Therapeutic Communication Nursing 2026 Practice
Test Questions Detailed Rationales Therapeutic
Responses Communication Barriers Professional
Boundaries Mental Health Care
SECTION 1: FOUNDATIONS OF THERAPEUTIC COMMUNICATION
(Questions 1–25)
1. A nurse is establishing a therapeutic relationship with a client. Which is the
primary purpose of therapeutic communication?
A. To gather information for the medical record
B. To promote the client's insight and growth
C. To provide advice and solutions to problems
D. To fulfill the nurse's need for connection
Rationale: The primary purpose of therapeutic communication is to promote the
client's insight, growth, and healing. It is client-centered and focused on the client's
needs, not the nurse's. While information gathering is a component, it is not the
primary purpose. Giving advice is nontherapeutic.
2. A nurse is using therapeutic communication. Which statement best
describes the nurse's role?
A. The nurse acts as a facilitator to help the client express feelings
B. The nurse acts as an advisor to solve the client's problems
C. The nurse acts as a friend to provide social support
D. The nurse acts as a authority figure to direct care
Rationale: In therapeutic communication, the nurse acts as a facilitator who helps
the client explore and express feelings. The nurse is not an advisor, friend, or
authority figure. The relationship is professional and goal-directed.
,3. A nurse is communicating with a client who is crying. Which response is
most therapeutic?
A. "Don't cry. Everything will be okay."
B. "I can see you're upset. Would you like to talk about it?"
C. "Why are you crying?"
D. "You should be grateful for what you have."
Rationale: Acknowledging the client's feelings and offering to listen is
therapeutic. "I can see you're upset. Would you like to talk about it?" validates the
client's emotions without judgment. "Don't cry" dismisses feelings. "Why are you
crying?" can feel accusatory. "You should be grateful" minimizes the client's
experience.
4. A nurse is communicating with a client who is angry. Which response is
most therapeutic?
A. "You shouldn't be angry."
B. "You seem angry. Can you tell me what's bothering you?"
C. "I'll come back when you're calmer."
D. "Why are you always angry?"
Rationale: Acknowledging anger and inviting the client to explore the feeling is
therapeutic. "You seem angry. Can you tell me what's bothering you?" is non-
judgmental and encourages expression. "You shouldn't be angry" dismisses the
feeling. Leaving can feel like abandonment. "Why are you always angry?" is
accusatory.
5. A nurse is communicating with a client who is silent. Which response is
most therapeutic?
A. "Why aren't you talking?"
B. Sitting quietly with the client
C. "I'll leave you alone."
D. "You need to talk to me."
,Rationale: Silence can be a therapeutic technique that allows the client time to
think and feel. Sitting quietly with the client conveys presence and acceptance.
Pressuring the client to talk or leaving can be nontherapeutic.
6. A nurse is using active listening. Which behavior demonstrates active
listening?
A. Maintaining eye contact and nodding
B. Interrupting to ask questions
C. Looking at the clock frequently
D. Writing notes continuously
Rationale: Active listening involves maintaining eye contact, nodding, and
providing verbal and nonverbal cues that indicate the nurse is fully present.
Interrupting, looking at the clock, and writing continuously can interfere with
listening.
7. A nurse is communicating with a client who speaks a different language.
Which intervention is most appropriate?
A. Use a professional medical interpreter
B. Ask a family member to interpret
C. Speak louder and slower
D. Use gestures only
Rationale: A professional medical interpreter ensures accurate communication and
confidentiality. Family members may not interpret accurately and may violate
confidentiality. Speaking louder and using gestures are not effective.
8. A nurse is communicating with a client who has hearing loss. Which
intervention is most appropriate?
A. Face the client and speak clearly
B. Speak loudly into the client's ear
, C. Write everything down
D. Use complex medical terminology
Rationale: Facing the client and speaking clearly allows for lip reading and better
communication. Speaking loudly into the ear can be painful and ineffective.
Writing everything down may not be necessary. Complex terminology should be
avoided.
9. A nurse is communicating with a client who has a cognitive impairment.
Which intervention is most appropriate?
A. Use simple, short sentences
B. Speak rapidly to maintain attention
C. Use abstract concepts
D. Provide multiple instructions at once
Rationale: Simple, short sentences are easier for clients with cognitive impairment
to understand. Rapid speech, abstract concepts, and multiple instructions can cause
confusion.
10. A nurse is communicating with a child. Which intervention is most
appropriate?
A. Use play therapy techniques
B. Speak in complex sentences
C. Use medical terminology
D. Avoid eye contact
Rationale: Play therapy techniques (e.g., drawing, dolls) help children express
feelings and understand medical procedures. Complex sentences and medical
terminology are not appropriate for children.
11. A nurse is communicating with an adolescent. Which intervention is most
appropriate?
Test Questions Detailed Rationales Therapeutic
Responses Communication Barriers Professional
Boundaries Mental Health Care
SECTION 1: FOUNDATIONS OF THERAPEUTIC COMMUNICATION
(Questions 1–25)
1. A nurse is establishing a therapeutic relationship with a client. Which is the
primary purpose of therapeutic communication?
A. To gather information for the medical record
B. To promote the client's insight and growth
C. To provide advice and solutions to problems
D. To fulfill the nurse's need for connection
Rationale: The primary purpose of therapeutic communication is to promote the
client's insight, growth, and healing. It is client-centered and focused on the client's
needs, not the nurse's. While information gathering is a component, it is not the
primary purpose. Giving advice is nontherapeutic.
2. A nurse is using therapeutic communication. Which statement best
describes the nurse's role?
A. The nurse acts as a facilitator to help the client express feelings
B. The nurse acts as an advisor to solve the client's problems
C. The nurse acts as a friend to provide social support
D. The nurse acts as a authority figure to direct care
Rationale: In therapeutic communication, the nurse acts as a facilitator who helps
the client explore and express feelings. The nurse is not an advisor, friend, or
authority figure. The relationship is professional and goal-directed.
,3. A nurse is communicating with a client who is crying. Which response is
most therapeutic?
A. "Don't cry. Everything will be okay."
B. "I can see you're upset. Would you like to talk about it?"
C. "Why are you crying?"
D. "You should be grateful for what you have."
Rationale: Acknowledging the client's feelings and offering to listen is
therapeutic. "I can see you're upset. Would you like to talk about it?" validates the
client's emotions without judgment. "Don't cry" dismisses feelings. "Why are you
crying?" can feel accusatory. "You should be grateful" minimizes the client's
experience.
4. A nurse is communicating with a client who is angry. Which response is
most therapeutic?
A. "You shouldn't be angry."
B. "You seem angry. Can you tell me what's bothering you?"
C. "I'll come back when you're calmer."
D. "Why are you always angry?"
Rationale: Acknowledging anger and inviting the client to explore the feeling is
therapeutic. "You seem angry. Can you tell me what's bothering you?" is non-
judgmental and encourages expression. "You shouldn't be angry" dismisses the
feeling. Leaving can feel like abandonment. "Why are you always angry?" is
accusatory.
5. A nurse is communicating with a client who is silent. Which response is
most therapeutic?
A. "Why aren't you talking?"
B. Sitting quietly with the client
C. "I'll leave you alone."
D. "You need to talk to me."
,Rationale: Silence can be a therapeutic technique that allows the client time to
think and feel. Sitting quietly with the client conveys presence and acceptance.
Pressuring the client to talk or leaving can be nontherapeutic.
6. A nurse is using active listening. Which behavior demonstrates active
listening?
A. Maintaining eye contact and nodding
B. Interrupting to ask questions
C. Looking at the clock frequently
D. Writing notes continuously
Rationale: Active listening involves maintaining eye contact, nodding, and
providing verbal and nonverbal cues that indicate the nurse is fully present.
Interrupting, looking at the clock, and writing continuously can interfere with
listening.
7. A nurse is communicating with a client who speaks a different language.
Which intervention is most appropriate?
A. Use a professional medical interpreter
B. Ask a family member to interpret
C. Speak louder and slower
D. Use gestures only
Rationale: A professional medical interpreter ensures accurate communication and
confidentiality. Family members may not interpret accurately and may violate
confidentiality. Speaking louder and using gestures are not effective.
8. A nurse is communicating with a client who has hearing loss. Which
intervention is most appropriate?
A. Face the client and speak clearly
B. Speak loudly into the client's ear
, C. Write everything down
D. Use complex medical terminology
Rationale: Facing the client and speaking clearly allows for lip reading and better
communication. Speaking loudly into the ear can be painful and ineffective.
Writing everything down may not be necessary. Complex terminology should be
avoided.
9. A nurse is communicating with a client who has a cognitive impairment.
Which intervention is most appropriate?
A. Use simple, short sentences
B. Speak rapidly to maintain attention
C. Use abstract concepts
D. Provide multiple instructions at once
Rationale: Simple, short sentences are easier for clients with cognitive impairment
to understand. Rapid speech, abstract concepts, and multiple instructions can cause
confusion.
10. A nurse is communicating with a child. Which intervention is most
appropriate?
A. Use play therapy techniques
B. Speak in complex sentences
C. Use medical terminology
D. Avoid eye contact
Rationale: Play therapy techniques (e.g., drawing, dolls) help children express
feelings and understand medical procedures. Complex sentences and medical
terminology are not appropriate for children.
11. A nurse is communicating with an adolescent. Which intervention is most
appropriate?
