# During separate supportive interviews, classify the dominant purpose of each nurse response in its preceding dialogue. Here reflection means returning a decision to the client to support their own problem-solving; clarification resolves an unclear meaning; focusing explores one already identified concern. Classify each exchange once. Several exchanges may share a category; no category quota is provided.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=569393&lang=en  
> language: en  
> subject: Therapeutic Communication  
> category: PSI

## Question

During separate supportive interviews, classify the dominant purpose of each nurse response in its preceding dialogue. Here reflection means returning a decision to the client to support their own problem-solving; clarification resolves an unclear meaning; focusing explores one already identified concern. Classify each exchange once. Several exchanges may share a category; no category quota is provided.

**1.** Client: The medicine makes me feel strange. Nurse: When you say strange, what change do you notice in your body or thoughts?

Select a category
Focusing
Clarification
Reflection of a decision

**2.** Client describes poor sleep, family conflict and fear of discharge. Nurse: You mentioned being afraid to go home; tell me more about that concern.

Select a category
Focusing
Clarification
Reflection of a decision

**3.** Client: Should I ask my sister to join the meeting? Nurse: What would involving your sister mean for the support you want?

Select a category
Focusing
Clarification
Reflection of a decision

**4.** Client: I cannot manage anymore. Nurse: What are you referring to when you say you cannot manage?

Select a category
Focusing
Clarification
Reflection of a decision

**5.** Client: Which of these coping activities should I choose tonight? Nurse: Which has helped you feel more in control before?

Select a category
Focusing
Clarification
Reflection of a decision

**6.** Client has clearly described panic during bus journeys, then changes subjects. Nurse: Let us return to what happens just before the panic on the bus.

Select a category
Focusing
Clarification
Reflection of a decision

**7.** Client: Do you think I should tell my partner about treatment? Nurse: What advantages and concerns do you see in sharing that information?

Select a category
Focusing
Clarification
Reflection of a decision

## Explanation

Clarification: exchanges 1 and 4. Focusing: exchanges 2 and 6. Reflection of a decision: exchanges 3, 5 and 7. The same open-ended sentence form can serve different purposes. The preceding client statement determines whether the nurse is defining a vague expression, choosing a topic for exploration, or supporting the client to weigh a decision.

## In-depth explanation

Correct answer
Clarification: exchanges 1 and 4. Focusing: exchanges 2 and 6. Reflection of a decision: exchanges 3, 5 and 7.

Why this is correct
The same open-ended sentence form can serve different purposes. The preceding client statement determines whether the nurse is defining a vague expression, choosing a topic for exploration, or supporting the client to weigh a decision.

Clinical picture
Therapeutic communication keeps the client involved rather than replacing their judgment with the nurse's personal advice. In an immediate safety crisis, supportive exploration would accompany the necessary safety response rather than delay it.

Memory hook
Meaning, topic, decision: determine what the nurse is helping the client work on. These are functional distinctions, not keywords to memorize.

NCLEX decision rule
Classify the dominant purpose within the dialogue. Do not label every open-ended question as the same technique, and do not infer a technique from wording without the preceding statement.

Why the alternatives are wrong
Exchange 1 seeks the meaning of strange; it does not select an already understood symptom for deeper discussion. Exchange 2 selects discharge fear from several established topics. Exchange 3 returns a request for advice to the client's own support goals. Exchange 4 clarifies what cannot manage refers to. Exchange 5 invites the client to choose using prior experience rather than prescribing a coping activity. Exchange 6 deliberately returns to a clear panic-related topic rather than asking what panic means. Exchange 7 helps the client weigh disclosure, rather than deciding for them. The operational definition of reflection is stated because texts use that label in more than one way.

Sources
Open RN therapeutic communication

## Clinical scenario

Practice transfer: Therapeutic communication keeps the client involved rather than replacing their judgment with the nurse's personal advice. In an immediate safety crisis, supportive exploration would accompany the necessary safety response rather than delay it.

## Key concepts

- **Clarification** — Seeking a more precise understanding of the client's intended meaning.
- **Focusing** — Selecting a relevant topic for further exploration.
- **Autonomy** — The client's ability to participate in decisions about their own life and care.

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