THERAPEUTIC COMMUNICATION EXAM 2 QUESTIONS
AND ANSWERS UPDATED 2025
ANS: A
Nurses need to know about culture because it influences both nurses' and clients'
health care perceptions and behaviours. Nurses should learn about the culture of
diverse clients and communities. Nurses need to recognize and overcome certain
attitudes basic to the American culture. To provide culturally competent care, the
nurse must address issues of discrimination. Learning how to speak another
language is important, but it is more important to seek understanding of cultural
influences on health a non-Hispanic white nurse provides care to mostly Hispanic
patients. It would be most important for the nurse to take which action?
A. Discover cultural influences on health care perceptions and behaviours.
B. Assist the patients to adapt to American culture and health beliefs.
C. Avoid confrontation of underlying issues of discrimination.
D. Improve communication by learning how to speak Spanish.
ANS: C
The initial action that the nurse should take to learn about delivering care to diverse
clients is to become familiar with personal health care beliefs and behaviours. Self-
awareness helps nurses recognize that their beliefs and behaviours are not
necessarily common to all. Nurses' lack of knowledge about their own culture can
distort their perceptions of the beliefs and behaviours of clients from diverse cultures.
Transcultural frameworks have been developed to help nurses provide culturally
appropriate nursing care. Ethnocentrism interferes with the appreciation of diverse
cultures and their health care beliefs and behaviour . The nurse cares for diverse
clients in a community health setting. Which action should the nurse take first to
learn about delivering care to diverse clients?
A. Adopt a transcultural framework to develop culturally appropriate care.
B. Ask clients about their personal health care beliefs.
C. Develop a self-awareness of personal health care beliefs.
D. Recognize ethnocentric beliefs of minorities in the community.
ANS: B
Tripp-Reimer and Afifi (1989) suggest two processes that nurses may use to
communicate with clients from diverse cultures: cultural assessment and cultural
negotiation. Cultural assessment refers to the appraisal of a client's health beliefs
and behaviours. The information is then used to determine appropriate nursing
interventions. Cultural negotiation refers to the process of negotiating with the client
regarding differences in the lay and professional belief systems concerning
appropriate care. Information obtained from other sources (e.g., written documents,
other nurses, experts, standards) is not specific to this client's health beliefs and
behaviours. The nurse provides care to a client from Nigeria who is visiting the
United States. Which should the nurse use to communicate with this client?
,A. Review the predominant health beliefs of the Nigerian population.
B. Appraise the client's health beliefs and behaviours with a cultural assessment.
C. Consult with other nurses who have taken care of clients from other countries.
D. Use standard communication techniques to establish a helping relationship.
ANS: B
Tripp-Reimer and Afifi (1989) suggest two processes that nurses may use to
communicate with clients from diverse cultures: cultural assessment and cultural
negotiation. Cultural assessment refers to the appraisal of a client's health beliefs
and behaviours. The information is then used to determine appropriate nursing
interventions. Cultural negotiation refers to the process of negotiating with the client
regarding differences in the lay and professional belief systems concerning
appropriate care. Information obtained from other sources (e.g., written documents,
other nurses, experts, standards) is not specific to this client's health beliefs and
behaviours. The nurse provides care to a client from Nigeria who is visiting the
United States. Which should the nurse use to communicate with this client?
A. Review the predominant health beliefs of the Nigerian population.
B. Appraise the client's health beliefs and behaviours with a cultural assessment.
C. Consult with other nurses who have taken care of clients from other countries.
D. Use standard communication techniques to establish a helping relationship.
ANS: C
Professional interpreters are able to communicate medical terms and can be of
assistance in reducing the risks of breaches in patient privacy and confidentiality.
Also, information can be directly obtained from the patient. When family members or
volunteers serve as the interpreter, patients are often uncomfortable sharing
sensitive information. Family members in a stressful situation may have difficulty
being the interpreter. Although nonverbal communication is important, this method
should only be used if an interpreter is not available. The nurse needs to obtain a
health history from a Spanish-speaking patient. Which action by the nurse is best?
A. Ask a bilingual friend of the patient to interpret.
B. Use nonverbal communication and draw pictures.
C. Request a Spanish-speaking medical interpreter.
D. Interview the patient's English-speaking daughter.
ANS: B
Eye contact is often cultural; some Native Americans believe that prolonged eye
contact is rude and intrusive. However, it is important to assess each individual
patient for preferences and comfort with eye contact the nurse is interviewing a
Native American client. It is most important for the nurse to take which action?
A. Maintain eye contact to show respect and interest.
B. Assess whether the client is comfortable with eye contact.
C. Avoid prolonged eye contact with this client.
D. Sit next to the patient to avoid any eye contact.
ANS: B
It is important to call the patient by the name he or she prefers. The nurse should ask
a person how he or she prefers to be addressed, because considerable cultural
,variation exists. Most Americans are comfortable with calling people by their first
names. This is perceived by some, however, as a failure to show respect the nurse
provides care for a male patient. When the nurse addresses the patient, which would
be most appropriate?
A. Use both first and last name with each encounter.
B. Ask the patient how he prefers to be addressed.
C. Call the patient by his first name.
D. Address the patient by his last name.
ANS: D
The elderly should not be addressed using disrespectful terms such as "honey,"
"sweetheart," "gramps," and "granny" and other patronizing forms of speech. Short
term memory may decline with age; health care providers may assist patients as
needed. The elderly may express their spirituality through prayer and reading the
Bible. Sharing stories helps an elderly patient to review life and establish
meaning.The nurse observes a nursing assistant interacting with an elderly patient.
Which statement by the nursing assistant requires an immediate intervention by the
nurse?
A. "I will help you remember where your room is located."
B. "Would you like me to read from your Bible today?"
C. "Tell me a story about when you were young."
D. "Sweetie, I will bring your coffee in a few minutes."
ANS: B
Simplicity of speech is recommended; use direct communication with few words. The
nurse should not assume a subservient role to the physician; there needs to be a
connection between communication, collaboration, and teamwork in the nurse-
physician relationship to provide quality care. The nurse should be assertive, expect
professional respect, and exude expertise.A female nurse discusses a concern
related to client care with a male physician. Which communication strategy, if used
by the nurse, is most effective?
A. Assume a subservient role to the physician.
B. Use a direct approach with succinct sentences.
C. Ask questions instead of making recommendations.
D. Be polite and expect politeness from the physician.
ANS: A
Different cultures prefer different degrees of closeness in personal space. Optimal
distance for a therapeutic conversation is usually 3 to 4 feet. Generally, middle-class
Americans feel uncomfortable when standing close to people they do not know well.
Latin Americans, African Americans, and the French welcome physical closeness. In
most cultures, men need more space than women do. Usually people will tolerate a
person standing close to them at their side more readily than directly in front of them.
Direct eye contact usually requires more space. Placing oneself at the same level
(e.g., sitting while the client is sitting, or standing at eye level when the client is
standing) is usually perceived as less threatening. Nurses should sit at eye level with
bedridden clients.Which patient would most likely be uncomfortable with close
personal space during an interaction with the nurse?
A. 19-year-old white female patient who is standing two feet in front of the nurse.
B. 40-year-old African-American male patient who is sitting next to the nurse.
, C. 60-year-old Latin-American female patient who is seated across from the nurse.
D. 82-year-old patient from France who is lying in bed with the nurse sitting next to
the bed.
ANS: A, D, E
Culture is the learned and shared beliefs, values, and lifeways of a particular group
that are generally transmitted intergenerationally and influence one's thinking and
actions. Ethnicity refers to the social identity and origins of a social group due largely
to language, religion, and national origin. Ethnocentrism is the universal tendency of
people rto rbelieve rthat rone's rown rrace ror rethnic rgroup ris rthe rmost rimportant rand/or
rthat rsome ror rall raspects rof rits rculture rare rsuperior rto rthose rof rother rgroups.Which
rcharacteristic rwould rthe rnurse ruse rto rdefine rculture? rSelect rall rthat rapply.
A. rLearned rand rshared rlifeways rof ra rparticular rgroup.
B. rSocial ridentity rinfluenced rby rlanguage rand rreligion.
C. rBelief rin rsuperiority rof rone's rown rethnic rgroup.
D. rValues rinfluence rboth rthinking rand ractions.
E. rSeveral rgenerations rshare rthe rsame rbeliefs.
rANS: rB
Empathy ris rfeeling rwith ra rdeep runderstanding rand rawareness rof rthe rclient's
rexperiences. rThe rnurse rshould rdevelop ra rnonjudgmental rattitude. rEvaluation rof
rfeelings rdoes rnot rconvey runderstanding ror rempathy. rSympathy rfocuses ron rthe rnurse
rand rnot rthe rpatient's rfeelings.The rnurse rcares rfor ra rpatient rwith ra rterminal rillness.
rWhich rway rwould rbe rthe rmost rtherapeutic rfor rthe rnurse rto rcommunicate rwith rthis
rpatient?
A. rUse ran rhonest, rjudgmental rattitude.
B. rDemonstrate runderstanding rwith rempathy.
C. rAcknowledge rhope rby rexpressions rof rsympathy.
D. rConsistently revaluate rthe rpatient's rfeelings.
rANS: rD
The rnurse rconveys rempathy rby roffering ra rverbal rreflection rthat ris raccurate rand
rspecific rbut ris rdelivered rin rthe rwords rof rthe rnurse rnot rthe rpatient. rNonverbal rfeatures
rof rempathy rare rjust ras rimportant ras rverbal raspects. rIt ris runrealistic rfor rthe rnurse rto
rexpect rto rcompletely rknow rand runderstand rthe rmother's rfeelings. rEmpathy rdoes rnot
rmean rrepeating rverbatim rwhat rothers rhave rsaid; rthis rmethod rmay rlead rto rirritation
rand rlessen runderstanding.The rnurse rcares rfor rthe rmother rof ra rchild rwho rdied rin rthe
remergency rroom ras ra rresult rof ran raccidental rpoisoning. rWhich rresponse rby rthe rnurse
ris rappropriate?
A. rPlace ra rgreater remphasis ron rnonverbal raspects rof rempathy rover rverbal.
B. rAccurately rreflect ron rthe rmother's rfeelings rto rconvey runderstanding rand rconcern.
C. rRepeat rexact rphrases rstated rby rthe rmother rto raid rin rexpressions rof rgrief.
D. rReflect ron rthe rexpressed rfeelings rof rthe rmother rbut rwith rthe rnurse's rown rwords.
rANS: rC
An rempathetic rresponse ris raccurate rand rspecific. rThe rword r"worry" raccurately
rreflects rverbal rand rnonverbal rcues rfrom rthe rmother. rThe rother rstatements rby rthe
rnurse rdo rnot raccurately rreflect rthe rmother's rverbal rand rnonverbal rcues.A ryoung
rmother rwho rfractured rher rleg ris rsobbing rwith rher rface rhidden rbehind rher rhands. rShe
rsays rto rthe rnurse, r"I rwill rnot rbe rable rto rwork rfor rat rleast r2 rmonths. rWithout rmy rjob, rI
AND ANSWERS UPDATED 2025
ANS: A
Nurses need to know about culture because it influences both nurses' and clients'
health care perceptions and behaviours. Nurses should learn about the culture of
diverse clients and communities. Nurses need to recognize and overcome certain
attitudes basic to the American culture. To provide culturally competent care, the
nurse must address issues of discrimination. Learning how to speak another
language is important, but it is more important to seek understanding of cultural
influences on health a non-Hispanic white nurse provides care to mostly Hispanic
patients. It would be most important for the nurse to take which action?
A. Discover cultural influences on health care perceptions and behaviours.
B. Assist the patients to adapt to American culture and health beliefs.
C. Avoid confrontation of underlying issues of discrimination.
D. Improve communication by learning how to speak Spanish.
ANS: C
The initial action that the nurse should take to learn about delivering care to diverse
clients is to become familiar with personal health care beliefs and behaviours. Self-
awareness helps nurses recognize that their beliefs and behaviours are not
necessarily common to all. Nurses' lack of knowledge about their own culture can
distort their perceptions of the beliefs and behaviours of clients from diverse cultures.
Transcultural frameworks have been developed to help nurses provide culturally
appropriate nursing care. Ethnocentrism interferes with the appreciation of diverse
cultures and their health care beliefs and behaviour . The nurse cares for diverse
clients in a community health setting. Which action should the nurse take first to
learn about delivering care to diverse clients?
A. Adopt a transcultural framework to develop culturally appropriate care.
B. Ask clients about their personal health care beliefs.
C. Develop a self-awareness of personal health care beliefs.
D. Recognize ethnocentric beliefs of minorities in the community.
ANS: B
Tripp-Reimer and Afifi (1989) suggest two processes that nurses may use to
communicate with clients from diverse cultures: cultural assessment and cultural
negotiation. Cultural assessment refers to the appraisal of a client's health beliefs
and behaviours. The information is then used to determine appropriate nursing
interventions. Cultural negotiation refers to the process of negotiating with the client
regarding differences in the lay and professional belief systems concerning
appropriate care. Information obtained from other sources (e.g., written documents,
other nurses, experts, standards) is not specific to this client's health beliefs and
behaviours. The nurse provides care to a client from Nigeria who is visiting the
United States. Which should the nurse use to communicate with this client?
,A. Review the predominant health beliefs of the Nigerian population.
B. Appraise the client's health beliefs and behaviours with a cultural assessment.
C. Consult with other nurses who have taken care of clients from other countries.
D. Use standard communication techniques to establish a helping relationship.
ANS: B
Tripp-Reimer and Afifi (1989) suggest two processes that nurses may use to
communicate with clients from diverse cultures: cultural assessment and cultural
negotiation. Cultural assessment refers to the appraisal of a client's health beliefs
and behaviours. The information is then used to determine appropriate nursing
interventions. Cultural negotiation refers to the process of negotiating with the client
regarding differences in the lay and professional belief systems concerning
appropriate care. Information obtained from other sources (e.g., written documents,
other nurses, experts, standards) is not specific to this client's health beliefs and
behaviours. The nurse provides care to a client from Nigeria who is visiting the
United States. Which should the nurse use to communicate with this client?
A. Review the predominant health beliefs of the Nigerian population.
B. Appraise the client's health beliefs and behaviours with a cultural assessment.
C. Consult with other nurses who have taken care of clients from other countries.
D. Use standard communication techniques to establish a helping relationship.
ANS: C
Professional interpreters are able to communicate medical terms and can be of
assistance in reducing the risks of breaches in patient privacy and confidentiality.
Also, information can be directly obtained from the patient. When family members or
volunteers serve as the interpreter, patients are often uncomfortable sharing
sensitive information. Family members in a stressful situation may have difficulty
being the interpreter. Although nonverbal communication is important, this method
should only be used if an interpreter is not available. The nurse needs to obtain a
health history from a Spanish-speaking patient. Which action by the nurse is best?
A. Ask a bilingual friend of the patient to interpret.
B. Use nonverbal communication and draw pictures.
C. Request a Spanish-speaking medical interpreter.
D. Interview the patient's English-speaking daughter.
ANS: B
Eye contact is often cultural; some Native Americans believe that prolonged eye
contact is rude and intrusive. However, it is important to assess each individual
patient for preferences and comfort with eye contact the nurse is interviewing a
Native American client. It is most important for the nurse to take which action?
A. Maintain eye contact to show respect and interest.
B. Assess whether the client is comfortable with eye contact.
C. Avoid prolonged eye contact with this client.
D. Sit next to the patient to avoid any eye contact.
ANS: B
It is important to call the patient by the name he or she prefers. The nurse should ask
a person how he or she prefers to be addressed, because considerable cultural
,variation exists. Most Americans are comfortable with calling people by their first
names. This is perceived by some, however, as a failure to show respect the nurse
provides care for a male patient. When the nurse addresses the patient, which would
be most appropriate?
A. Use both first and last name with each encounter.
B. Ask the patient how he prefers to be addressed.
C. Call the patient by his first name.
D. Address the patient by his last name.
ANS: D
The elderly should not be addressed using disrespectful terms such as "honey,"
"sweetheart," "gramps," and "granny" and other patronizing forms of speech. Short
term memory may decline with age; health care providers may assist patients as
needed. The elderly may express their spirituality through prayer and reading the
Bible. Sharing stories helps an elderly patient to review life and establish
meaning.The nurse observes a nursing assistant interacting with an elderly patient.
Which statement by the nursing assistant requires an immediate intervention by the
nurse?
A. "I will help you remember where your room is located."
B. "Would you like me to read from your Bible today?"
C. "Tell me a story about when you were young."
D. "Sweetie, I will bring your coffee in a few minutes."
ANS: B
Simplicity of speech is recommended; use direct communication with few words. The
nurse should not assume a subservient role to the physician; there needs to be a
connection between communication, collaboration, and teamwork in the nurse-
physician relationship to provide quality care. The nurse should be assertive, expect
professional respect, and exude expertise.A female nurse discusses a concern
related to client care with a male physician. Which communication strategy, if used
by the nurse, is most effective?
A. Assume a subservient role to the physician.
B. Use a direct approach with succinct sentences.
C. Ask questions instead of making recommendations.
D. Be polite and expect politeness from the physician.
ANS: A
Different cultures prefer different degrees of closeness in personal space. Optimal
distance for a therapeutic conversation is usually 3 to 4 feet. Generally, middle-class
Americans feel uncomfortable when standing close to people they do not know well.
Latin Americans, African Americans, and the French welcome physical closeness. In
most cultures, men need more space than women do. Usually people will tolerate a
person standing close to them at their side more readily than directly in front of them.
Direct eye contact usually requires more space. Placing oneself at the same level
(e.g., sitting while the client is sitting, or standing at eye level when the client is
standing) is usually perceived as less threatening. Nurses should sit at eye level with
bedridden clients.Which patient would most likely be uncomfortable with close
personal space during an interaction with the nurse?
A. 19-year-old white female patient who is standing two feet in front of the nurse.
B. 40-year-old African-American male patient who is sitting next to the nurse.
, C. 60-year-old Latin-American female patient who is seated across from the nurse.
D. 82-year-old patient from France who is lying in bed with the nurse sitting next to
the bed.
ANS: A, D, E
Culture is the learned and shared beliefs, values, and lifeways of a particular group
that are generally transmitted intergenerationally and influence one's thinking and
actions. Ethnicity refers to the social identity and origins of a social group due largely
to language, religion, and national origin. Ethnocentrism is the universal tendency of
people rto rbelieve rthat rone's rown rrace ror rethnic rgroup ris rthe rmost rimportant rand/or
rthat rsome ror rall raspects rof rits rculture rare rsuperior rto rthose rof rother rgroups.Which
rcharacteristic rwould rthe rnurse ruse rto rdefine rculture? rSelect rall rthat rapply.
A. rLearned rand rshared rlifeways rof ra rparticular rgroup.
B. rSocial ridentity rinfluenced rby rlanguage rand rreligion.
C. rBelief rin rsuperiority rof rone's rown rethnic rgroup.
D. rValues rinfluence rboth rthinking rand ractions.
E. rSeveral rgenerations rshare rthe rsame rbeliefs.
rANS: rB
Empathy ris rfeeling rwith ra rdeep runderstanding rand rawareness rof rthe rclient's
rexperiences. rThe rnurse rshould rdevelop ra rnonjudgmental rattitude. rEvaluation rof
rfeelings rdoes rnot rconvey runderstanding ror rempathy. rSympathy rfocuses ron rthe rnurse
rand rnot rthe rpatient's rfeelings.The rnurse rcares rfor ra rpatient rwith ra rterminal rillness.
rWhich rway rwould rbe rthe rmost rtherapeutic rfor rthe rnurse rto rcommunicate rwith rthis
rpatient?
A. rUse ran rhonest, rjudgmental rattitude.
B. rDemonstrate runderstanding rwith rempathy.
C. rAcknowledge rhope rby rexpressions rof rsympathy.
D. rConsistently revaluate rthe rpatient's rfeelings.
rANS: rD
The rnurse rconveys rempathy rby roffering ra rverbal rreflection rthat ris raccurate rand
rspecific rbut ris rdelivered rin rthe rwords rof rthe rnurse rnot rthe rpatient. rNonverbal rfeatures
rof rempathy rare rjust ras rimportant ras rverbal raspects. rIt ris runrealistic rfor rthe rnurse rto
rexpect rto rcompletely rknow rand runderstand rthe rmother's rfeelings. rEmpathy rdoes rnot
rmean rrepeating rverbatim rwhat rothers rhave rsaid; rthis rmethod rmay rlead rto rirritation
rand rlessen runderstanding.The rnurse rcares rfor rthe rmother rof ra rchild rwho rdied rin rthe
remergency rroom ras ra rresult rof ran raccidental rpoisoning. rWhich rresponse rby rthe rnurse
ris rappropriate?
A. rPlace ra rgreater remphasis ron rnonverbal raspects rof rempathy rover rverbal.
B. rAccurately rreflect ron rthe rmother's rfeelings rto rconvey runderstanding rand rconcern.
C. rRepeat rexact rphrases rstated rby rthe rmother rto raid rin rexpressions rof rgrief.
D. rReflect ron rthe rexpressed rfeelings rof rthe rmother rbut rwith rthe rnurse's rown rwords.
rANS: rC
An rempathetic rresponse ris raccurate rand rspecific. rThe rword r"worry" raccurately
rreflects rverbal rand rnonverbal rcues rfrom rthe rmother. rThe rother rstatements rby rthe
rnurse rdo rnot raccurately rreflect rthe rmother's rverbal rand rnonverbal rcues.A ryoung
rmother rwho rfractured rher rleg ris rsobbing rwith rher rface rhidden rbehind rher rhands. rShe
rsays rto rthe rnurse, r"I rwill rnot rbe rable rto rwork rfor rat rleast r2 rmonths. rWithout rmy rjob, rI
