Deck 7: Relationship Development

Question 1

A nurse moving out of state speaks to a client about the need to work with a new nurse.The client states,"I'm not well enough to switch to a different nurse." Which of the following does the nurse recognize the client is demonstrating?

A)Manipulation to receive secondary gain
B)The defense mechanism of denial
C)Difficulty terminating the relationship
D)Use of "splitting" to remain dependent on the nurse

Answer 1

Difficulty terminating the relationship

Question 2

A mother who has learned that her child was killed in a tragic car accident states,"I can't bear to go on with my life." Which nursing statement conveys empathy?

A)"This situation is very sad,but time is a great healer."
B)"You are sad,but you must be strong for your other children."
C)"Once you cry it all out,things will seem so much better."
D)"It must be horrible to lose a child;I'll stay with you until your husband arrives."

Answer 2

"It must be horrible to lose a child;I'll stay with you until your husband arrives."

Question 3

Which of the nursing actions described by Peplau demonstrates the nurse's role as a resource person?

A)Balances a safe therapeutic environment to increase the client's sense of belonging
B)Conducts a group on the unit to discuss common feelings about mental illness
C)Administers medications and watches for signs of "cheeking"
D)Provides information using language the client can understand

Answer 3

Provides information using language the client can understand

Question 4

Which of the following is the main goal of the working phase of the nurse-client therapeutic relationship?

A)Role-model to improve interaction with others.
B)Resolve the client's problems.
C)Use therapeutic communication to clarify perceptions.
D)Help the client access outpatient treatment.

Question 5

Which of the following is the nurse's primary goal during the preinteraction phase of the nurse-client relationship?

A)Evaluate goal attainment and ensure therapeutic closure.
B)Establish trust and formulate a contract for intervention.
C)Explore self-perceptions.
D)Promote client change.

Question 6

Which task is the nurse's priority during the working phase of a therapeutic relationship?

A)Establishing a contract for intervention
B)Examining feelings about working with the client
C)Establishing a plan for continuing aftercare
D)Promoting the client's insight and perception of reality

Question 7

A hungry,homeless client,diagnosed with Schizophrenia,refuses to participate in an admission interview.The nurse postpones the admission interview,verbally assures safety,and provides the client a warm meal.Which of the following does the nurse's action demonstrate?

A)Sympathy
B)Trust
C)Veracity
D)Manipulation

Question 8

Which of the following is the priority nursing action during the orientation (introductory)phase of the nurse-client relationship?

A)Acknowledge the client's actions and generate alternative behaviors.
B)Establish rapport and develop mutually agreeable treatment goals.
C)Attempt to find alternative placement for the client.
D)Explore how thoughts and feelings may adversely impact nursing care.

Question 9

Which outcome does the nurse expect during the working phase of the nurse-client relationship?

A)The client gains insight and incorporates alternative behaviors.
B)The client and nurse establish rapport and mutually develop treatment goals.
C)The client explores feelings related to reentering the community.
D)The client explores personal strengths and weaknesses that impact behaviors.

Question 10

Which is the nurse's best action when a client demonstrates transference?

A)Promote safety and immediately terminate the relationship with the client.
B)Encourage the client to ignore these thoughts and feelings.
C)Immediately reassign the client to another staff member.
D)Help the client clarify the meaning of the current nurse-client relationship.

Question 11

Which phase of the nurse-client relationship begins when the nurse and client first meet and is characterized by an agreement to continue meeting and working on setting client-centered goals?

A)Preinteraction
B)Orientation
C)Working
D)Termination

Question 12

A client has made the decision to leave her alcoholic husband and reports feeling very depressed.Which nontherapeutic statement by the nurse represents sympathy?

A)"You are feeling very depressed.I felt the same way when I decided to leave my husband."
B)"I can understand you are feeling depressed.It was a difficult decision.I'll sit with you."
C)"You seem depressed.It was a difficult decision to make.Would you like to talk about it?"
D)"I know this is a difficult time for you.Would you like medication for anxiety?"

Question 13

Which client statement indicates to the nurse that the client may be experiencing a transference reaction?

A)"I need a real nurse.You are young enough to be my daughter and I don't want to tell you about my personal life."
B)"I deserve more than I am getting here.Do you know who I am and what I do? Let me talk to your supervisor."
C)"I don't seem to be able to relate to people.I would rather stay in my room and be by myself."
D)"My mother is the source of my problems.She has always told me what to do and what to say."

Question 14

Which nursing action demonstrates the role of the teacher in the therapeutic milieu?

A)The nurse implements a self-affirmation exercise during a one-to-one client interaction.
B)The nurse conducts a group meeting to present common side effects of psychiatric medications.
C)The nurse introduces the concept of fair play while playing cards with a group of clients.
D)The nurse models adaptive and effective coping mechanisms with clients on the psychiatric unit.

Question 15

What is the most essential task for a nurse prior to forming a therapeutic relationship with a client?

A)Clarify personal attitudes,values,and beliefs.
B)Obtain thorough assessment data.
C)Determine the client's length of stay.
D)Establish personal goals for the interaction.

Question 16

Which of the following essential characteristics of a therapeutic relationship is missing if the nurse perceives a client to be "two-faced"?

A)Respect
B)Genuineness
C)Sympathy
D)Rapport

Question 17

Which nursing intervention described by Peplau demonstrates the nurse's role as a surrogate?

A)Functions as a nurturing parent to build a trusting relationship
B)Plays cards with a small group of clients on the inpatient unit
C)Discusses the client's childhood events that affect personality development
D)Creates a safe social environment within the milieu

Question 18

Which is the nurse's most therapeutic statement when the client and nurse move from the orientation stage to the working stage of the therapeutic relationship?

A)"I want to assure you that I will maintain your confidentiality."
B)"A long-term goal for someone your age would be to develop better job skills."
C)"Which problems that we identified would you like for us to address first?"
D)"I think we need to focus on your relationship issues first."

Question 19

When asked to play a game,a client diagnosed with Paranoid Schizophrenia becomes agitated.The client states,"Do you want to be my girlfriend?" Which nursing response is best?

A)"You are upset now.It would be best if you go to your room until you feel better."
B)"Remember,we have a professional relationship.Are you feeling uncomfortable?"
C)"We have discussed this before.I am not allowed to date clients."
D)"I think you should discuss your fantasies with your therapist."

Question 20

Which client statement does the nurse recognize as the client's typical response to stress most often experienced in the working phase of the nurse-client relationship?

A)"I can't bear the thought of leaving here and failing."
B)"You remind me of my mother.I might have a hard time working with you."
C)"I can't tell my husband how I feel;he wouldn't listen anyway."
D)"I'm not sure that I can count on you to protect my confidentiality."

Question 21

Which client statement indicates to the nurse that termination of the therapeutic nurse-client relationship has been successful?

A)"I know I can count on you for continued support."
B)"I am looking forward to discharge,but I am surprised that we will no longer work together."
C)"Reviewing the changes that have happened during our time together has helped me put things in perspective."
D)"I don't know how comfortable I will feel when talking to someone else."

Question 22

Which of the following is necessary for the psychiatric nurse to convey trustworthiness to a client?

A)Self-confidence
B)Self-awareness
C)Personal integrity
D)Positive regard

Question 23

Which of the following indicates that the nurse understands self-disclosure is appropriate in a therapeutic nurse-client relationship?

A)The information may benefit the nurse and client.
B)There is a duty to warn.
C)The nurse feels emotionally indebted toward the client.
D)The information may benefit the client.

Question 24

A client who was discharged 2 weeks ago sends a thank you card to the psychiatric nurse.The nurse finds season tickets to the city's professional football team in the card.Which of the following must the nurse consider when deciding whether to keep the tickets?

A)Material boundaries
B)Personal boundaries
C)Social boundaries
D)Professional boundaries

Question 25

The nurse-client therapeutic relationship includes which of the following characteristics? Select all that apply.

A)Meeting the psychological needs of the nurse and the client
B)Ensuring therapeutic termination
C)Promoting client insight into problematic behavior
D)Collaborating to set appropriate goals
E)Meeting both the physical and psychological needs of the client

Question 26

The psychiatric nurse is counseling a client whose infant daughter recently died from sudden infant death syndrome.Which nursing response demonstrates empathy?

A)"It must have been frightening when you realized something was wrong."
B)"Tell me how you and your husband have been doing since the funeral."
C)"Let me help you understand the different stages of the grieving process."
D)"Have you had feelings of hurting yourself or someone else lately?"

Question 27

The psychiatric nurse understands which of the following is the foundation of patient-centered care?

A)Quality of nursing care
B)Mutual respect
C)Therapeutic relationship
D)Therapeutic communication

Question 28

Which of the following can the psychiatric nurse utilize to best increase self-awareness? Select all that apply.

A)Values clarification
B)The Johari window
C)Countertransference
D)Positive regard
E)Personal boundaries

Question 29

Which of the following indicate that the integrity of the nurse-client relationship may be in jeopardy? Select all that apply.

A)Requesting to be reassigned to a particular client
B)Informing the client that a behavior is unacceptable
C)Hugging the client
D)Expressing sympathy for the client
E)Contacting the client after discharge