1. Therapeutic Communication
NCLEX Strategies
Therapeutic Communication

2. Eliminate the Wrong Choices!
Authoritarian Answers
Close-Ended Questions
“Why” Responses
“Let’s Explore” Responses
“Don’t Worry” Statements
Nurse-Focused Answers

3. Eliminate the Wrong Choices!
Authoritarian Answers
Nurse tells the patient what to do without regard to the patient’s desires or feelings
Insisting the patient follow unit rules
Insisting that the patient does what the nurse commands, immediately

4. Eliminate the Wrong Choices!
Close-Ended Questions
answered with one word, usually yes or no
discourage client from sharing thoughts and feelings
“Are you feeling guilty about what happened?”
“How many children do you have?”

5. Eliminate the Wrong Choices!
“Why” Questions
seek reasons or justification
implies disapproval of patient
causes patient to become defensive
“What makes you think that?”
“Why do you feel that way?”

6. Eliminate the Wrong Choices!
“Let’s Explore” Questions
Not nurses role to find out reasons why the patient is feeling a certain way
Pt must be allowed to verbalize the fact that he or she is feeling sad, angry, fearful, overwhelmed etc.
“Let’s talk about why you didn’t take your medication
“Tell me the reason why you injured yourself”

7. Eliminate the Wrong Choices!
Don’t Worry Statements
Offer false reassurance
Discourage communication by not allowing the patient to express ideas and feelings
Discounts/devalues what patient is saying
“It’s going to be OK.”
“Don’t worry. Your doctors will do everything necessary for your care

8. Eliminate the Wrong Choices!
Nurse-Focused Answers
Focus is on the client, not the nurse
Be careful, these choices sound empathetic
“That happened to me once”
“I know from experience this is difficult for you.”

9. Choose Whatever Response is Left!!
The correct response will contain one or both of the following
GIVE CORRECT INFORMATION
BE EMPATHETIC AND REFLECT THE PATIENT’S FEELINGS

10. The Correct Response GIVE CORRECT INFORMATION
Encourages further communication
“You are experiencing acute alcohol withdrawal; you may see and feel things that aren’t real.”
“There are many reasons for memory loss; tell me more about what you have noticed.”

11. The Correct Response BE EMPATHETIC AND REFLECT THE PATIENT’S FEELINGS
Empathy is the ability to perceive what another person experiences using that person’s frame of reference
Reflection communicates to the patient that the nurse has heard and understands what the what the patient is trying to communicate
Nurse focuses on the feelings and not on the content of what is said

12. The Correct Response Examples of empathetic, reflective statements
“ I can see that you are frightened about being here:
“You seem very upset. Tell me how you are feeling.”

13. Remember!!
No matter how confident you are about an answer choice, READ ALL THE CHOICES BEFORE SELECTING A RESPONSE
Even if you would never say any of the responses choose the “textbook” answer
When you first read the responses, don’t look for the correct response. Always eliminate incorrect answers first.