Select the Correct Response

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So, how do you select the correct response? By choosing from the answer choices that are left! The correct response will usually contain one or both of the following elements:

• Gives correct information. Offering information encourages further communication from the client. Examples of giving correct information include:
  • “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.”
• Is empathetic and reflects the client’s feelings. Empathy is the ability to perceive what another person experiences using that person’s frame of reference. Reflection communicates to the client that the LPN/LVN has heard and understands what the client is trying to communicate. When reflecting feelings, the LPN/LVN focuses on the feelings and not the content of what is said. Examples of empathetic, reflective statements include:
  • “I can see that you are frightened about being here.”
  • “You seem very upset. Tell me how you’re feeling.”

Let’s practice with a few exam-style questions.

1. A client is admitted to the telemetry unit with a diagnosis of acute myocardial infarction. The client tells the LPN/LVN, “I’m scared, I think I’m going to die.” Which of the following responses by the LPN/LVN would be most appropriate?
   1. “Everything is going to be fine. We’ll take good care of you.”
   2. “I know what you mean. I thought I was having a heart attack once.”
   3. “I’ll call your primary health care provider so you can discuss it.”
   4. “It’s normal to feel frightened. We’re doing everything we can for you.”

Step 1. Eliminate incorrect answer choices.

1. This is a “don’t worry” response. There is no acknowledgment of the client’s fears. Eliminate it.
2. The focus of this response is on the LPN/LVN, not the client. Eliminate it.
3. It is within the scope of nursing practice for the LPN/LVN to respond to the client’s feelings. Don’t pass the responsibility to the primary health care provider. Eliminate it.
4. This answer choice responds to feelings and provides information. Keep it in consideration.

Step 2. Select an answer from the remaining choices.

One answer was not eliminated: (4). This is the correct answer. The LPN/LVN both acknowledges that the client feels frightened and provides information.

Let’s try another question.

1. A client is to undergo a breast biopsy. The client tells the LPN/LVN, “If I lose my breast, I know my husband will no longer find me attractive.” Which of the following responses by the LPN/LVN would be most appropriate?
   1. “You don’t know if you are going to lose your breast. They are just doing the biopsy now.”
   2. “You should focus on your children right now. They are young and they need you.”
   3. “You seem to be concerned that your relationship with your husband might change.”
   4. “Why don’t you wait and see what your husband’s reaction is before you get upset.”

Step 1. Eliminate answer choices.

1. This response gives false reassurance and discounts the client’s feelings. Eliminate it.
2. This response is authoritarian: the LPN/LVN tells the client what to do. Eliminate it.
3. This response reflects the fears of the client. The response is open-ended and allows the client to express what she is feeling. Keep it in for consideration.
4. This response dismisses the feelings that the client is experiencing and gives advice. Eliminate it.

Step 2. Select an answer from the remaining choices.

You have eliminated three of the four answer choices. The correct answer is the only answer choice remaining, (3).

Let’s look at one more question.

1. A client in the psychiatric unit asks the LPN/LVN, “Am I in a special radioactive shelter? When was it last checked for radioactivity?” Which of the following responses by the LPN/LVN would be most appropriate?
   1. “This is a hospital, and we do not have a nuclear medicine department here.”
   2. “Don’t worry, you’re safe. There’s no radioactivity here.”
   3. “I’m sure your safety is of concern to you, but this is a hospital.”
   4. “Please share with me what makes you think there is radioactivity here.”

Step 1. Eliminate answer choices.

1. This response provides information. Leave it in for consideration.
2. This response offers false reassurances. Eliminate it.
3. This response reflects the client’s concern about safety and provides information. Keep it in for consideration.
4. This response allows the client to verbalize, but you don’t want to encourage a client with psychological problems to talk about hallucinations or delusions. Rather, you want your discussion to focus on the feelings that accompany them. Eliminate this choice.

Step 2. Select an answer from the remaining choices.

You have more than one possible answer choice: (1) and (3). Look for the answer choice that reflects feelings and gives information. The correct answer is (3).

Some things to remember about selecting correct answers to therapeutic communication questions are:

• No matter how confident you are about an answer choice, read all of the choices before selecting an answer.
• Even if you would never say any of the responses given in the answer choices, choose the “textbook” answer.
• When you first read the answer choices, don’t look for the correct answer. Always eliminate answer choices first.

If you follow the Kaplan strategies for therapeutic communication, you will be able to select the correct answers to this question type on the NCLEX-PN^® exam.