Deck 7: Relationship Development

Question 1

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

A)Role modeling to improve interaction with others
B)Resolution of the client's problems
C)Using therapeutic communication to clarify perceptions
D)Helping the client access outpatient treatment

Answer 1

Resolution of the client's problems

Question 2

A client diagnosed with paranoid schizophrenia becomes agitated when asked to play a game. The client responds, "Do you want to be my girlfriend?" Which nursing response is most appropriate?

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."

Answer 2

"Remember, we have a professional relationship.Are you feeling uncomfortable?"

Question 3

Which client statement should a nurse identify as a 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)"I might have a hard time working with you.You remind me of my mother."
C)"I really don't want to talk any more about my childhood abuse."
D)"I'm not sure that I can count on you to protect my confidentiality."

Answer 3

"I really don't want to talk any more about my childhood abuse."

Question 4

What 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 treatment goals
C)Attempt to find alternative placement
D)Explore how thoughts and feelings about this client may adversely impact care

Question 5

On which task should a nurse place priority during the working phase of relationship development?

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

Question 6

A hungry, homeless client, diagnosed with schizophrenia, refuses to participate in an admission interview. A nurse streamlines the assessment, verbally assures safety, and provides a warm meal. What is the nurse promoting by these actions?

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

Question 7

According to Peplau, which nursing action demonstrates the nurse's role as a resource person?

A)The nurse balances a safe therapeutic environment to increase the client's sense of belonging.
B)The nurse holds a group meeting with the clients on the unit to discuss common feelings about mental illness.
C)The nurse monitors the administration of medications and watches for signs of "cheeking."
D)The nurse explains, in language the client can understand, information related to the client's health care.

Question 8

Which is the best nursing action when a client demonstrates transference toward a nurse?

A)Promoting safety and immediately terminating the relationship with the client
B)Encouraging the client to ignore these thoughts and feelings
C)Immediately reassigning the client to another staff member
D)Helping the client to clarify the meaning of the current nurse-client relationship

Question 9

Which client statement may indicate 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 that 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 10

Which client response should a 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 11

A nurse moving out of state speaks to a client about the need to work with a new nurse. The client states, "You're the only one who can make me well." What does this client response indicate to the nurse?

A)The client is using manipulation to receive secondary gain.
B)The client is using the defense mechanism of denial.
C)The client is having trouble terminating the relationship.
D)The client is using "splitting" as a way to remain dependent on the nurse.

Question 12

What should be the nurse's primary goal during the preinteraction phase of the nurse-client relationship?

A)To evaluate goal attainment and ensure therapeutic closure
B)To establish trust and formulate a contract for intervention
C)To explore self-perceptions
D)To promote client change

Question 13

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

A)To clarify personal attitudes, values, and beliefs
B)To obtain thorough assessment data
C)To determine the client's length of stay
D)To establish personal goals for the interaction

Question 14

If an individual is "two-faced," which characteristic essential to the development of a therapeutic relationship should a nurse identify as missing?

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

Question 15

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

A)The nurse implements a self-affirmation exercise during a one-to-one client interaction.
B)The nurse holds 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 16

According to Peplau, which nursing intervention is most appropriate when the nurse is functioning in the role of a surrogate?

A)The nurse functions as a nurturing parent in order to build a trusting relationship.
B)The nurse plays cards with a small group of clients.
C)The nurse discusses childhood events that may affect personality development.
D)The nurse provides a safe social environment.

Question 17

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

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

Question 18

A client has made the decision to leave her alcoholic husband. She is feeling very depressed. Which nontherapeutic statement by the nurse conveys 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 a prn medication for anxiety?"

Question 19

As the client and nurse move from the orientation stage to the working stage of the therapeutic relationship, which is the nurse's most therapeutic statement?

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 identified problems would you like for us to initially address?"
D)"I think first we need to focus on your relationship issues."

Question 20

A mother notified 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."

Question 21

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 22

When is self-disclosure by the nurse appropriate in a therapeutic nurse-client relationship?

A)When it is judged that the information may benefit the nurse and client
B)When the nurse has a duty to warn
C)When the nurse feels emotionally indebted toward the client
D)When it is judged that the information may benefit the client

Question 23

Which client statement indicates that termination of the therapeutic nurse-client relationship has been handled successfully?

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."