Building Therapeutic Relationships

A nurse is using the Cultural Formulation Interview (CFI) tool while collecting a health history from a client who is from a different culture than the nurse. Which of the following statements should the nurse make? ·"It seems like your issue is defined by our definition for disease and disorder." ·"I am wondering what you believe the cause of the problem is." ·"Here is a list of coping skills that will be best for your concerns." ·"I think you could benefit from our treatment."

√"I am wondering what you believe the cause of the problem is." While using the CFI, the nurse should elicit the client's perspective of what they believe is causing the problem.

A nurse is caring for a client who states, "I really like you. Can we get together socially after I am discharged?" Which of the following responses should the nurse make? ·"Thank you. You are very kind. However, I am currently in a relationship." ·"I appreciate your comment. However, I am your nurse, and it would be inappropriate for us to engage socially outside of treatment." ·"I am your nurse. You are not allowed to ask me those types of questions." ·"That might be possible, but let's focus on treatment first."

√"I appreciate your comment. However, I am your nurse, and it would be inappropriate for us to engage socially outside of treatment." The client might not be familiar with the boundaries of the professional nurse-client relationship. The nurse should reiterate the boundaries of the relationship while acknowledging the client's statement.

A nurse is interviewing a client who states they are unsure whether they should continue with their medication therapy. Which of the following responses should the nurse make to evoke client motivation? ·"Would you tell me more about what is important to you in your life?" ·"Medications will greatly reduce the occurrence of your symptoms." ·"This might not be the best medication for you, but we can discuss some options that others have found to be helpful." ·"On a scale of 0 to 10, how confident are you that you could adhere to your medication regimen if you tried?"

√"On a scale of 0 to 10, how confident are you that you could adhere to your medication regimen if you tried?" This is a question the nurse would use to evoke client motivation. ·"This might not be the best medication for you, but we can discuss some options that others have found to be helpful." This is an example of a statement that helps the client to focus rather than evoke motivation. ·"Medications will greatly reduce the occurrence of your symptoms." This statement is an example of an expert trap and does not motivate the client. ·"Would you tell me more about what is important to you in your life?" This open-ended question engages the client to discuss topics that are important in their life but does not evoke motivation.

A nurse is interviewing a client who is contemplating a behavior change. Which of the following statements should the nurse make to engage with the client? ·"Tell me about the things that are important to you in your life." ·"I think it would be best for you to gain other perspectives before making any changes." ·"If you prefer, I can offer you some options that others have found to be helpful." ·"You first must decide how important it is for you to make this behavior change."

√"Tell me about the things that are important to you in your life." This open-ended statement engages the client to discuss topics that are important in their life and related to the potential change of behavior.

A nurse is caring for a client who states, "I don't think medications are for me." Which of the following statements should the nurse make? ·"You should trust that your provider knows what's best for you." ·"I think medications are your best option." ·"Tell me more about what you feel would work best for you." ·"Alternative forms of treatment seldom work."

√"Tell me more about what you feel would work best for you." This statement by the nurse is an open-ended therapeutic statement that invites the client to share their ideas or emotions.

A nurse is using the Cultural Formulation Interview (CFI) tool while collecting a health history for a client who is from a culture different than the nurse. Which of the following statements should the nurse make? ·"There are many treatments to relieve symptoms related to your health." ·"You are having issues that are commonly associated with mental illness." ·"Tell me some of the coping skills that have previously helped you." ·"Your issue can be resolved with minimal treatments."

√"Tell me some of the coping skills that have previously helped you." While using the CFI, the nurse should ask the client to discuss what coping skills they have previously used to provide relief from the issues being discussed.

A nurse is interviewing a client who states they are thinking about smoking cessation by using patches. Which of the following responses should the nurse use to focus with the client? ·"What are some important topics in your life?" ·"Smoking increases your chance for developing lung cancer." ·"This might not be the best method for you, but we can discuss some options that others have found to be helpful." ·"On a scale of 0 to 10, how confident are you that you could stop smoking if you tried right now?"

√"This might not be the best method for you, but we can discuss some options that others have found to be helpful." This is an example of a statement that helps the client to focus. ·"What are some important topics in your life? "This open-ended statement engages the client to discuss topics that are important in their life but does not encourage focus. ·"Smoking increases your chance for developing lung cancer." This statement is an example of an expert trap and does not focus the client. ·"On a scale of 0 to 10, how confident are you that you could stop smoking if you tried right now? This statement evokes client motivation rather than focus.

A nurse manager is providing teaching to a group of newly licensed nurses about organizational culture. Which of the following statements by a newly licensed nurse indicates an understanding of organizational culture? ·"This organization believes that each client should be at the center of their own care." ·"Organizational culture refers to reimbursement policies for health care procedures." ·"Clients on an involuntary hold might have certain rights revoked." ·"This organization is a private, for-profit operation."

√"This organization believes that each client should be at the center of their own care." This statement by the nurse represents the beliefs of the organization, which refers to organizational culture.

A nurse is preparing to interview a client and is reviewing therapeutic communication techniques. Which of the following should the nurse include in the interview to encourage the client to continue sharing feelings and information? ·"Do you understand your next step for discharge?" ·"What are some of the stressors that you have in your life?" ·"Would you like more information on social support?" ·"You understand your medications and are ready to discharge."

√"What are some of the stressors that you have in your life?" Open-ended questions allow the client to elaborate on what is important to them in their own words. It is an open invitation to share feelings and information.

A nurse is preparing to interview a client and is reviewing therapeutic communication techniques. Which of the following statements should the nurse make to affirm the client's behavior change? ·"You do not like your medications and would like to try an alternative." ·"You would like to speak to a therapist after treatment." ·"You would like more information. I will get that for you right away." ·"You completed your antibiotic regimen. You are serious about improving your health."

√"You completed your antibiotic regimen. You are serious about improving your health." This statement by the nurse affirms the client's behavior and offers positive reinforcement.

A nurse wants to improve their therapeutic communication by implementing the use of bias-free language. Which of the following actions should the nurse take to provide bias-free language? ·Ask the client how they prefer to be addressed. ·Include the client's sex when ordering a meal tray. ·Withhold religious demographic data when discussing treatment alternatives. ·Record the client's sexuality as "normal" in the plan of care.

√Ask the client how they prefer to be addressed. If the nurse is unsure about how to address a client, they should ask the client for clarification.

A nurse is caring for a client who is from a different culture than them. Which of the following actions should the nurse take to provide culturally competent care? ·Contact an interpreter if the client does not respond to nonverbal communication cues. ·Rely on intuition when interacting with the client. ·Master the communication cues of a single culture. ·Minimize allotted time with the client's spiritual leaders.

√Contact an interpreter if the client does not respond to nonverbal communication cues. The nurse should not hesitate to contact an interpreter if they detect a language barrier or if the client does not respond to nonverbal cues of communication.

A nurse is seeking to improve outcomes in mental health by incorporating technology as a part of primary prevention interventions. Which of the following actions should the nurse take? ·Distribute a video discussing risk factors for suicide and depression at a local high school. ·Record each client's risk factors in an electronic medical record. ·Refer clients to a smartphone application to help reduce manifestations of anxiety. ·Refer at-risk clients to a local health care provider.

√Distribute a video discussing risk factors for suicide and depression at a local high school. This action by the nurse represents a strategy for incorporating technology as a primary prevention intervention.

A nurse is admitting a new client. Which of the following actions should the nurse take during the orientation phase of the nurse-client relationship? ·Recognize educational needs. ·Establish boundaries. ·Affirm client attitude toward treatment. ·Provide community resource referrals.

√Establish boundaries. In the orientation phase, the nurse sets the tone for the relationship by setting boundaries and developing mutual goals.

A nurse is interviewing a client who is irritable and agitated. Which of the following actions should the nurse take to portray engagement with the client? ·Touch the client's upper arm. ·Avoid making eye contact. ·Sit directly across from the client. ·Give a slight nod throughout the interview.

√Give a slight nod throughout the interview. To avoid appearing too relaxed, the nurse should give a slight nod or slightly lean forward to exhibit engagement.

A nurse is researching methods of incorporating technology in their nursing practice. Which of the following strategies should the nurse use to incorporate technology in nursing care? ·Implement a client-centered self-schedule smartphone application. ·Incorporate therapeutic communication during each client appointment. ·Allow clients to self-disclose religious affiliations. ·Include bias-free language in educational brochures.

√Implement a client-centered self-schedule smartphone application. The nurse can utilize electronic health records, educational videos, and smartphone applications to improve mental health care outcomes.

A nurse is researching methods of incorporating technology in their nursing practice. Which of the following strategies should the nurse use to incorporate technology in nursing care? ·Implement a video conferencing policy for clients in rural locations. ·Include the client's spiritual leader during discharge planning. ·Allow the client to disclose gender identity upon admission. ·Provide education discussing the importance of treatment adherence.

√Implement a video conferencing policy for clients in rural locations. The nurse could utilize video conferencing to improve equity for clients in rural locations.

A nurse is participating in an interdisciplinary team meeting for clients on the unit. Which of the following actions should the nurse recommend to improve inclusion among the treatment team? ·Integrate complementary and alternative therapies for clients. ·Provide vouchers for free or low-cost medical transportation. ·Include discussion of the clients' spiritual needs in team meetings. ·Suggest that clients be identified by their diagnoses to protect confidentiality.

√Include discussion of the clients' spiritual needs in team meetings. Recommending this action supports inclusion. Inclusion refers to the ability of all care team members, including the clients, to voice their concerns with treatment and influence the decision-making process based on their needs.

A nurse is participating in an interdisciplinary team meeting for clients on the unit. Which of the following actions should the nurse recommend to improve diversity among the treatment team? ·Integrate clinicians from various cultural backgrounds into the team meeting. ·Include nonlicensed staff members in the team meeting. ·Include each client in team meetings. ·Initiate autocratic leadership into meetings.

√Integrate clinicians from various cultural backgrounds into the team meeting. To support diversity among the interdisciplinary team, the nurse should recommend integrating clinicians from various cultural backgrounds.

A nurse is preparing to discharge a client. Which of the following actions should the nurse plan to take to improve the client's level of functioning beyond the nurse-client relationship? ·Establish boundaries. ·Recognize educational needs. ·Affirm client attitude toward treatment. ·Provide community resource referrals.

√Provide community resource referrals. The nurse should provide community referrals and resources in the resolution phase of the nurse-client relationship.

A nurse is participating in an interdisciplinary team meeting for clients on the unit. Which of the following actions should the nurse recommend to improve equity among the clients? ·Suggest complementary and alternative treatments for clients. ·Provide free or low-cost treatment options for all clients. ·Integrate each client's family in team meetings. ·Automatically refer each client to a local health care provider.

√Provide free or low-cost treatment options for all clients. Recommending this action will support equity among the clients. Equity ensures that each client has equal opportunity to initiate and continue fair treatment. Suggest complementary and alternative treatments for clients. Recommending this action will support diversity for clients. Diversity refers to the qualities of a client that differ from those of the nurse. Integrate each client's family in team meetings. Recommending this action will support inclusion. Inclusion refers to the ability of all care team members, including the client and those involved in their care, to voice their concerns with treatment and influence the decision-making process. Automatically refer each client to a local health care provider. Recommending this action will not support diversity, equity, or inclusion. The client's preference for treatment should be considered.

A nurse is seeking to improve outcomes in mental health care by integrating technology in a local clinic. Which of the following actions should the nurse take to incorporate technology as a part of tertiary prevention interventions? ·Organize a video streaming event to raise awareness about mental illness. ·Utilize an electronic survey to help identify at-risk clients. ·Refer clients to a support group that meets on social media. ·Host peer-facilitated support groups for clients who struggle with addiction.

√Refer clients to a support group that meets on social media. This action by the nurse represents a strategy for incorporating technology as a tertiary prevention intervention.

A nurse is working in a mental health facility in an occupational role. Which of the following activities is a function of the occupational role of the nurse? ·Participating on a health advisory board ·Referring the client for chaplain services ·Reinforcing client education on risk factors ·Assisting in developing community health policies

√Reinforcing client education on risk factors The occupational role of a nurse includes education, group facilitation, and care management. Participating on a health advisory board The social role of a nurse includes participating on health advisory boards, policymaking, and community advocacy. Referring the client for chaplain services The therapeutic role of the nurse includes coordinating spiritual leaders, processing emotional turmoil, and reinforcing cognitive behavioral techniques. Assisting in developing community health policies The social role of a nurse includes policymaking and community advocacy.

A nurse is using considerations from Leininger's Transcultural Nursing Theory to plan care for a client who is from a different culture than the nurse. Which of the following actions should the nurse plan to take to demonstrate the consideration of cultural preservation? ·Request specific meal tray items to support a client's spiritual beliefs. ·Provide education about the client's illness. ·Assist the client with planning for diet alternatives. ·Administer medications in replacement of herbal remedies.

√Request specific meal tray items to support a client's spiritual beliefs. The nurse demonstrates cultural preservation by seeking to retain the client's core cultural beliefs and values related to healthcare, such as diet and clothing preference.

A nurse is helping a client develop a plan for successful behavior change. Which of the following interventions should the nurse include in the plan? ·Allow the client to choose a range of guidelines for success. ·Implement the use of a reflective journal to measure success. ·Provide a general list of resources that are popular for most clients. ·Schedule an appointment with a provider who lives within walking distance of the client.

√Schedule an appointment with a provider who lives within walking distance of the client. The nurse should plan to work within the constraints of available resources for the client.

A charge nurse manager is reinforcing teaching to a newly licensed nurse about ways to provide culturally competent care. Which of the following instructions should the charge nurse provide? ·Encourage clients to adjust to the culture of the nurse caring for them. ·Exclusively participate in events focused on a single culture. ·Focus on working with clients from a familiar cultural background. ·Seek assistance from an interpreter for language barriers.

√Seek assistance from an interpreter for language barriers. The charge nurse should reinforce to the newly licensed nurse not to hesitate to contact an interpreter if they detect a language barrier or if the client does not respond to nonverbal cues of communication.

A nurse is reflecting on their performance after engaging with a client in an interview. Which of the following actions should the nurse plan to implement to improve receptiveness in their next client interview? ·Keep eye contact to a minimum. ·Sit at a slight angle across from the client. ·Cross legs to portray relaxation. ·Lean away from the client to build trust.

√Sit at a slight angle across from the client. If a client is feeling vulnerable, sitting directly in front of them might be perceived as confrontational. The nurse should sit across from the client at a slight angle to create a comfortable environment.

A nurse is assisting a client to develop a plan to reduce caloric intake. Which of the following interventions should the nurse include in the plan as a measurable goal for this client? ·The client will lose 3 kg (6.6 lb) of total body weight over the next 30 days. ·The client will record consuming no more than 1,800 calories per day. ·The client will provide a list of foods that they like to consume. ·The client will avoid using fried foods when preparing meals.

√The client will record consuming no more than 1,800 calories per day. This is an example of a measurable goal. The nurse should plan to use objective measurements, like calories consumed per day, or use a tool to translate subjective experiences into something that is measurable.

A nurse is working to build rapport and trust with a new client. Which of the following actions by the nurse could serve as a barrier to building rapport? ·The nurse fulfills a promise made to the client and allows them to use a telephone. ·The nurse reinforces the importance of the client's medication regimen. ·The nurse asks the client to clarify their most recent statement. ·The nurse uses clinical terminology to help the client better understand their diagnosis.

√The nurse uses clinical terminology to help the client better understand their diagnosis. The client's education level might serve as a barrier for building rapport. Initially, the nurse should use simple vocabulary when building rapport with the client and avoid clinical terminology.

A nurse is seeking to improve outcomes in mental health care by integrating technology in a local clinic. Which of the following actions should the nurse take to incorporate technology as a part of secondary prevention interventions? ·Distribute an email discussing risk factors for anxiety to a local community organization. ·Utilize a video conferencing application to perform a suicide risk screening. ·Refer clients to a website that provides strategies for reducing manifestations of depression. ·Identify factors that contribute to disparities in mental health.

√Utilize a video conferencing application to perform a suicide risk screening. This action by the nurse represents a strategy for incorporating technology as a secondary prevention intervention.