NUR 117 – Communication in Nursing | Professional
Nursing Communication Study Guide, Therapeutic
Communication, Patient Interaction, Documentation,
and Examination Success
1. A nurse is caring for a patient who has just received a terminal diagnosis.
The patient states, "I can't believe this is happening to me. Why me?" Which
response by the nurse demonstrates the most therapeutic communication?
A. "Everything happens for a reason."
B. "I can see that you're struggling with this news. Tell me more about what
you're feeling."
C. "You need to stay positive."
D. "I understand exactly how you feel."
Rationale: The correct response uses empathy and open-ended questioning to
encourage the patient to express their feelings. It validates the patient's emotions
and invites further communication. Options A and C are false reassurance and
dismiss the patient's feelings. Option D uses inappropriate self-disclosure by
claiming to understand exactly how the patient feels.
2. A nurse is communicating with a patient from a different cultural
background. Which action best demonstrates culturally competent
communication?
A. Speaking loudly and slowly.
B. Avoiding eye contact.
C. Using a certified medical interpreter and asking about the patient's
communication preferences.
D. Assuming the patient understands English.
Rationale: Culturally competent communication involves using a certified
medical interpreter when needed and asking about the patient's communication
preferences. Speaking loudly, avoiding eye contact, and assuming English
proficiency can be disrespectful and ineffective. This demonstrates patient-
centered care and respect for cultural diversity.
3. A patient is crying and appears upset. The nurse sits down at the patient's
bedside and remains silent for a few minutes. This technique is known as:
A. Therapeutic silence
,B. Active listening
C. Empathy
D. Nonverbal communication
Rationale: Therapeutic silence involves sitting quietly with the patient, allowing
them time to process their emotions and collect their thoughts. It communicates
presence and respect without pressuring the patient to speak. This is a powerful
therapeutic communication technique, especially during times of emotional
distress.
4. A nurse is preparing to provide education to a patient with low health
literacy. Which action is most appropriate?
A. Use complex medical terminology.
B. Provide all information in writing.
C. Use simple language, teach back, and provide visual aids.
D. Give the patient a pamphlet to read alone.
Rationale: For patients with low health literacy, the nurse should use simple
language, avoid medical jargon, use the teach-back method to confirm
understanding, and provide visual aids. Providing written information alone may
not be effective. This demonstrates health literacy-sensitive communication.
5. A patient states, "I don't want to take this medication anymore. It makes
me feel sick." Which response by the nurse is most therapeutic?
A. "You need to take it anyway."
B. "Tell me more about how the medication is making you feel."
C. "The doctor knows best."
D. "You can stop taking it if you want."
Rationale: The correct response uses an open-ended question to explore the
patient's concerns about the medication. This demonstrates active listening and
validates the patient's experience. It also provides the nurse with important
information about potential side effects that need to be addressed.
6. A nurse is communicating with a patient who is deaf. Which action is most
appropriate?
A. Speak loudly and directly into the patient's ear.
B. Use a qualified sign language interpreter or written communication.
C. Ask a family member to interpret.
D. Avoid communicating with the patient.
,Rationale: The nurse should use a qualified sign language interpreter or written
communication to communicate effectively with a patient who is deaf. Family
members should not be used as interpreters unless the patient specifically requests
it, as this raises confidentiality and accuracy concerns.
7. A patient tells the nurse, "I'm so scared about my surgery tomorrow."
Which response is an example of reflecting?
A. "You shouldn't be scared. The surgery is routine."
B. "You're feeling scared about tomorrow's surgery."
C. "Tell me about your previous surgeries."
D. "The surgeon is excellent."
Rationale: Reflecting involves restating the patient's feelings or message to
confirm understanding and encourage further expression. Option B reflects the
patient's statement back to them. Option A uses false reassurance. Option C uses
focusing. Option D uses giving advice.
8. A nurse is providing education to a patient about a new diagnosis. Which
action demonstrates effective patient education?
A. Providing all information at once.
B. Using the teach-back method to confirm understanding.
C. Speaking in a loud voice.
D. Providing information quickly to avoid overwhelming the patient.
Rationale: The teach-back method involves asking the patient to explain the
information back to the nurse in their own words to confirm understanding. This is
a key strategy for effective patient education and health literacy-sensitive
communication.
9. A patient is angry and yelling at the nurse. Which response is most
therapeutic?
A. "Calm down right now."
B. "I'm not going to talk to you when you're angry."
C. "I can see you're upset. Let's talk about what's bothering you."
D. "You have no right to speak to me that way."
Rationale: The correct response acknowledges the patient's emotion (validation)
and invites the patient to discuss the underlying concern. This de-escalates the
situation and promotes therapeutic communication. Telling the patient to calm
down or threatening to leave is confrontational.
, 10. A nurse is documenting in the patient's medical record. Which
documentation is most appropriate?
A. "Patient was uncooperative."
B. "Patient refused to take medication. Patient stated, 'I don't want to take it
right now.' Education provided on importance of medication."
C. "Patient is angry and rude."
D. "Patient is non-compliant."
Rationale: Documentation should be objective, factual, and non-judgmental.
Option B provides a factual account of the patient's refusal, quotes the patient, and
documents the nurse's interventions. Options A, C, and D are subjective and
judgmental.
11. A nurse is caring for a patient who is anxious about a procedure. Which
intervention is most appropriate to reduce anxiety?
A. Provide extensive details about the procedure.
B. Explain the procedure in simple terms and allow time for questions.
C. Tell the patient not to worry.
D. Leave the patient alone to calm down.
Rationale: Providing simple, clear explanations about the procedure and allowing
time for questions helps reduce anxiety by addressing uncertainty. Extensive
details may increase anxiety. False reassurance and leaving the patient alone are
not therapeutic.
12. A patient states, "I think I'm just going to die anyway." Which response
by the nurse is most therapeutic?
A. "Don't talk like that."
B. "You sound like you're feeling hopeless. What makes you feel that way?"
C. "Everything will be fine."
D. "You need to think positively."
Rationale: The correct response acknowledges the patient's feelings and uses an
open-ended question to explore their concerns. This validates the patient's
emotions and allows for further exploration of potential suicidal ideation or
hopelessness.
13. A nurse is using active listening with a patient. Which action demonstrates
active listening?
A. Interrupting to ask clarifying questions.
Nursing Communication Study Guide, Therapeutic
Communication, Patient Interaction, Documentation,
and Examination Success
1. A nurse is caring for a patient who has just received a terminal diagnosis.
The patient states, "I can't believe this is happening to me. Why me?" Which
response by the nurse demonstrates the most therapeutic communication?
A. "Everything happens for a reason."
B. "I can see that you're struggling with this news. Tell me more about what
you're feeling."
C. "You need to stay positive."
D. "I understand exactly how you feel."
Rationale: The correct response uses empathy and open-ended questioning to
encourage the patient to express their feelings. It validates the patient's emotions
and invites further communication. Options A and C are false reassurance and
dismiss the patient's feelings. Option D uses inappropriate self-disclosure by
claiming to understand exactly how the patient feels.
2. A nurse is communicating with a patient from a different cultural
background. Which action best demonstrates culturally competent
communication?
A. Speaking loudly and slowly.
B. Avoiding eye contact.
C. Using a certified medical interpreter and asking about the patient's
communication preferences.
D. Assuming the patient understands English.
Rationale: Culturally competent communication involves using a certified
medical interpreter when needed and asking about the patient's communication
preferences. Speaking loudly, avoiding eye contact, and assuming English
proficiency can be disrespectful and ineffective. This demonstrates patient-
centered care and respect for cultural diversity.
3. A patient is crying and appears upset. The nurse sits down at the patient's
bedside and remains silent for a few minutes. This technique is known as:
A. Therapeutic silence
,B. Active listening
C. Empathy
D. Nonverbal communication
Rationale: Therapeutic silence involves sitting quietly with the patient, allowing
them time to process their emotions and collect their thoughts. It communicates
presence and respect without pressuring the patient to speak. This is a powerful
therapeutic communication technique, especially during times of emotional
distress.
4. A nurse is preparing to provide education to a patient with low health
literacy. Which action is most appropriate?
A. Use complex medical terminology.
B. Provide all information in writing.
C. Use simple language, teach back, and provide visual aids.
D. Give the patient a pamphlet to read alone.
Rationale: For patients with low health literacy, the nurse should use simple
language, avoid medical jargon, use the teach-back method to confirm
understanding, and provide visual aids. Providing written information alone may
not be effective. This demonstrates health literacy-sensitive communication.
5. A patient states, "I don't want to take this medication anymore. It makes
me feel sick." Which response by the nurse is most therapeutic?
A. "You need to take it anyway."
B. "Tell me more about how the medication is making you feel."
C. "The doctor knows best."
D. "You can stop taking it if you want."
Rationale: The correct response uses an open-ended question to explore the
patient's concerns about the medication. This demonstrates active listening and
validates the patient's experience. It also provides the nurse with important
information about potential side effects that need to be addressed.
6. A nurse is communicating with a patient who is deaf. Which action is most
appropriate?
A. Speak loudly and directly into the patient's ear.
B. Use a qualified sign language interpreter or written communication.
C. Ask a family member to interpret.
D. Avoid communicating with the patient.
,Rationale: The nurse should use a qualified sign language interpreter or written
communication to communicate effectively with a patient who is deaf. Family
members should not be used as interpreters unless the patient specifically requests
it, as this raises confidentiality and accuracy concerns.
7. A patient tells the nurse, "I'm so scared about my surgery tomorrow."
Which response is an example of reflecting?
A. "You shouldn't be scared. The surgery is routine."
B. "You're feeling scared about tomorrow's surgery."
C. "Tell me about your previous surgeries."
D. "The surgeon is excellent."
Rationale: Reflecting involves restating the patient's feelings or message to
confirm understanding and encourage further expression. Option B reflects the
patient's statement back to them. Option A uses false reassurance. Option C uses
focusing. Option D uses giving advice.
8. A nurse is providing education to a patient about a new diagnosis. Which
action demonstrates effective patient education?
A. Providing all information at once.
B. Using the teach-back method to confirm understanding.
C. Speaking in a loud voice.
D. Providing information quickly to avoid overwhelming the patient.
Rationale: The teach-back method involves asking the patient to explain the
information back to the nurse in their own words to confirm understanding. This is
a key strategy for effective patient education and health literacy-sensitive
communication.
9. A patient is angry and yelling at the nurse. Which response is most
therapeutic?
A. "Calm down right now."
B. "I'm not going to talk to you when you're angry."
C. "I can see you're upset. Let's talk about what's bothering you."
D. "You have no right to speak to me that way."
Rationale: The correct response acknowledges the patient's emotion (validation)
and invites the patient to discuss the underlying concern. This de-escalates the
situation and promotes therapeutic communication. Telling the patient to calm
down or threatening to leave is confrontational.
, 10. A nurse is documenting in the patient's medical record. Which
documentation is most appropriate?
A. "Patient was uncooperative."
B. "Patient refused to take medication. Patient stated, 'I don't want to take it
right now.' Education provided on importance of medication."
C. "Patient is angry and rude."
D. "Patient is non-compliant."
Rationale: Documentation should be objective, factual, and non-judgmental.
Option B provides a factual account of the patient's refusal, quotes the patient, and
documents the nurse's interventions. Options A, C, and D are subjective and
judgmental.
11. A nurse is caring for a patient who is anxious about a procedure. Which
intervention is most appropriate to reduce anxiety?
A. Provide extensive details about the procedure.
B. Explain the procedure in simple terms and allow time for questions.
C. Tell the patient not to worry.
D. Leave the patient alone to calm down.
Rationale: Providing simple, clear explanations about the procedure and allowing
time for questions helps reduce anxiety by addressing uncertainty. Extensive
details may increase anxiety. False reassurance and leaving the patient alone are
not therapeutic.
12. A patient states, "I think I'm just going to die anyway." Which response
by the nurse is most therapeutic?
A. "Don't talk like that."
B. "You sound like you're feeling hopeless. What makes you feel that way?"
C. "Everything will be fine."
D. "You need to think positively."
Rationale: The correct response acknowledges the patient's feelings and uses an
open-ended question to explore their concerns. This validates the patient's
emotions and allows for further exploration of potential suicidal ideation or
hopelessness.
13. A nurse is using active listening with a patient. Which action demonstrates
active listening?
A. Interrupting to ask clarifying questions.
