NLE Reviewer: Levels of Communication in Nursing
Therapeutic communication is an essential nursing skill. It helps nurses understand clients, establish rapport, identify concerns, and provide appropriate care. In nursing board exam questions, recognizing the type and depth of a client's statement can help you identify the communication concept being tested.
Nursing Practice Question #17
Situation: The effectiveness of nursing action often depends largely on the nurse's ability to communicate with others. The nurse uses therapeutic communication to understand the client and, in turn, be understood.
Question: The child states, “I am Charles, I am 12 years old.” Which level of communication is the child at?
- First-level
- Second-level
- Third-level
- Fourth-level
Answer and Rationale
Most likely intended answer: First-level communication.
The child is simply sharing basic personal information by stating his name and age. If the question uses a framework in which first-level communication refers to basic or superficial exchanges, this statement fits that description because it does not reveal deeper feelings, personal conflicts, or significant emotional concerns.
However, the exact meaning of “first-level,” “second-level,” “third-level,” and “fourth-level” communication can vary between nursing textbooks and teaching frameworks. The supplied question does not identify the specific framework, so the answer should be checked against the terminology used in the examinee's reference material.
Understanding Therapeutic Communication
Therapeutic communication is purposeful communication used by nurses to understand a client's needs, encourage expression, and support the nurse-client relationship. It involves more than exchanging information. The nurse must also pay attention to verbal and nonverbal cues, listen actively, and respond in a manner appropriate to the client's situation.
A simple statement of one's name and age provides basic information. By contrast, statements that disclose fears, emotional struggles, or personal concerns may indicate a greater degree of self-disclosure, depending on the communication model being studied.
Board Exam Tip
- Identify exactly what the client is communicating.
- Distinguish basic factual information from deeper personal or emotional disclosure.
- Check the textbook's definitions when a question uses numbered communication levels.
- Do not assume that every nursing reference uses the same classification system.
Key Takeaway
The child's statement provides basic personal information. First-level communication is the likely intended answer under a basic-to-deeper communication framework, but confirm the specific classification used by your nursing reviewer.
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This article is intended for nursing education and board-exam review. It is not an official PRC publication and does not replace current clinical protocols, institutional policies, or professional judgment.