Communication is emphasized on the NCLEX-RN® exam because it is critical to your success as a beginning practitioner. Therapeutic communication means listening to and understanding the client while promoting clarification and insight. It enables the nurse to form a working relationship with both the client and the health care team, using both verbal and nonverbal communication. Remember that nonverbal communication is the most accurate reflection of attitude. Therapeutic responses include the following: Show
There are many questions on the NCLEX-RN® exam that require you to select the correct therapeutic communication response. As with other NCLEX-RN® exam questions, one of the biggest errors that test takers commit when trying to answer this type of question is to look for the correct answer. Remember, you are selecting the best answer from the four possible answers that you are given. NCLEX QUESTION STRATEGY: Do Not Worry AnswersEliminate answer choices that offer false reassurance. These type of responses discourage communication between the nurse and the client by not allowing the client to explore his or her own ideas and feelings. False reassurance also discounts what the client is feeling. Examples include:
NCLEX QUESTION STRATEGY: Let’s Explore AnswersAnother incorrect answer choice that many graduate nurses select is the choice that includes the word “explore.” On the NCLEX-RN® exam, avoid being a junior psychiatrist. It isn’t the nurse’s role to delve into the reasons why the client is feeling a particular way. The client must be allowed to verbalize the fact that he or she is sad, angry, fearful, or overwhelmed. Examples include:
NCLEX QUESTION STRATEGY: Why QuestionsEliminate answer choices that include “why” questions: ones that seek reasons or justification. “Why” questions imply disapproval of the client, who may become defensive. A “why” question can come in many forms, and need not always begin with “why.” Any response that puts the client on the defensive is nontherapeutic and therefore incorrect. Examples include:
NCLEX QUESTION STRATEGY: Authoritarian AnswersEliminate answer choices in which the nurse is telling the client what to do without regard for the client’s desires or feelings. Examples include:
NCLEX QUESTION STRATEGY: Nurse-Focused AnswersEliminate answer choices in which the focus of the comment is on the nurse. Be careful, because these answer choices may sound very empathetic. The focus of your communication should always be on the client. Examples include:
NCLEX QUESTION STRATEGY: Closed-Ended QuestionsEliminate answer choices that include closed-ended questions that can be answered with the words yes, no, or another monosyllabic response. Closed- ended questions discourage the client from sharing thoughts and feelings. Examples include:
Eliminating these types of non-therapeutic responses that appear as answer choices is an effective strategy when answering therapeutic communication questions. Don’t simply look for the specific words that you see here; you may need to “translate” the
answer choices into the above errors of therapeutic communication. NCLEX QUESTION STRATEGY: Gives Correct InformationOffering information encourages further communication from the client. Examples of giving correct information include:
Is empathetic and reflects the client’s feelingsEmpathy is the ability to perceive what another person experiences using that person’s frame of reference. Reflection communicates to the client that the nurse has heard and understands what the client is trying to communicate. When reflecting feelings, the nurse focuses on the feelings and not the content of what is said. The following are examples of empathetic, reflective statements include:
Let’s practice therapeutic communication with a few exam-style questions. Step 1. Eliminate incorrect answer choices.
Step 2. Select an answer from the remaining
choices. Step 1. Eliminate answer choices.
Step 2. Select an answer from the remaining choices. What are the three types of questions used in therapeutic communication?There are three types of questions that guide the client interview.. Closed-ended questions.. Open-ended questions.. Probing questions.. What are three components of therapeutic communication?Accurate empathic understanding means that the therapist understands their client's experience and feelings in an accurate and compassionate way.. CONGRUENCE (GENUINENESS) ... . UNCONDITIONAL POSITIVE REGARD and ACCEPTANCE. ... . ACCURATE EMPATHIC UNDERSTANDING.. What are the types of therapeutic communications?There are two main types of therapeutic communication: verbal and non-verbal. Verbal therapeutic communication is spoken with a patient whereas non-verbal therapeutic communication pays attention to a patient's facial expressions or body language.
What type of questioning might be used in a patient assessment?In general, open-ended questioning is the preferred technique to use during patient interviews to compel the patient to provide more in-depth and insightful responses. Because open- ended questions do not limit the patient to responding with a yes or no, they encour- age the patient to disclose more information.
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