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Speak loudly and slowly to the client. - This is not an appropriate strategy, as speaking loudly can be perceived as shouting or anger, and speaking slowly can be patronizing or insulting. The nurse should speak clearly and at a normal pace, using simple and familiar words.

Ask the client yes or no questions only. - This is not an optimal strategy, as it limits the client's ability to communicate their feelings, thoughts, and concerns. The nurse should ask open-ended questions whenever possible, and allow the client time to respond.

Avoid eye contact with the client to reduce anxiety. - This is not a helpful strategy, as eye contact is an important aspect of communication that conveys interest, respect, and empathy. The nurse should maintain eye contact with the client, unless it is culturally inappropriate.

Ask a family member or friend of the client to act as an interpreter. - This is not a recommended practice, as family members or friends may not be fluent in both languages, may not understand medical terms, may omit or add information, or may have biases or emotional involvement that affect the communication.

Repeat the questions several times until the client understands. - This is not an effective strategy, as repeating the same words may not improve comprehension, and may frustrate or offend the client. The nurse should rephrase or simplify the questions, or use nonverbal cues such as gestures or pictures, to facilitate understanding.

Use medical jargon and technical terms to explain the diagnosis and treatment. - This is not an appropriate strategy, as medical jargon and technical terms may confuse or intimidate the client, especially if they have limited English proficiency. The nurse should use plain language and avoid acronyms, abbreviations, or slang when communicating with the client.

"That sounds very stressful. You must be feeling overwhelmed." - This statement does not demonstrate active listening skills, as it assumes how the client feels without checking for accuracy. The nurse should avoid making assumptions or judgments about the client's feelings, and instead ask them how they feel or reflect their emotions back to them.

"I understand what you are going through. I had a similar problem last year." - This statement does not demonstrate active listening skills, as it shifts the focus from the client to the nurse's personal experience. The nurse should avoid self-disclosure or comparisons that may minimize or invalidate the client's situation.

"Let me tell you what you need to do to improve your health." - This statement does not demonstrate active listening skills, as it implies that the nurse knows better than the client what is best for them. The nurse should avoid giving advice or directives that may undermine the client's autonomy or motivation.

Beneficence - This is the ethical principle of doing good or acting in the best interest of the client, which may or may not align with the client's wishes or choices.

Justice - This is the ethical principle of treating all clients fairly and equitably, and distributing resources and services based on need and availability.

Fidelity - This is the ethical principle of being faithful or loyal to the client, and keeping one's promises and commitments.

Beneficence - This is the ethical principle of doing good or acting in the best interest of the client, which may or may not align with the client's wishes or choices.

Justice - This is the ethical principle of treating all clients fairly and equitably, and distributing resources and services based on need and availability.

Fidelity - This is the ethical principle of being faithful or loyal to the client, and keeping one's promises and commitments.

Speak in a high-pitched voice to increase clarity. - This is not a helpful technique, as a high-pitched voice may be more difficult to hear or understand than a normal or low-pitched voice. The nurse should speak in a normal or slightly lower tone of voice, and avoid shouting or whispering.

Stand behind the client and speak into their ear. - This is not an effective technique, as standing behind the client prevents them from seeing the nurse's face and lips, which can aid in communication. The nurse should stand in front of the client, at their eye level, and speak into their better ear if they have one.

Cover the mouth with a hand while speaking to reduce background noise. - This is not an appropriate technique, as covering the mouth with a hand obscures the nurse's lips and facial expressions, which can hinder communication. The nurse should avoid covering their mouth or wearing a mask if possible, and reduce background noise by closing doors or windows, turning off radios or televisions, or moving to a quieter location.

"Do you remember what we talked about yesterday?" - This statement does not indicate an understanding of therapeutic communication, as it tests the client's memory, which may be impaired due to dementia. The nurse should avoid asking questions that rely on recall, and instead provide cues or reminders of previous conversations.

"Why are you so agitated today? What's wrong with you?" - This statement does not indicate an understanding of therapeutic communication, as it implies that there is something wrong with the client, and may sound accusatory or judgmental. The nurse should avoid asking "why" questions that may put the client on the defensive, and instead use "what" or "how" questions that explore the client's feelings or needs.

"You seem confused. Let me explain everything to you again." - This statement does not indicate an understanding of therapeutic communication, as it labels the client as confused, which may be demeaning or discouraging. The nurse should avoid using negative labels or terms that may affect the client's self-esteem or confidence.