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NC-BC practice questions

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Question 1Foundations and Professional Role of the Nurse Coach

In the nurse coach model, who is considered the primary authority on the client's life and health experience?

  1. The interdisciplinary care team
  2. The nurse coach
  3. The client's physician
  4. The client Correct answer.

Explanation

Nurse coaching rests on the premise that the client is the expert on their own life, values, and circumstances. The coach contributes expertise about the change process and health information, but does not hold authority over the content of the client's life. This partnership stance is what separates coaching from prescribing or directing.

Question 2Foundations and Professional Role of the Nurse Coach

Which organization awards the Nurse Coach Board Certified (NC-BC) credential?

  1. AHNCC Correct answer.
  2. The National League for Nursing
  3. The Joint Commission
  4. Sigma Theta Tau International

Explanation

The American Holistic Nurses Credentialing Corporation (AHNCC) administers board certification for holistic nurses and nurse coaches, including the HN-BC and NC-BC credentials. Certification is voluntary and signifies that defined education and practice standards have been met.

Question 3Foundations and Professional Role of the Nurse Coach

Which statement best captures the core activity of the nurse coach?

  1. Diagnosing and treating acute illness
  2. Directing clients toward the coach's preferred health plan
  3. Partnering with clients to mobilize their own resources Correct answer.
  4. Teaching standardized disease education curricula

Explanation

Nurse coaching is a client-centered, partnership-based process that helps people activate their own strengths, values, and resources for health. The coach facilitates rather than directs, and the agenda belongs to the client. Health teaching may occur, but it is not the defining activity.

Question 4Foundations and Professional Role of the Nurse Coach

Which nursing framework is most often cited as the philosophical foundation for nurse coaching's emphasis on caring and relationship?

  1. Neuman's systems model
  2. Orem's self-care deficit theory
  3. Watson's caring science Correct answer.
  4. Roy's adaptation model

Explanation

Nurse coaching draws heavily on caring science, which places the caring relationship, presence, and the whole person at the center of practice. Caring science frames the coach-client encounter as a healing relationship rather than a task-driven procedure.

Question 5Foundations and Professional Role of the Nurse Coach

Which set of elements describes the spirit of motivational interviewing?

  1. Persuasion, direction, confrontation, and warning
  2. Empathize, reassure, advise, warn
  3. Partnership, acceptance, compassion, evocation Correct answer.
  4. Assess, diagnose, plan, evaluate

Explanation

The motivational interviewing spirit comprises partnership, acceptance, compassion, and evocation. These elements orient the coach toward collaboration and drawing out the client's own motivation rather than installing it. The spirit matters because technique without it tends to reproduce a persuading stance.

Question 6Foundations and Professional Role of the Nurse Coach

According to the transtheoretical model, a client who is not intending to change a behavior within the next six months is in which stage?

  1. Contemplation
  2. Preparation
  3. Maintenance
  4. Precontemplation Correct answer.

Explanation

Precontemplation is defined by the absence of intention to change in the foreseeable future, conventionally the next six months. Contemplation involves awareness and ambivalence, while preparation involves intent to act soon. Matching coaching strategies to the stage prevents premature action planning.

Question 7Foundations and Professional Role of the Nurse Coach

Holistic nursing practice is grounded in which view of the person?

  1. A physical organism determined mainly by genetic inheritance
  2. A set of separate body systems to be managed individually
  3. A collection of behaviors addressed one at a time
  4. An integrated whole of body, mind, spirit, and environment Correct answer.

Explanation

Holistic nursing holds that the person is an integrated whole whose physical, emotional, spiritual, social, and environmental dimensions interact continuously. Care therefore addresses patterns and context rather than isolated parts. This whole-person stance underpins the nurse coach's broad assessment of the client's life.

Question 8Foundations and Professional Role of the Nurse Coach

In nurse coaching, presence is best described as:

  1. Filling moments of silence with encouragement and advice
  2. Documenting thoroughly in the record while the client speaks
  3. Offering full, attentive awareness in the moment Correct answer.
  4. Sharing the coach's own recovery stories to build rapport

Explanation

Presence means bringing full, undivided attention to the client and the unfolding moment, without rehearsing a response or steering the agenda. It is a deliberate way of being that communicates respect and safety. It differs from techniques used to fill or manage the conversation.

Question 9Foundations and Professional Role of the Nurse Coach

A client says, 'I don't see why everyone makes a fuss about my blood pressure.' Which response is most appropriate for a nurse coach?

  1. Set a goal to walk thirty minutes daily starting tomorrow
  2. Explore what the client already knows and values Correct answer.
  3. Provide a detailed handout on hypertension complications
  4. Explain that denial will worsen the client's prognosis

Explanation

This statement suggests the client is not yet considering change, so the coach builds rapport and explores the client's own perspective and values. Pushing information or action goals at this stage tends to provoke resistance. Curiosity preserves the partnership and opens the door to future change talk.

Question 10Foundations and Professional Role of the Nurse Coach

A client asks the nurse coach whether they should stop taking their antidepressant. What is the most appropriate coach response?

  1. Instruct the client to keep taking the medication as prescribed
  2. Explore concerns and encourage a talk with the prescriber Correct answer.
  3. Suggest a tapering schedule the client can follow at home
  4. Decline to discuss the topic at all

Explanation

Medication decisions lie outside the coaching scope, but dismissing the topic damages trust. The coach honors the client's autonomy, explores the underlying concerns, and ensures the client connects with the prescriber who holds that clinical authority.

Question 11Foundations and Professional Role of the Nurse Coach

A nurse coach notices feeling impatient when clients choose goals the coach considers unwise. What is the most appropriate action?

  1. Continue and hope the feeling resolves with more sessions
  2. End the coaching relationship to avoid imposing values
  3. Redirect the client toward a goal the coach thinks is safer
  4. Reflect on the reaction in peer consultation Correct answer.

Explanation

Unresolved reactions are a well-recognized source of bias and countertransference in coaching, so the coach seeks reflective supervision or peer consultation. Bringing the reaction into awareness protects the client's agenda from the coach's preferences. Ignoring it risks subtle steering or rupture.

Question 12Foundations and Professional Role of the Nurse Coach

Which coach statement is an example of an affirmation?

  1. You should try scheduling workouts in the morning
  2. So you feel frustrated that your plan is not working
  3. Why do you think you keep missing your planned gym sessions?
  4. You kept showing up for yourself in a hard month Correct answer.

Explanation

An affirmation names a genuine client strength, effort, or value, which supports self-efficacy and the working alliance. It differs from a question, a reflection of feeling, or unsolicited advice. Accurate affirmations are specific rather than global praise.

Question 13Foundations and Professional Role of the Nurse Coach

Which feature best distinguishes nurse coaching from psychotherapy?

  1. Coaching uses structured conversation and active listening
  2. Coaching is delivered by licensed registered nurses
  3. Coaching focuses on present and future wellness goals Correct answer.
  4. Coaching requires a signed agreement with the client

Explanation

Psychotherapy treats diagnosable mental health conditions, whereas coaching supports wellness goal attainment in clients who are appropriate for a coaching relationship. The two can share conversational methods, so the goals and clinical indication are what separate them. Coaches refer when clinical disorders are present or emerge.

Question 14Foundations and Professional Role of the Nurse Coach

A client from a culture different from the coach's describes a health practice unfamiliar to the coach. What is the best action?

  1. Record the practice and continue with the coaching plan
  2. Ask how the practice fits the client's values and daily life Correct answer.
  3. Gently explain why the practice lacks evidence
  4. Refer the client to a clinician who shares their background

Explanation

Cultural humility involves curiosity about the client's own meanings rather than assuming, judging, or matching by identity. Asking how the practice fits the client's values and routines keeps the client as the cultural expert. Referral based solely on background would be a form of stereotyping.

Question 15Foundations and Professional Role of the Nurse Coach

At the start of a coaching relationship, the nurse coach should:

  1. Schedule a fixed number of sessions and outcomes in advance
  2. Review the coaching agreement, confidentiality, and scope Correct answer.
  3. Obtain the client's medical record from their provider
  4. Diagnose the client's readiness and write a treatment plan

Explanation

Coaching begins with a clear agreement covering the nature of coaching, confidentiality and its limits, and what falls outside the coach's scope. This informed consent protects client autonomy and prevents role confusion. The client, not the coach, sets the direction thereafter.

Question 16Foundations and Professional Role of the Nurse Coach

A client discloses an intention to seriously harm a neighbor. What should the nurse coach do?

  1. Maintain absolute confidentiality as promised
  2. Continue coaching and revisit the topic in the next session
  3. Ask the client to sign a release before any action
  4. Explain confidentiality limits and follow duty-to-warn law Correct answer.

Explanation

Confidentiality in coaching is bounded by law and safety obligations, including duty to warn or protect where it applies. The coach explains these limits, responds to the imminent risk, and involves appropriate authorities. Secrets that create serious danger cannot be held.

Question 17Foundations and Professional Role of the Nurse Coach

To build a client's self-efficacy for a new health behavior, the nurse coach most usefully:

  1. Sets a demanding goal to accelerate progress
  2. Helps the client recall past successes and small wins Correct answer.
  3. Compares the client with others who succeeded
  4. Explains the physiology behind the recommended behavior

Explanation

Self-efficacy grows most strongly through mastery experiences, so the coach helps the client recognize prior successes and accumulate small wins. Information and comparison are weaker sources and can backfire. A demanding goal set by the coach may set the client up for failure.

Question 18Foundations and Professional Role of the Nurse Coach

A well-formed coaching goal is one that:

  1. Is broad enough to cover several behaviors at once
  2. The coach writes based on the client's diagnosis
  3. Reflects the clinic's quality improvement targets
  4. The client phrases it and is motivated to pursue it Correct answer.

Explanation

Coaching goals belong to the client, so the client's own words and genuine motivation are essential. Ownership sustains engagement when obstacles arise. Goals driven by the coach's agenda or organizational metrics tend to produce compliance rather than commitment.

Question 19Foundations and Professional Role of the Nurse Coach

Which action is most consistent with the coaching role rather than the consultant role?

  1. Providing expert recommendations on supplement dosing
  2. Elicit the client's own ideas before offering expertise Correct answer.
  3. Designing a nutrition plan for the client to follow
  4. Auditing the client's food diary and correcting each error

Explanation

Coaching begins by drawing out the client's own knowledge, ideas, and preferences, with expert input offered only when the client wants it or safety requires it. The consultant stance instead supplies answers and solutions from the outset. Eliciting first preserves ownership and autonomy.

Question 20Foundations and Professional Role of the Nurse Coach

A client repeatedly misses appointments because of shift work and no transportation. How should the nurse coach best respond?

  1. Referring the client to a different clinic
  2. Offering a stricter schedule of in-person visits
  3. Exploring social barriers and adapting the coaching format Correct answer.
  4. Documenting nonadherence and closing out the coaching episode

Explanation

Missed visits often reflect social determinants rather than a lack of motivation, so the coach explores barriers and adapts the format, such as telehealth or flexible timing. Adapting the delivery preserves engagement and equity. Labeling the client nonadherent misreads the situation.

Question 21Foundations and Professional Role of the Nurse Coach

A nurse coach without additional mental health certification is asked to help a client manage recurrent panic attacks. What is the most appropriate response?

  1. Begin exposure exercises and monitor the client's response weekly
  2. Support wellness goals and refer for evaluation of panic symptoms Correct answer.
  3. Continue coaching only after the client signs a waiver
  4. Explain that coaching cannot address stress of any kind

Explanation

Panic symptoms warrant clinical evaluation because they may represent a treatable mental health condition. Within the coaching relationship, the coach supports wellness goals and stress-related self-management while ensuring the client receives appropriate care. Structured exposure techniques require preparation and licensure beyond general coaching practice.

Question 22Foundations and Professional Role of the Nurse Coach

A nurse coach working from Newman's health as expanding consciousness framework would focus primarily on:

  1. Restoring the client to a prior level of function
  2. The client's emerging awareness of meaning and pattern Correct answer.
  3. Removing risk factors identified in a screening
  4. Matching the client's behavior to clinical guidelines

Explanation

Newman views health as expanding consciousness, with nursing helping clients recognize their patterns and the meaning of their experiences. The focus is on pattern recognition and transformation rather than risk reduction or restoring a baseline. This framework supports coaching questions about what the client is noticing and what matters now.

Question 23Foundations and Professional Role of the Nurse Coach

A competent adult client chooses a plan the nurse coach believes is unwise but not immediately dangerous. What should the coach do?

  1. Present the coach's preferred plan as a condition for continuing
  2. Respect the choice while exploring the client's reasoning Correct answer.
  3. Refuse to continue until the client revises the plan
  4. Inform the client's family so they can intervene

Explanation

Respect for autonomy means the client retains the right to make decisions the coach would not make, provided no serious harm is imminent. The coach stays curious about the client's reasoning, which keeps dialogue open and may reveal new considerations. Coercive conditions or family involvement without consent breach the coaching alliance.

Question 24Foundations and Professional Role of the Nurse Coach

How should a nurse coach best evaluate whether coaching is effective?

  1. By comparing the client's progress against other clients
  2. By whether the client follows the coach's recommendations
  3. By the client's own measures of agreed goals Correct answer.
  4. By the total number of sessions the client completes

Explanation

Outcome evaluation in coaching centers on the client's self-reported progress toward goals the client helped define, alongside relevant health indicators the client chooses to track. Session counts and compliance measure process or obedience, not the client's own change. Comparisons across clients ignore each person's starting point and priorities.

Question 25Foundations and Professional Role of the Nurse Coach

A registered nurse practicing as a nurse coach remains accountable to which standard?

  1. The client's personal health philosophy
  2. The nurse practice act and holistic nursing standards Correct answer.
  3. Only the employer's wellness program policies
  4. Only the coaching program's own code of ethics and values

Explanation

The nursing license carries accountability to the state nurse practice act and to professional standards such as those for holistic nursing, and coaching does not suspend that accountability. Program codes and employer policies add obligations but do not replace licensure requirements. Client philosophy informs the partnership but never governs the nurse's legal duties.

Question 26Foundations and Professional Role of the Nurse Coach

Which description best characterizes health and wellness coaching?

  1. A client-centered partnership that supports the client's own agenda for change Correct answer.
  2. A structured program in which the professional sets the targets for the client
  3. An educational lecture series on disease prevention delivered to groups
  4. A therapeutic treatment for mental health disorders delivered by a clinician

Explanation

Coaching is a collaborative partnership in which the client, not the coach, sets the agenda and the goals. The coach applies behavior-change theory and communication skills to support the client's self-directed change.

Question 27Foundations and Professional Role of the Nurse Coach

The spirit of motivational interviewing is best summarized by which set of elements?

  1. Partnership, acceptance, compassion, and evocation Correct answer.
  2. Directing, advising, persuading, and confirming
  3. Teaching, modeling, practicing, and reinforcing
  4. Assessment, diagnosis, planning, and evaluation

Explanation

The motivational interviewing spirit is captured by partnership, acceptance, compassion, and evocation, which together frame the conversation as collaborative rather than prescriptive. Evocation means drawing out the client's own reasons and resources for change.

Question 28Foundations and Professional Role of the Nurse Coach

A nurse coach receives a request from a client's employer for details of the coaching sessions. What is the appropriate response?

  1. Decline unless the client gives written authorization Correct answer.
  2. Share the information because the employer is paying for the coaching
  3. Provide the information only if the employer signs a release
  4. Provide a summary of the goals the client has set so far

Explanation

Coaching conversations are confidential, and disclosure to a third party requires the client's informed written authorization. Payment by a third party does not transfer the client's right to control their health information.

Question 29Foundations and Professional Role of the Nurse Coach

Which activity falls outside the scope of practice of a registered nurse acting as a nurse coach without additional prescribing authority?

  1. Helping a client explore readiness to change dietary habits
  2. Referring a client to a dietitian for medical nutrition therapy
  3. Prescribing a dietary supplement for the client's fatigue Correct answer.
  4. Teaching a client to use a food and activity log

Explanation

Prescribing, including supplements, is an authority granted by state licensure and additional credentialing, not by the coaching role. Coaching supports behavior change and connects clients with appropriate clinical resources rather than initiating treatment.

Question 30Foundations and Professional Role of the Nurse Coach

A client says, 'I know I should cut back on soda, but I really do not want to talk about it today.' Which coach response is most consistent with motivational interviewing?

  1. Let me explain again why soda is harmful to your kidneys.
  2. I will add soda reduction to your plan so that you stay on track.
  3. It sounds like discussing soda feels like pressure today. Correct answer.
  4. You need to decide today whether you are serious about changing this habit.

Explanation

A reflection that names the client's experience honors autonomy and avoids the righting reflex, which typically increases resistance. Pushing information or consequences at this moment would shift the conversation into persuasion.

Question 31Foundations and Professional Role of the Nurse Coach

Which question from the nurse coach is most likely to invite client exploration?

  1. Don't you think sleep is important for your blood pressure?
  2. Did your physician tell you to lose weight?
  3. What would change in your week if you felt more rested? Correct answer.
  4. Have you tried cutting out snacks after dinner?

Explanation

Open-ended questions that invite description and reflection create space for the client to explore their own experience. Each of the other choices can be answered in a word or embeds the coach's judgment.

Question 32Foundations and Professional Role of the Nurse Coach

A client being coached for physical activity says, 'My spouse thinks I should join a gym, but I would rather walk with a friend.' Which response best supports autonomy?

  1. Most people need structure, so a scheduled class would be safer.
  2. Walking with a friend seems to fit you; say more about that. Correct answer.
  3. Joining a gym would give you the best results, so it is worth considering.
  4. Your spouse knows you well, so their suggestion is probably worth trying.

Explanation

Self-determination theory holds that durable motivation grows when the client's own values and preferences guide the plan. Affirming the client's stated preference and inviting elaboration supports autonomy and competence.

Question 33Foundations and Professional Role of the Nurse Coach

A client who currently walks five minutes a day sets a goal of running a marathon in six weeks. What is the best coach response?

  1. I will write the marathon plan and you can follow it as written.
  2. How confident are you, from 0 to 10, that this plan fits your life right now? Correct answer.
  3. That goal is unrealistic; let us pick something you can actually achieve.
  4. Marathon training is admirable, but you should probably see a physician before you begin.

Explanation

Scaling confidence lets the client appraise the goal's fit themselves while keeping ownership of the decision. The coach's task is to structure that reflection, not to judge the goal or take over the planning.

Question 34Foundations and Professional Role of the Nurse Coach

A nurse coach designing education for an adult client should build on which principle of adult learning?

  1. Adults learn best when content is presented in a fixed sequence of topics.
  2. Adults learn best when content is immediately useful to a real problem. Correct answer.
  3. Adults learn best when information is delivered in long lecture format.
  4. Adults learn best when the educator controls the pace of the session.

Explanation

Adult learning principles hold that adults are problem-centered and motivated by the immediate relevance of content to their own lives. Coaching education therefore starts from the client's concerns rather than a preset curriculum.

Question 35Foundations and Professional Role of the Nurse Coach

A client says, 'I know walking would help my diabetes, but my neighborhood is not safe after dark.' Which health belief model construct does this statement reflect?

  1. Perceived barriers Correct answer.
  2. Perceived susceptibility
  3. Cues to action
  4. Perceived severity

Explanation

Perceived barriers are the obstacles a person anticipates in taking a recommended action, such as an unsafe walking environment. Coaching addresses such obstacles directly because they reduce the likelihood of action even when the benefit is understood.

Question 36Foundations and Professional Role of the Nurse Coach

During a coaching session a client reports new chest pressure that occurs when climbing stairs. What should the nurse coach do first?

  1. Continue the session and add activity pacing to the client's goal.
  2. Stop the coaching agenda and advise prompt medical evaluation. Correct answer.
  3. Ask the client to rate how motivated they are to seek care.
  4. Document the symptom and review it at the next scheduled session.

Explanation

New exertional chest pressure is a potentially serious symptom, and client safety takes precedence over the coaching agenda. The nurse coach responds to the clinical concern and facilitates timely evaluation rather than continuing behavior-change work.

Question 37Foundations and Professional Role of the Nurse Coach

Which entry best reflects appropriate documentation of a coaching session?

  1. Client set a goal to walk 10 minutes after lunch, 3 days weekly. Correct answer.
  2. Client was resistant and unmotivated throughout the session.
  3. Client seems to be in denial about their weight.
  4. Client had a good attitude and made progress this week.

Explanation

Coaching documentation should record observable, behavioral information such as the client's stated goal, plan, and follow-up. Judgmental labels and impressions are subjective and can bias later care and review.

Question 38Foundations and Professional Role of the Nurse Coach

A nurse coach guided by Watson's Theory of Human Caring would give priority to which action?

  1. Tracking the client's biometric outcomes at the start of each session
  2. Standardizing the client's plan so it matches the clinic protocol for everyone
  3. Exploring the meaning the client gives to their illness experience Correct answer.
  4. Teaching the client the pathophysiology of their diagnosed condition

Explanation

Watson's theory centers caring-healing presence and the client's subjective meaning and lived experience of health. The coaching relationship itself, expressed through attending to the client's story, is the vehicle of healing.

Question 39Foundations and Professional Role of the Nurse Coach

After four sessions, a client asks the nurse coach to become a paid consultant for the client's business. What is the best coach response?

  1. Decline the role and end the coaching relationship immediately.
  2. Accept the role, since the client was the one who initiated the request.
  3. Decline and discuss how it would alter the coaching relationship. Correct answer.
  4. Accept the role but keep coaching sessions separate from it.

Explanation

A second, financial relationship with a client creates a dual relationship that can compromise objectivity and the client's trust. The coach declines and openly explores the meaning and impact of the request rather than acting as if nothing changed.

Question 40Foundations and Professional Role of the Nurse Coach

A nurse coach reads a blog claiming that a supplement doubles weight loss, citing a single small uncontrolled study. What is the best interpretation of this evidence?

  1. The evidence is weak because the study lacked a comparison group. Correct answer.
  2. The evidence is strong enough to recommend the supplement to clients.
  3. The claim can be trusted because a published study supports it.
  4. The claim can be trusted because weight change is hard to measure.

Explanation

A single small study without a control group cannot separate the intervention's effect from chance, maturation, or concurrent behavior change. Coaching practice should rest on evidence that is replicated and designed to control for alternative explanations.

Question 41Therapeutic Communication and Relationship-Centered Coaching

Which coach behavior best demonstrates active listening during a coaching session?

  1. Reflecting the content and feeling the client expressed Correct answer.
  2. Typing notes silently while the client speaks
  3. Sharing a similar personal experience right away
  4. Changing the subject when the client becomes emotional

Explanation

Active listening requires the coach to receive the message and signal understanding by reflecting back the content and the emotion heard. This invites the client to confirm, correct, or elaborate. Silent note-taking, topic changes, and immediate self-disclosure all shift attention away from the client.

Question 42Therapeutic Communication and Relationship-Centered Coaching

Which statement is an example of empathy rather than sympathy?

  1. It sounds like this diagnosis has left you feeling very alone. Correct answer.
  2. At least you caught it early, so try to stay positive.
  3. I feel so sorry for you; that must be awful.
  4. My aunt had the exact same diagnosis, so I know exactly how you feel.

Explanation

Empathy names the client's felt experience from the client's frame of reference, which helps the person feel understood. Sympathy expresses the observer's own distress, and reassurance or personal comparison shifts attention away from the client.

Question 43Therapeutic Communication and Relationship-Centered Coaching

Which of these is an open-ended question?

  1. Are you ready to set a goal?
  2. Did you take your medication today?
  3. What would feeling healthier look like? Correct answer.
  4. Do you want to talk about the stress you're feeling?

Explanation

Open-ended questions invite description and cannot be answered with a single word, which gives the client room to explore. Closed questions produce brief yes/no answers and can narrow the conversation prematurely.

Question 44Therapeutic Communication and Relationship-Centered Coaching

What is the primary purpose of paraphrasing a client's message?

  1. To steer the client toward the coach's preferred solution
  2. To demonstrate that the coach agrees with the client's choices
  3. To confirm understanding and invite elaboration Correct answer.
  4. To fill silence during pauses in the conversation

Explanation

Paraphrasing restates the essence of what the client said so the client can confirm accuracy and add detail. It is a check on understanding, not an endorsement or a persuasive tool. Using it merely to fill silence wastes a therapeutic opening.

Question 45Therapeutic Communication and Relationship-Centered Coaching

A client asks whether what they share will stay private. Which response is most accurate?

  1. It stays private unless there is serious risk of harm, which we would discuss first. Correct answer.
  2. I cannot discuss confidentiality with you because it is covered in the intake paperwork.
  3. Everything you share is completely confidential, and there are no exceptions to that.
  4. I share my notes with your family so that they can support you at home.

Explanation

Informed consent for coaching includes an honest description of confidentiality and its limits, such as risk of serious harm. Stating the limits up front preserves trust and the client's right to decide what to disclose. Falsely promising absolute secrecy or deferring to paperwork undermines the alliance.

Question 46Therapeutic Communication and Relationship-Centered Coaching

Which coach behavior most directly builds trust at the start of a coaching relationship?

  1. Using technical clinical language to show expertise
  2. Explaining the coaching process and keeping agreed boundaries Correct answer.
  3. Offering a detailed plan before hearing the client's goals
  4. Keeping the agenda hidden so the client does not feel pressured

Explanation

Trust grows when the coach is transparent about the process and reliably follows through on what was agreed. Predictability and clear boundaries make the relationship feel safe. Presenting a plan first or obscuring the agenda does the opposite.

Question 47Therapeutic Communication and Relationship-Centered Coaching

Which nonverbal behavior most supports a client's sense that they are being heard?

  1. Checking the clock regularly to stay on schedule
  2. Standing over the client during the conversation
  3. Facing the client with open posture and steady eye contact Correct answer.
  4. Crossing arms while the client describes a setback

Explanation

Open posture, orienting toward the client, and culturally appropriate eye contact communicate presence and attention. Incongruent nonverbal cues undercut verbal reflections and are often noticed before words are. Time-checking and closed or towering posture signal disinterest or pressure.

Question 48Therapeutic Communication and Relationship-Centered Coaching

Which client statement is an example of change talk?

  1. I have tried every single thing and honestly nothing ever works.
  2. I don't see why I need to change anything.
  3. My whole family is against me on this.
  4. I could cut back to one soda a day if I plan ahead. Correct answer.

Explanation

Change talk is any client speech that favors movement toward a change, including desire, ability, reasons, need, or commitment. This statement expresses ability and a concrete plan. Statements of hopelessness, blaming others, or denying need are sustain talk.

Question 49Therapeutic Communication and Relationship-Centered Coaching

A client says, "I know I should walk more, but my knees hurt and I'm exhausted after work." Which response fits best with reflective listening?

  1. You want to be more active, and pain and fatigue get in the way. Correct answer.
  2. Walking is really the single best thing you can do for your knees.
  3. You should ask your doctor for a knee replacement.
  4. Have you considered swimming instead?

Explanation

A good reflection captures both sides of the client's ambivalence without arguing for change. Naming the desire and the obstacles shows the client is understood exactly as they are. Advice and premature problem-solving tend to increase resistance.

Question 50Therapeutic Communication and Relationship-Centered Coaching

A client says, "I'm not sure I can manage my insulin on my shift schedule." The coach notices an urge to list solutions. Which response best avoids the righting reflex?

  1. You really need to make this a priority for your health.
  2. Tell me more about what a typical shift looks like. Correct answer.
  3. Let me give you a schedule that will work better.
  4. Most nurses manage it fine once they get organized.

Explanation

The righting reflex is the urge to fix, advise, or reassure, which typically provokes resistance. Asking for more information keeps the client in the expert role on their own life and opens exploration. Advice and comparison shut that down.