NCLEX-PN Test #17 1 — Questions and Answers
Question 1: A patient who was recently diagnosed with cancer says, 'I don't know why I should bother with treatment. I'm going to die anyway.' Which response by the nurse is most therapeutic?
- 'You shouldn't think that way — many people beat cancer.'
- 'I understand how you feel. My aunt had cancer too.'
- 'It sounds like you're feeling hopeless about your diagnosis. Tell me more about what you're thinking.' (Correct answer)
- 'You need to stay positive. A negative attitude won't help your recovery.'
Correct answer: 'It sounds like you're feeling hopeless about your diagnosis. Tell me more about what you're thinking.'
Reflecting the patient's emotions and using an open-ended statement invites the patient to express their feelings more fully — a core therapeutic communication technique. Telling the patient not to think a certain way is dismissive. Sharing a personal story shifts focus from the patient. Demanding positivity minimizes the patient's distress.
Question 2: A nurse asks a patient, 'How are you feeling today?' The patient does not respond verbally but looks away and sighs deeply. What is the nurse's best action?
- Repeat the question more loudly in case the patient did not hear
- Document that the patient refused to communicate
- Acknowledge the nonverbal cues: 'You seem troubled — would you like to talk?' (Correct answer)
- Leave the room to give the patient privacy
Correct answer: Acknowledge the nonverbal cues: 'You seem troubled — would you like to talk?'
Acknowledging nonverbal communication and gently offering an opportunity to talk demonstrates empathy and respects the patient's cues. Looking away and sighing deeply may indicate distress, sadness, or reluctance to communicate that deserves attention, not avoidance.
Question 3: A nurse is performing patient teaching about a new insulin regimen. The patient frequently says 'Yes, I understand.' Which action by the nurse best evaluates comprehension?
- Accept the patient's verbal confirmation and document teaching done
- Ask the patient to demonstrate the injection technique and explain the process (Correct answer)
- Provide written handouts and ask the patient to read them
- Repeat the instructions in simpler language
Correct answer: Ask the patient to demonstrate the injection technique and explain the process
The 'teach-back' method — asking the patient to demonstrate a skill or explain the information in their own words — is the gold standard for evaluating health teaching comprehension. Verbal 'yes' responses do not confirm understanding.
Question 4: A nurse caring for a patient who is crying and upset begins by saying, 'Don't worry — everything will be fine.' Which communication error has occurred?
- Using medical jargon
- Offering false reassurance (Correct answer)
- Asking a leading question
- Failing to maintain eye contact
Correct answer: Offering false reassurance
Saying 'everything will be fine' without knowing the outcome is false reassurance — a non-therapeutic communication technique that dismisses the patient's legitimate concerns and can damage trust. The nurse should instead acknowledge the patient's feelings and explore their concerns.
Question 5: A nurse is working with a patient who speaks limited English. Which approach is most appropriate for effective communication?
- Speak loudly and slowly so the patient can understand
- Ask the patient's family member to interpret all clinical information
- Request a trained medical interpreter for all significant communications (Correct answer)
- Use gestures only, since verbal communication may cause confusion
Correct answer: Request a trained medical interpreter for all significant communications
A trained medical interpreter must be used for significant clinical communications to ensure accuracy and protect patient confidentiality. Family members may omit, misinterpret, or alter information, especially sensitive findings. Speaking loudly does not aid comprehension for language barriers.
Question 6: A patient with a new amputation tells the nurse, 'I just want to be left alone.' What is the nurse's best therapeutic response?
- Respect the patient's request completely and check back at end of shift
- 'I understand you need space. I'll be back in 10 minutes to check on you.' (Correct answer)
- 'You really need to talk to someone — shall I call the chaplain?'
- 'That is not an option — you need your scheduled care right now.'
Correct answer: 'I understand you need space. I'll be back in 10 minutes to check on you.'
Acknowledging the patient's need for privacy while setting a short specific check-back time balances therapeutic presence with respect for autonomy. This prevents the patient from feeling abandoned while honoring their expressed need. Completely leaving without follow-up could be unsafe for a patient adjusting to a significant loss.
NCLEX-PN Test #17 1
A patient who was recently diagnosed with cancer says, 'I don't know why I should bother with treatment.
I'm going to die anyway.' Which response by the nurse is most therapeutic?