—just a tube down your throat and it’s done.
Tell me what part of the procedure feels most scary to you right now.
Take a deep breath and stop thinking about it; you’re making it worse.
Explanation
This question tests therapeutic communication skills in nursing. The key technique being tested is open-ended exploration of fears. The correct answer, choice B, effectively uses this by pinpointing specific anxieties, aiding de-escalation. Choice A advises without listening, choice C pressures, and choice D minimizes. Therapeutic communication is vital in pre-procedure areas to manage panic. It also prevents procedure delays. A transferable strategy is to ask 'Tell me what part... feels most scary...' to break down fears.
In a hospice inpatient unit, a 73-year-old client is actively dying. The client’s spouse says, "He hasn’t eaten in days—are we starving him?" The spouse appears distressed and wrings their hands. How should the LPN/VN respond to express empathy using reflective listening?
Do you want to speak with the chaplain about this?
You’re worried that he’s suffering because he isn’t eating, and you want to make sure he’s comfortable.
He’s not hungry anymore; this is normal, so you shouldn’t worry.
If you want, we can try to get him to take a few bites and sips.
Explanation
This question tests therapeutic communication skills in nursing. The key technique being tested is reflective listening to express empathy. The correct answer, choice B, effectively uses this by restating the spouse's concerns, showing understanding of their distress. In contrast, choice A gives false reassurance, choice C offers unsolicited action, and choice D redirects to another resource without addressing feelings. Therapeutic communication is vital in hospice care as it comforts families and validates their emotions during grief. It also aids in providing holistic end-of-life support. A transferable strategy is to reflect concerns with statements like 'You're worried that...' to demonstrate empathy and open dialogue.
In a busy pediatric clinic, a 34-year-old parent who took unpaid time off work says angrily, "We’ve been waiting forever, and my child is getting fussy!" The LPN/VN is at the front desk and can provide updates. What is the best way for the nurse to address the client's concern?
If you don’t like the wait, you can go somewhere else.
Try giving your child your phone to watch a video so they’ll be quiet.
I can see this delay is frustrating. Let me check how much longer it may be and talk with you about options.
We’re busy—everyone has to wait.
Explanation
This question tests therapeutic communication skills in nursing. The key technique being tested is validating frustration and providing updates. The correct answer, choice B, effectively uses this by acknowledging emotions and offering information, which calms the situation. Choice A is dismissive, choice C is unsympathetic, and choice D distracts without addressing the issue. Therapeutic communication is important in pediatric settings to support families under stress. It also enhances clinic efficiency and client satisfaction. A transferable strategy is to empathize with 'I can see this delay is frustrating...' then check and update on status.
On a telemetry unit, a 58-year-old client who lives alone has just been diagnosed with atrial fibrillation. The client looks confused and says, "I don't really get what this means—am I having a heart attack?" The LPN/VN is reinforcing teaching and assessing understanding. Which statement by the nurse demonstrates therapeutic communication?
It’s an irregular rhythm. You’ll need to take your medications as prescribed.
You’re not having a heart attack; the provider would have told you if you were.
Let me give you a detailed explanation of the electrical conduction system of the heart.
What did the provider tell you about atrial fibrillation, and what questions do you have?
Explanation
This question tests therapeutic communication skills in nursing. The key technique being tested is assessing understanding and inviting questions. The correct answer, choice C, effectively uses this by clarifying what the client knows and addressing gaps, promoting accurate information. Alternatively, choice A dismisses fears, choice B provides incomplete info without engagement, and choice D overwhelms with technical details. Therapeutic communication is key in reinforcing teaching as it ensures clients are informed and less anxious. It also supports self-management for chronic conditions like atrial fibrillation. A transferable strategy is to start with 'What did the provider tell you...' to gauge knowledge before adding information.
In an emergency department hallway bed, a 46-year-old client who works hourly wages says angrily, "I've been here all day and no one tells me anything!" The client’s voice is loud and other patients can hear. The LPN/VN approaches to update the client. Which statement by the nurse demonstrates therapeutic communication?
I understand you’re upset about the lack of updates; let’s step to a quieter area so I can explain what’s happening.
You should be grateful you’re being treated at all.
There’s nothing I can do; you’ll be seen when the doctor is ready.
If you keep yelling, security will be called.
Explanation
This question tests therapeutic communication skills in nursing. The key technique being tested is acknowledging emotions and de-escalating in a public setting. The correct answer, choice A, effectively uses this by validating upset and suggesting a private discussion, which respects dignity. However, choice B is dismissive, choice C threatens, and choice D is ungrateful and rude. Therapeutic communication is crucial in emergency departments to manage stress and maintain safety. It also enhances client cooperation and reduces complaints. A transferable strategy is to validate first with 'I understand you're upset...' then propose solutions like moving to a quieter area.