Examkin

Question

Difficulty: HardTherapeutic Communication

A nurse is initiating a therapeutic interaction with a newly admitted client who recently received a terminal prognosis. The client is sitting alone in a darkened room, staring at the wall, and has not touched their meal. Arrange the following therapeutic communication actions in the most appropriate progressive sequence from first to last to establish trust and explore the client's feelings.

  1. 1Pull up a chair, sit quietly at eye level with the client, and maintain an open, attentive posture without immediately speaking.
  2. 2State softly, 'I notice you are sitting in the dark and haven't touched your lunch.'
  3. 3Respond to the client's heavy sigh by stating, 'You seem to be carrying a very heavy burden today.'
  4. 4Ask gently, 'Would you be willing to share what is going through your mind right now?'
  5. 5Conclude the interaction by stating, 'Over the last few minutes, we have talked about your fears regarding your family's future and your pain management.'

Answer

The correct sequence of therapeutic communication progresses from offering self (presence), to making observations, reflecting feelings, exploring deeply, and finally summarizing the interaction.
Therapeutic communication with an overwhelmed, withdrawn client must follow a progression that builds trust incrementally. It begins with establishing a non-demanding presence (active silence), moves to gentle verbal initiation (making observations), validates emerging emotions (reflection), invites deeper discussion once trust is established (exploration), and finally synthesizes the conversation for closure (summarization).

Step-by-Step Solution

1
Identify the initial goal for a withdrawn, overwhelmed client.
The nurse must first establish physical and emotional presence without applying pressure.
Offering self through active silence demonstrates availability and respect for the client's current coping state.
2
Determine the best technique to initiate verbal contact.
Making a factual observation about the dark room and uneaten food is selected.
Observations prompt the client to respond to their immediate environment without requiring them to articulate complex emotions right away.
3
Select the appropriate response to the client's subsequent nonverbal cue (a sigh).
The nurse uses reflection of feelings ('heavy burden').
Reflection shows the client that the nurse is attuned to their emotional distress, validating their feelings and fostering a safe space.
4
Choose the technique to broaden the conversation.
The nurse uses open-ended exploration to ask what is on the client's mind.
Exploration is most effective after a foundation of empathy has been laid, encouraging the client to direct the flow of the conversation.
5
Identify the technique used to close the interaction.
The nurse summarizes the key points discussed (fears and pain).
Summarization brings the interaction to a logical conclusion, ensuring the nurse has accurately understood the client's primary concerns.

Key Concept

Progressive Phases of Therapeutic Communication
Estimated Time:2m 0s
Rate this question

Topics

Therapeutic Communication

More questions from this topic