| Course | NR 326 Mental Health Nursing |
|---|---|
| Week | 2 |
| Paper type | Therapeutic communication exercise |
| Length | About 1,130 words, 6 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 326 Week 2
Therapeutic Communication Exercise: Five Nurse Responses on an Adult Inpatient Unit, Each Diagnosed Before It Is Repaired
Student Name
College of Nursing, Chamberlain University
NR 326: Mental Health Nursing
Instructor Name
Month Day, Year
Therapeutic Communication Exercise: Five Nurse Responses on an Adult Inpatient Unit, Each Diagnosed Before It Is Repaired
The Exercise
The exercise issues five short exchanges from an adult inpatient psychiatric unit, each ending in a nurse response that closed the conversation. For each one I quote the original exactly, say what it did to the conversation, give a replacement written the way I would say it standing in a hallway, and match it to a technique from the reading only where the technique describes what the new sentence actually does. One pair is kept as a near miss: a replacement that improves on the original but still falls short, with the reason.
Hartley et al. (2020) reviewed studies that tried to improve the relationship between mental health nurses and patients and found only eight that measured it, with mixed results and mostly weak designs. That is a reason to be modest about any single phrasing. A sentence does not build a relationship; it can only keep a conversation open long enough for one to begin. The standard applied to each replacement below is narrower and easier to test: could the patient still answer it in a single word?
Pair 1: The Question That Asks for a Yes
Situation. Mr. B., 44, admitted after an overdose, is sitting on his bed at 1000 with his breakfast untouched.
Original. "Are you feeling okay this morning?"
What it did. It invited one word. Most people asked whether they are okay say yes, especially to someone they have just met, and a patient who has survived an overdose may say yes precisely because the true answer is hard to begin. The question also carried its own preferred answer, since okay is the word the nurse is hoping to hear.
Replacement. "How has this morning been for you so far?"
Technique. A broad opening question. It asks for a description of a period of time rather than a verdict on a state, so the smallest honest answer is a sentence.
Pair 2: The Subject Moved Onto the Nurse
Situation. Ms. L., 29, admitted with depression after her divorce, says: "I keep thinking I wrecked my whole life."
Original. "I went through a divorce too, and it does get better, I promise."
What it did. Two things, both closing. The first half moved the conversation onto the nurse, so the next natural thing for Ms. L. to say is something about the nurse's divorce. The second half offered reassurance the nurse cannot know to be true, before Ms. L. has said what "wrecked" means to her.
Replacement. "Wrecked is a strong word. What does it mean for you right now?"
Technique. Restating her own word back to her, followed by a request for clarification. The word stays hers, and the question asks her to fill it in.
Pair 3: Comfort Arriving Too Early
Situation. Mr. W., 67, admitted with a first episode of psychotic depression, says quietly at the medication window: "My wife would be ashamed of me being in here."
Original. "Don't say that. I'm sure she'd just want you to get better."
What it did. It told him not to say the thing he had just said, and then answered for his wife. Both halves are kind in intent, and both close the subject. It also missed a question the nurse needs answered: whether his wife is alive, since "would be" can mean either.
Replacement. "You said she would be ashamed. Tell me about her."
Technique. Reflecting his statement, then an open invitation to continue. The replacement avoids reassurance entirely, and his answer will show whether he is grieving, estranged or worried about a wife waiting at home.
Pair 4: The Near Miss
Situation. Jordan, 19, admitted after self-harm, has refused group therapy twice. When asked why, Jordan says: "It's pointless."
Original. "Why don't you want to go to group?"
What it did. Asking why tends to put a person on the defensive, because it asks them to justify a decision rather than describe it. Jordan had already answered the question once, and a second why invites a second shrug.
Replacement, kept as a near miss. "What makes group feel pointless to you?"
Why it still misses. This is better. It uses Jordan's own word and asks for content instead of a justification. But it keeps group as the subject, and the nurse's interest in attendance is still visible in it. Jordan can answer it with "all of it," which is almost a single word. A stronger version would move off the refusal and toward Jordan: "What would make today feel less pointless?" I kept the near miss because the difference between the two lines is small on paper and large in how a 19-year-old hears it: one is about the unit's schedule, the other is about the patient's day.
Pair 5: The Line That Was Nearly Right
Situation. Mrs. G., 52, admitted with bipolar disorder in a depressive phase, has been silent for several minutes in a one-to-one conversation, then says: "I don't know what to say."
Original. "That's okay. We can just sit for a while."
What it did. Very little harm. Of the five originals, this one was closest to what I would say. It accepts the silence and does not demand talk. Its only weakness is that it may end the conversation by default, because "just sit" can sound like the nurse has given up on talking.
Replacement. "That's okay. I'll stay here. Say something whenever you want to, or nothing."
Technique. Offering self and accepting silence. The replacement keeps the original's permission and adds the one thing it lacked: a clear statement that the nurse is not leaving and the door to speaking is still open.
What the Set Shows
Laid side by side, the five originals fail in three different ways: two made a one-word answer easy, two filled the space with the nurse's own comfort or experience, and one asked for a justification. Only one of the five was genuinely poor in intent; the rest were attempts at warmth that arrived before the patient had finished. The replacements are shorter than the originals in four of five cases, which surprised me. The repair was usually to take something out: the reassurance, the story about myself, the second why. Kornhaber et al. (2016), reviewing studies from acute care, named therapeutic listening and responding to the patient's emotions as central to the relationships that worked. On paper, listening turned out to mean removing words more often than finding better ones.
References
Hartley, S., Raphael, J., Lovell, K., & Berry, K. (2020). Effective nurse-patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance. International Journal of Nursing Studies, 102, Article 103490. https://doi.org/10.1016/j.ijnurstu.2019.103490
Kornhaber, R., Walsh, K., Duff, J., & Walker, K. (2016). Enhancing adult therapeutic interpersonal relationships in the acute health care setting: An integrative review. Journal of Multidisciplinary Healthcare, 9, 537-546. https://doi.org/10.2147/JMDH.S116957
What the NR 326 Week 2 assignment asks for
The Week 2 assignment hands you a set of nontherapeutic nurse responses and asks you to identify what is wrong with each, rewrite it and name the therapeutic technique you used. The instructions typically list every exchange to be handled, a rationale for each rewrite, at least one scholarly source and APA format. Quote the original line exactly so the reader can compare. Say what the line did to the patient's next turn before offering anything better. Write the replacement in words you would actually say aloud. Match the technique name to what the new line does, not to what you hoped it would do. Leave room at the end to say what the set as a whole teaches.
How this NR 326 Week 2 example is built
A short introduction states the method and uses Hartley and colleagues' 2020 review to admit that the evidence for any one phrasing is weak. Pair 1 replaces "Are you feeling okay this morning?" with a broad opening question about the morning so far. Pair 2 removes the nurse's own divorce from the conversation and hands Ms. L. her word "wrecked" back. Pair 3 drops early comfort and invites Mr. W. to talk about his wife. Pair 4 keeps an improved line as a near miss and explains why it still centers on group attendance. Pair 5 is nearly right already, so the repair only adds a promise to stay. The closing section notes that most repairs took words away rather than adding them.
NR 326 Week 2 rubric: what full points look like
Points on this exercise usually go to accurate identification of the barrier, a replacement that is genuinely therapeutic, correct naming of the technique, a rationale for each change, use of evidence and APA. Identification earns the most when it describes the effect on the patient's next words, such as inviting a one-word answer, rather than labeling the line "bad." Replacements are credited when they could be spoken naturally and keep the patient's own words. Technique names score only when they match the new line. The near miss in Pair 4 shows the kind of careful judgment the analysis row rewards. Kornhaber and colleagues support the rationale, and a synthesis at the end lifts the paper above a list of corrections.
Common NR 326 Week 2 mistakes, and how to avoid them
The weakest version of this exercise makes every replacement longer without making it more open, so a closed question gains a preamble and stays closed. Another common loss is a missing diagnosis, where a better line appears but nothing explains what was wrong with the first one. Technique labels pasted onto lines they do not describe cost points, and so do replacements written in textbook phrases no nurse would say. Some students skip the hardest pair or claim every original was cruel, which ignores the one that was nearly right. Check that each quoted line is reproduced exactly. If your list of exchanges is different from these five, send it and an NR 326 Week 2 exercise can be built from your own pairs.
Get a NR 326 Week 2 example written to your instructions
Send the Week 2 worksheet or prompt with the lines your section issued, and a custom example is written against those exact lines and returned inside 24 to 48 hours. The first one is free. Where the exercise asks you to use responses from your own rotation, those stay with you and we work from the kind of exchange instead.
More NR 326 papers and pre-licensure samples
- NR 326 Week 1: Psychiatric Unit Expectations Post
- NR 326 Week 3: Process Recording
- NR 326 Week 4: Mental Status Write-up
- NR 326 Week 5: Risk Assessment Write-up
- NR 326 Week 6: Case Study Analysis
- NR 326 Week 7: Therapeutic Milieu Brief
- NR 326 Week 8: Reflection
- NR 327 Week 2: Antenatal Assessment Write-up
- NR 325 Week 2: Postoperative Trend Case Analysis
- NR 328 Week 2: Growth and Development Write-up
- NR 324 Week 2: Heart Failure Daily Jobs Concept Map
NR 326 Week 2 questions, answered
Can a reassuring line ever be the right one?
Yes, and a set claiming otherwise is too blunt to score well. Comfort has a place once somebody has finished saying the hard thing. What this exercise marks is comfort used early, where it lets both people leave a subject that was about to open. Saying when your own replacement would still be premature is more convincing than treating every warm sentence as an error.
Do the replacements have to use the textbook wording?
The technique names usually do, because the rubric is written around them. The sentences themselves should not. A replacement built out of a stem from the reading sounds like a form being read aloud, and patients answer it the way people answer forms. Put the course vocabulary in your defense of the line and ordinary speech in the line itself.
What if I cannot improve one of the lines?
Say so and argue it. An original that was already reasonable, kept and explained, is worth more than a change made because the assignment expected one in every slot. Instructors are marking judgment here, and a set in which every line was terrible reads as an exercise worked through in bulk rather than one where each sentence was genuinely heard.
Where can I find a free NR 326 Week 2 sample paper?
The complete Week 2 exercise, with five nurse responses diagnosed and repaired, the near miss on group attendance, the closing finding and two references, is on this page.
Which technique does the NR 326 Week 2 paper use for the patient who says "I don't know what to say"?
Offering self and accepting silence. The repaired line keeps permission to stay quiet and adds that the nurse will remain, so the chance to speak stays open.