Therapeutic vs. Nontherapeutic Communication

1. Yesterday, a 67-year-old man underwent an operation to have a total knee prosthesis installed. It is 4pm, and the patient is visited by the LPN at the beginning her shift. The patient is angry, speaks loudly and complains of not receiving any care. He says he rang several times to get help, but no one came. He ended up using his urinal, which eventually spilled on him. His jacket and bed are now wet. He is also humiliated by the situation and is cold. Which of the following demonstrates the necessary skills and attitude for establishing a therapeutic relationship in this situation? *
2. It is 10 a.m. in a medical unit. Mrs. Bouchard, 72 years old, has just been told she will need another surgery due to complications from her first operation. When the LPN enters the room to check her vital signs, Mrs. Bouchard begins to cry and says, “I can’t go through this again. I don’t think I’ll make it this time.” Which nursing intervention best demonstrates therapeutic communication in this situation? *
3. During visiting hours, Mr. Nguyen, 68 years old, is visibly upset after his daughter leaves. He tells the LPN, “She doesn’t understand how tired I am. She keeps pushing me to walk even when I’m in pain.” What should the LPN do to promote effective communication? *
4. The LPN approaches Mrs. Lavoie, 80 years old, to administer her morning medication. She crosses her arms and says, “I don’t want any more pills. They just make me sicker.” Which response by the LPN reflects therapeutic communication? *
5. Mr. Abdi, 60 years old, has been recently admitted with diabetes complications. When the LPN discusses his meal plan, he seems uncomfortable and avoids eye contact. The nurse suspects cultural differences may influence his communication.
Which action best supports effective, culturally sensitive communication? *
6. At 7 p.m., the LPN begins the evening round. Mr. Roy, 55 years old, is angry and says, “No one tells me what’s going on! I’ve been waiting all day for my test results.” He raises his voice and crosses his arms. What should the LPN do first to establish a therapeutic relationship? *
7. Mrs. Tremblay, 81 years old, has terminal cancer and has recently stopped eating. Her daughter tells the LPN, “I can’t stand watching my mother fade away. Why aren’t you giving her something to make her better?” Which response from the LPN demonstrates therapeutic communication? *
8. During morning rounds, the LPN informs Mrs. Gagnon that her blood sugar is high again. She replies, “That machine must be wrong. I’ve been eating perfectly!” She appears defensive and irritated. What is the best nursing response? *
9. After receiving a new diagnosis of multiple sclerosis, Mrs. Poirier says to the LPN, “My life is over. I’ll never walk again.” Tears stream down her face. Which response is most therapeutic? *
10. During a team meeting, the LPN feels that the RN is criticizing her work unfairly. After the meeting, the LPN feels hurt and angry but must continue working with the same team. What communication approach demonstrates professionalism and self-awareness? *
11. In the surgical unit, the LPN is preparing Mrs. Li, a 58-year-old woman who recently immigrated, for discharge after an appendectomy. Mrs. Li speaks very little French and limited English. Her daughter, who speaks both languages, offers to translate the discharge instructions. The LPN must explain wound care, medication administration, and signs of infection that require immediate attention. What is the most appropriate action by the LPN to ensure safe and effective communication? *
12. A 98-year-old woman awaiting accommodation it, is hospitalized due to deterioration of her general condition and repeated falls. A week ago, she fell during the night, resulting in a fractured coccyx. She is suffering and often changes position. Although she asked the staff at least once every hour to bring her to the commode chair to urinate, she often does not urinate. The LPN just left the room five minutes ago, and the woman has rung again. Which of the following skills are necessary for establishing a therapeutic relationship in this situation? *
13. A young mother has undergone a thyroidectomy due to the presence of a malignant tumor. The LPN is about to enter the room to provide care, but notices that the patient has her head down and she is crying. Which of the following demonstrates the necessary skills and attitudes for establishing a therapeutic relationship in this situation? *
14. Among her pediatric patient’s an LPN must care for a hospitalized fifteen-year-old girl by monitoring her weight gain as well as her food intake during meals. The patient’s weight and height are 48 kg and 1.67 m, respectively. While checking vital signs, the LPN, who had already advised the nurse, permanently installs a nasal cannula at 2L/min. The patient never answers questions but keeps on requesting laxatives for what she says is chronic constipation. When it’s time to change her nightgown, which is soiled from food, the patient refuses help because she does not want the LPN to see her naked, saying she is too fat. The LPN discovers small snack bags under the patient’s pillow, which are filled with food that’s been chewed and spat out. Which intervention would be appropriate to attenuate the patient’s disruptive behavior? *
15. Mr. Badour, age 46, had surgery yesterday for a colostomy. You go to his room and you see that his breakfast tray is upside down on the floor. He is sitting on the edge of his bed and his fists are clenched and resting on the bedside table, next to his jug of water. you notice that he is sweating profusely, his face is red and he coughs twice. His ostomy bag is on the floor. When he sees you come in, Mr. Badour says to you: "Get out of here right now. Leave me alone, like my wife! What will you say? *