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NSG 4300 Therapeutic Communication - Quiz
Exam 1 LATEST 2026 EXAM QUESTION AND
ANSWERS| 100% PASS GUARENTED|GRADED
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1. Which of the following is the most therapeutic nurse response
when a client says, “I’m so anxious about my surgery tomorrow”?
A) "Don't worry, the surgeon is very skilled.” B) "It's normal to feel anxious. Would you like to talk about what specifically worries you?" C) "You'll be fine; thousands of people have this surgery." D) "Let's not focus on that—would you like to watch TV?" Correct Answer: B "It's normal to feel anxious." Would you like to talk about what specifically worries you?" Rationale: This response validates the client’s feelings (anxiety), normalizes the emotion, and invites the client to elaborate, which promotes exploration of concerns. Options A, C, and D minimize the client’s feelings or divert the topic, which can inhibit therapeutic communication.
2. A client is crying and states, “My family doesn’t visit me anymore.”
The nurse sits quietly with the client, tissues within reach, and
maintains eye contact. This is an example of:
A) Offering false reassurance. B) Using silence as a therapeutic technique. C) Approving. D) Rejecting.
Correct Answer: B Using silence as a therapeutic technique. Rationale: Silence, when used purposefully, allows the client to experience and process emotions. It demonstrates acceptance and gives the client space to speak when ready. It is non-judgmental and supportive.
3. Which statement by the nurse demonstrates the use of
“clarification”?
A) "So, you are saying you feel lonely when your children don’t call?" B) "You should call your children if you feel that way." C) "Don’t worry, they probably are just busy." D) "Tell me more about your relationship with your children." Correct Answer: A "So you are saying you feel lonely when your children don’t call?" Rationale: Clarification seeks to restate or summarize what the client has said to ensure accurate understanding. It encourages the client to confirm or correct the nurse's interpretation, enhancing clarity, and validation.
4. Nonverbal communication accounts for what percentage of the
total message in face-to-face interactions according to
communication studies?
A) 10-20%
B) 30-40%
C) 50-60%
D) 70-90%
Correct Answer: D 70 - 90% Rationale: Research suggests nonverbal cues (facial expression, tone, posture, eye contact) convey the majority of the emotional meaning in communication. This highlights
7. Which of the following is a barrier to therapeutic communication?
A) Reflecting. B) Giving advice. C) Summarizing. D) Using silence. Correct Answer: B ) Giving advice. Rationale: Giving advice takes decision-making away from the client, fosters dependency, and implies that the client cannot solve their own problems. Therapeutic communication focuses on facilitating the client’s own problem-solving.
8. The nurse states, “You say you’re angry, but you’re smiling.” This
is an example of:
A) Confrontation. B) False reassurance. C) Interpretation. D) Reflection. Correct Answer: A Confrontation. Rationale: Gentle confrontation involves pointing out discrepancies between verbal and nonverbal behavior in a non-judgmental way. It helps the client become aware of inconsistencies that may indicate unresolved feelings.
9. When a client asks the nurse for personal advice about a marital
problem, the best response is:
A) "If I were you, I would consider marriage counseling." B) "My husband and I had a similar issue, and here’s what we did…"
C) "Let's explore the options you have considered." D) "You should talk to your spouse about how you feel." Correct Answer: C "Let's explore the options you have considered." Rationale: The nurse’s role is to help clients explore their own feelings and solutions, not to give personal advice. Redirecting the focus back to the client promotes autonomy and self-efficacy.
10. Therapeutic communication differs from social communication in
that therapeutic communication:
A) Is reciprocal and mutual. B) Focuses on the nurse’s needs. C) Is client-centered and goal-directed. D) Avoids difficult emotions. Correct Answer: C Is client-centered and goal-directed. Rationale: Therapeutic communication is a purposeful, professional interaction focused on the client’s needs, with goals such as assessment, intervention, or emotional support. Social communication is mutual and meets the needs of all parties.
11. “I notice you clenched your fist when you talked about your
boss.” This statement is an example of:
A) Making observations. B) Approving. C) Challenging. D) Reassuring. Correct Answer: A Making Observation.
14. A client with anxiety is pacing and breathing rapidly. The nurse
says, “You seem anxious. Would you like to sit and do some deep
breathing with me?” This demonstrates:
A) Invalidation of feelings. B) Recognition and offering a coping strategy. C) Changing the subject. D) Disapproval. Correct Answer: B Recognition and offering a coping strategy Rationale: The nurse first acknowledges the observed emotion (anxiety) and then collaboratively offers a specific, evidence-based intervention (deep breathing) to help manage the symptoms, promoting self-regulation.
15. Empathy in nursing is best defined as:
A) Feeling sorry for the client’s situation. B) Understanding and communicating awareness of the client’s feelings. C) Sharing a similar personal experience. D) Agreeing with the client’s perspective. Correct Answer; B Understanding and communicating awareness of the client’s feelings. Rationale: Empathy is the ability to understand and convey an understanding of the client’s emotional state without necessarily having experienced it oneself. It is a cognitive and affective process that fosters connection. Sympathy (feeling sorry) is different and can hinder objectivity.
16. When a client says, “I hate this hospital food,” the nontherapeutic
response is:
A) "What about food don’t you like?" B) "The dietitian plans the meals carefully for your health."
C) "Many patients feel that way." D) "It can be hard to adjust to hospital meals." Correct Answer: B "The dietitian plans the meals carefully for your health." Rationale: This response is defensive and gives a factual rebuttal, which dismisses the client’s complaint. Therapeutic communication would first acknowledge the feeling before providing information if needed.
17. The phase of the nurse-client relationship where confidentiality
and boundaries are established is:
A) Pre-interaction phase. B) Orientation phase. C) Working phase. D) The Termination phase. Correct Answer: B Orientation phase. Rationale: During the orientation (or introductory) phase, the nurse and client establish trust, set goals, clarify roles, and discuss the parameters of the relationship, including confidentiality and meeting times.
18. A nurse ends a conversation by saying, “We have discussed your
coping strategies for stress today.” This is an example of:
A) Summarizing. B) Confronting. C) Requesting an explanation. D) Belittling. Correct Answer: A Summarizing
21. A nurse tells a client, “Everything will be okay.” This is an
example of:
A) Validating. B) False reassurance. C) Encouraging comparison. D) Focusing. Correct Answer: B ) False reassurance. Rationale: False reassurance dismisses the client’s concern with a cliché and can minimize their worry. It is nontherapeutic because it is not based on facts and blocks further communication of fears.
22. The primary purpose of therapeutic communication is to:
A) Socialize and build friendships. B) Assess and intervenes to meet client goals. C) Give the nurse personal satisfaction. D) Provide entertainment for the client. Correct Answer: B ) Assess and intervenes to meet client goals. Rationale: Therapeutic communication is a clinical skill with the intentional purpose of understanding the client, building rapport, identifying needs, and facilitating positive health outcomes.
23. Which question is most therapeutic when assessing suicide risk?
A) "You’re not thinking of hurting yourself, are you?" B) "Have you had thoughts of harming yourself or ending your life?" C) "I hope you’re not suicidal."
D) "Things aren’t that bad, are they?" Correct Answer: B "Have you had thoughts of harming yourself or ending your life?" Rationale: This is a direct, clear, and non-judgmental question that assesses suicidal ideation. It avoids minimization and allows the client to answer honestly. It is a necessary and responsible clinical question.
24. “Why did you stop taking your medication?” is a nontherapeutic
question because it:
A) Is open-ended. B) Implies criticism and can make the client defensive. C) Shows empathy. D) Seeks clarification. Correct Answer: B Implies criticism and can make the client defensive. Rationale: “Why” questions can sound accusatory and put the client on the defensive. A more therapeutic approach is, “Can you help me understand what led to stopping your medication?”
25. Active listening involves:
A) Thinking about what to say next while the client talks
. B) Listening to the words only. C) Paying full attention verbally and nonverbally. D) Interrupting showing understanding. Correct Answer: C Paying full attention verbally and nonverbally. Rationale: Active listening requires full concentration, observation of nonverbal cues, and responsive verbal feedback to demonstrate understanding. The listener is fully engaged at the moment with the client.
28. A client is silent after discussing a painful memory. The nurse
should:
A) Immediately ask another question. B) Sit quietly and allow the client time. C) Leave the room to give privacy. D) Reassure the client that it’s okay to cry. Correct Answer: B Sit quietly and allow the client time. Rationale: Silence can be a powerful therapeutic tool, allowing for processing of emotion. The nurse’s calm, patient presence communicates acceptance and support without pressure to speak.
29. Which behavior best demonstrates cultural competence in
communication?
A) Using medical jargon to appear knowledgeable. B) Maintaining direct eye contact at all times. C) Assessing the client’s cultural beliefs and preferences. D) Assuming all clients want to be addressed by first name. Correct Answer: C Assessing the client’s cultural beliefs and preferences. Rationale: Cultural competence involves actively seeking to understand the client’s cultural background, including communication styles (eye contact, touch, decision- making), to provide respectful and effective care.
30. “Tell me about your relationship with your father.” This is an
example of:
A) A closed-ended question.
B) Exploring. C) Approving. D) Defending. Correct Answer: B Exploring. Rationale: Exploring encourages the client to delve deeper into a topic, person, or relationship. It helps gather more comprehensive psychosocial data and understand the client’s experiences.
31. When a client makes a sexually suggestive remark to the nurse,
the appropriate action is to:
A) Ignore it to avoid embarrassment. B) Laugh it off as a joke. C) Set a clear, professional boundary. D) Ask the client to explain the remark. Correct Answer: C Set a clear, professional boundary. Rationale: The nurse must maintain professional boundaries. A clear, firm, and non- punitive statement such as, “That comment is not appropriate for our therapeutic relationship,” clarifies expectations while preserving dignity.
32. A client states, “I’m useless since I had my stroke.” The nurse
responds, “You’re focusing on what you can’t do. Let’s list the things
you can still do.” This is an example of:
A) Reframing. B) Rejecting. C) Requesting an explanation.
35. A client with depression says, “What’s the point of trying?” The
nontherapeutic response is:
A) "You’re feeling hopeless right now." B) "The point is to get better." C) "That sounds like a very hard feeling to have." D) "Can you tell me more about ‘no point’?" Correct Answer: B "The point is to get better." Rationale: This response is dismissive and minimizes the client’s profound feeling of hopelessness. It offers a simplistic solution to a complex emotional state, which is nontherapeutic.
36. Confidentiality in the therapeutic relationship means:
A) The nurse will not share information with anyone. B) Information is shared only with the healthcare team directly involved in care. C) The nurse can discuss cases with the family if concerned. D) Information can be shared if the client is a danger to others. Correct Answer: B Information is shared only with the healthcare team directly involved in care. Rationale: Confidentiality is a professional and legal obligation. Information is shared on a need-to-know basis within the healthcare team for treatment purposes. Exceptions include duty to warn (danger to self/others) or mandated reporting.
37. “I’m here with you,” spoken softly to a grieving client, is primarily
an example of:
A) Giving advice. B) Offering self. C) Probing. D) Disagreeing. Correct Answer: B Offering Self. Rationale: Offering self involves making oneself available emotionally and physically. It is a simple, powerful statement of presence and support, especially during times of distress.
38. A nurse responds to an angry client by saying, “You need to calm
down right now.” This is likely to:
A) De-escalate the situation. B) Increase the client’s anger. C) Show the nurse is in control. D) Make the client feel safe. Correct Answer: B ) Increase the client’s anger. Rationale: Telling someone to “calm down” is often perceived as dismissive and authoritarian, which can escalate anger. A therapeutic approach is to acknowledge the anger and set safe behavioral limits.
39. The primary ethical principle underlying therapeutic
communication is:
A) Justice.
Correct Answer: A Therapeutic closed-ended questions. Rationale: While it requires a specific number (closed-ended), it is a standard, therapeutic assessment tool that gathers precise data efficiently. It can be followed by open-ended questions to describe the quality of pain.
42. Which response demonstrates “validation”?
A) "That never happened." B) "I can see why that situation made you feel betrayed." C) "You’re overreacting." D) "Let’s talk about something else." Correct Answer: B "I can see why that situation made you feel betrayed." Rationale: Validation acknowledges the client’s emotional experience as real and understandable given their perspective. It fosters trust and respect, confirming that their feelings matter.
43. The termination phase should include:
A) Avoiding discussion of endings to prevent sadness. B) Introducing new problems to work on. C) Reviewing progress and discussing coping strategies for the future. D) Making plans for social contact after being discharged. Correct Answer: C Reviewing progress and discussing coping strategies for the future. Rationale: Termination involves preparing the client for the end of the relationship, reviewing achievements, discussing feelings about separation, and consolidating learning for future use. It is a planned, gradual process.
44. A client with aphasia after a stroke is struggling to speak. The
nurse’s best action is to:
A) Finish the client’s sentences to reduce frustration. B) Ask yes/no questions and use a communication board. C) Tell the client to try harder. D) Talk only to the family to get information. Correct Answer: B Ask yes/no questions and use a communication board. Rationale: Adapting communication methods (simple questions, gestures, tools) respects the client’s ability and promotes autonomy. Finishing sentences can increase frustration and is disempowering.
45. “You said you’re angry with your doctor and also scared about
your prognosis.” This nurse statement is:
A) Giving advice. B) Making stereotypes. C) Identifying a theme. D) Rejecting. Correct Answer: C Identifying a theme. Rationale: Identifying a theme links together different elements of communication (anger and fear) to reveal an underlying connection or pattern (e.g., fear underlying anger). It helps the client gain insight.
46. Which is a goal of the pre-interaction phase?
A) Explore transference issues. B) Evaluate outcomes of care.
