Which of the following response(s) is/are NOT forbidden during therapeutic communication?

NVS Staff Nurse - 2019

Nursing Foundation

Easy

Appeared in: NVS Staff Nurse - 2019

Explanation

The question asks for the response that is NOT forbidden, which means it is looking for a therapeutic (allowed) communication technique.
Reflecting and clarifying are foundational therapeutic communication techniques used by nurses.
Reflecting involves repeating the patient's main thought or feeling to show understanding and encourage further exploration. For example, 'You seem worried about the test results.'.
Clarifying involves asking for more information to ensure the nurse accurately understands the patient's message, preventing misunderstandings. For example, 'I'm not sure I follow. Could you explain what you mean by that?'.
Both techniques empower the patient, demonstrate active listening, and build a trusting nurse-patient relationship.

Option A: Arguing with or judging a patient is a major barrier to communication. It invalidates the patient's feelings, creates defensiveness, and destroys trust.
Option B: Giving personal advice is non-therapeutic because it takes decision-making power away from the patient, implies the nurse knows best, and can lead to blame if the advice doesn't work. It is different from providing health information or options.
Option D: While not as strictly forbidden as arguing, asking close-ended questions (which elicit a 'yes' or 'no' answer) is generally discouraged in therapeutic communication because it limits the patient's ability to express themselves. Open-ended questions are preferred to explore feelings and concerns.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Therapeutic vs. Non-Therapeutic Communication Techniques as background academic context rather than a clinical decision trigger.
Effective therapeutic communication is a cornerstone of nursing practice. It is essential for building trust, gathering accurate assessment data, providing patient education, and delivering holistic, patient-centered care.
Using therapeutic techniques like reflecting and clarifying shows respect for the patient as an individual, which can increase their satisfaction with care and adherence to treatment plans.
What if? If a patient is from a different cultural background, the nurse must be even more mindful. While reflecting and clarifying are generally universal, the nurse should pay close attention to non-verbal cues and may need to clarify the meaning of certain phrases or gestures to avoid cultural misunderstandings.

How to Approach the Question

First, analyze the question's lead-in. The phrase 'NOT forbidden' is a double negative, which simplifies to 'allowed' or 'permitted'. The question is asking which of the options is a correct, therapeutic communication technique.
Next, evaluate each option based on the principles of therapeutic communication.
Option A, 'Arguing and judgmental response,' is clearly a communication barrier and non-therapeutic. Eliminate this.
Option B, 'Giving advice,' is a classic non-therapeutic technique that undermines patient autonomy. Eliminate this.
Option D, 'Asking close-ended questions,' is a technique that should be used sparingly as it limits patient expression. It's not a primary therapeutic tool for exploration.
Option C, 'Reflecting and clarifying,' are well-known, core therapeutic techniques that facilitate communication and understanding.

Concept Tested & Keywords

Concept Tested: Therapeutic vs. Non-Therapeutic Communication Techniques
Stem keywords: therapeutic communication, forbidden
Lead-in keywords: NOT
Negative lead-in flag: The question uses negative framing ('NOT forbidden'), asking for the response that IS appropriate.

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