Review Communication and Therapeutic Relationships in Chronic Illness Care

Care of Patients with Chronic Illnesses > Fundamentals

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Communication and Therapeutic Relationships in Chronic Illness Care

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Total Questions : 4

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Question 1:

A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD) and is experiencing dyspnea. Which of the following actions should the nurse take to facilitate effective communication with the client?

A. Ask open-ended questions that require detailed responses. B. Use gestures and nonverbal cues to supplement verbal communication. C. Speak loudly and clearly to ensure the client can hear the nurse. D. Interrupt the client frequently to save time and energy.

Answer and Explanation

Choice A:

This is an incorrect action, as asking open-ended questions that require detailed responses can increase the client's dyspnea and anxiety, as well as decrease the client's oxygenation.

Choice B:

The nurse should use gestures and nonverbal cues, such as nodding, smiling, and eye contact, to supplement verbal communication with the client who has dyspnea. This helps to convey empathy, understanding, and interest, as well as reduce the need for the client to speak excessively.

Choice C:

This is an incorrect action, as speaking loudly and clearly can be perceived as shouting or aggressive by the client, which can impair the therapeutic relationship and increase the client's stress level.

Choice D:

This is an incorrect action, as interrupting the client frequently can be disrespectful and rude, which can damage the rapport and trust between the nurse and the client.

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Question 2:

A client who has diabetes mellitus is admitted to the hospital for a foot ulcer. The client tells the nurse that they have been feeling depressed and hopeless about their condition. Which of the following responses by the nurse demonstrates therapeutic communication?

A. "You should be more optimistic. Things could be worse." B. "Why do you feel depressed and hopeless? You have a lot to live for." C. "I understand how you feel. I have a family member who has diabetes too." D. "Tell me more about how you are feeling. I am here to listen."

Answer and Explanation

Choice A:

This is a nontherapeutic response that minimizes the client's feelings and implies that the client is wrong or ungrateful for feeling depressed and hopeless.

Choice B:

This is a nontherapeutic response that uses a closed-ended question that can make the client feel defensive or guilty for feeling depressed and hopeless. The nurse also makes an assumption about the client's life without exploring their perspective.

Choice C:

This is a nontherapeutic response that uses false reassurance and self-disclosure that can shift the focus away from the client and their feelings.

Choice D:

The nurse demonstrates therapeutic communication by using an open-ended statement that invites the client to express their feelings and concerns. The nurse also shows empathy, respect, and genuineness by offering to listen attentively.

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Question 3:

A nurse is conducting a health history interview with a client who has rheumatoid arthritis. The nurse notices that the client is grimacing and rubbing their hands. Which of the following statements by the nurse is appropriate at this time?

A. "You seem to be in pain. Would you like some medication?" B. "How long have you had rheumatoid arthritis? What treatments have you tried?" C. "Let's take a break from the interview. I will come back later when you are feeling better." D. "How does your pain affect your daily activities? How do you cope with it?"

Answer and Explanation

Choice A:

This is an inappropriate statement that assumes that the client wants medication without assessing their pain level, preference, or history of medication use.

Choice B:

This is an inappropriate statement that ignores the client's pain and continues with the interview without addressing their comfort or needs.

Choice C:

This is an inappropriate statement that terminates the interview prematurely and may make the client feel dismissed or abandoned.

Choice D:

The nurse uses an appropriate statement that acknowledges the client's pain and explores its impact on their quality of life and coping strategies. This helps to assess the client's physical, emotional, and social needs, as well as provide support and education.

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Question 4:

A client who has cancer is receiving palliative care at home. The client's spouse tells the nurse that they are overwhelmed by the caregiving responsibilities and feel guilty for wanting some time for themselves. Which of the following statements by the nurse reflects the use of empathy?

A. "You have been doing a great job caring for your spouse. You deserve some time for yourself." B. "You should not feel guilty for wanting some time for yourself. It is normal to feel that way." C. "You must be feeling very stressed and exhausted. It is not easy to care for a terminally ill spouse." D. "You need to take care of yourself too. Have you considered respite care or hospice services?"

Answer and Explanation

Choice A:

This is a statement that reflects the use of praise, which can be helpful in some situations, but does not demonstrate empathy or address the spouse's feelings of guilt.

Choice B:

This is a statement that reflects the use of reassurance, which can be counterproductive in some situations, as it can minimize or dismiss the spouse's feelings of guilt.

Choice C:

The nurse reflects the use of empathy by recognizing and validating the spouse's feelings and situation, without judging or offering advice.

Choice D:

This is a statement that reflects the use of information, which can be beneficial in some situations, but does not demonstrate empathy or explore the spouse's feelings or needs.

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Communication and Therapeutic Relationships in Chronic Illness Care

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