Therapeutic Relationships Review Questions

When comparing social interactions with therapeutic interactions, the nurse understands that therapeutic interactions do what? A. Encourage personal goal setting B. Involve doing favors for others C. Create constructive dependencies D. Are personal and intimate

A. Encourage personal goal setting

During a first meeting a client asks that information shared will not be relayed to immediate family members. Which should the nurse say in response? A. "Any information is only shared with other professionals involved in your care." B. "I cannot promise that. Your family may ask me questions and I will need to answer truthfully." C. "Is there some reason why you don't want your family to know your problems?" D. "It depends upon what they ask me. I might be able to withhold some information, but not all."

A. "Any information is only shared with other professionals involved in your care."

The nurse and client are discussing discharge plans. Which statement should the nurse make that demonstrates empathy for the client's fear of returning to a group home environment? A. "It can be scary to leave a place that you trust and feel supported." B. "Just think of all of the things you can do in the home that you can't do here." C. "Don't you think you're ready to be independent?" D. "You are more than ready to get out of here. Have faith in your accomplishments."

A. "It can be scary to leave a place

Which statement is the most empathic response to a client's disclosure that the client's father abandoned the family when the client was a young child? A. "That must have been terribly hurtful experience for you." B. "I too have been disappointed by important people in my life." C. "What do you think motivated your father to do that." D. "You will find that one of the constants in life is that people will often let you down."

A. "That must have been terribly hurtful experience for you."

The client presents with signs and symptoms of anxiety. What conversation initiated by the nurse demonstrates an ineffective therapeutic use of self? A. "What types of dresses do you like wearing?" B. "Do you want me to inform your spouse about your illness?" C."How did the pain start?" D. "Do you take a vegetarian or nonvegetarian diet?"

A. "What types of dresses do you like wearing?"

A client tells the nurse, "I had to slap my child, I couldn't help that." Which response of the nurse indicates that the nurse is in the state of unknowing? A. "What was going on for you when this happened?" B. "How could you do this to your child?" C. "I really feel sorry for your child." D. "Punishing your child would only make your child worse."

A. "What was going on for you when this happened?"

Which situation would most likely indicate a violation of professional boundaries? Select all that apply. A. A nurse tells other staff that the nurse is the only one who understands the client. B. The nurse strongly defends a client's behavior during a staff meeting. C. A nurse begins to spend increasing amounts of time with one client on the unit. D. The nurse refuses a gift from a client and the client's family. E. A nurse reports information to the physician after the client asks that it be kept a secret.

A. A nurse tells other staff that the nurse is the only one who understands the client. B. The nurse strongly defends a client's behavior during a staff meeting. C. A nurse begins to spend increasing amounts of time with one client on the unit.

Which are the nurse's expectations of the client's responsibilities during the orientation phase of the nurse-client relationship? Select all that apply. A. Attendance is expected for each session. B. Demonstrating the ability to actively listen to the discussions that occur C. Participation is expected during each session. D. Addressing the client's need for adjustments to medication therapies E. Sharing of feelings and needs are vital to the productivity of the session

A. Attendance is expected for each session. C. Participation is expected during each session. E. Sharing of feelings and needs are vital to the productivity of the session

A client with a diagnosis of bipolar I disorder has been presented with a coping strategy by the therapist that may help the client manage behavior during manic episodes. The client has responded to the therapist's suggestion by saying, "What's the use? I don't ever see this changing." The client's statement is suggestive of a potential problem with what factor that influences communication? A. Attitude B. Knowledge C. Values D. Ability to relate to others

A. Attitude

The nurse and client are discussing an upcoming sporting event in which they both share an interest. This form of interaction has the potential to pose which threat to the nurse-client relationship? A. Avoid the work needed for the client to reach set goals. B. Let the client know that the nurse is genuine with diverse interests. C. Overstep the ethical boundaries that the nurse should maintain. D. Influence whether the client likes the nurse or not.

A. Avoid the work needed for the client to reach set goals.

In what phase of the therapeutic relationship does the assessment process begin? A. During the initiating or orienting phase B. After the initiating or orienting phase has been completed C. After the working phase has been completed D.

A. During the initiating or orienting phase

An experienced nurse takes pride in the therapeutic use of self. Nurse-client relationships are meaningful to both the nurse and the client. Nurses that have use of self skills help clients do what? A. Grow, change, and heal B. Maintain skills after discharge C. Participate in all aspects of care D. Serve as peer clients for new admissions

A. Grow, change, and heal

The client tells the nurse, "I am regularly doing my sitting breathing exercises. Why do I still feel breathless while walking?" The nurse replies, "Sitting breathing exercises alone may not achieve the desired effects. You also should perform daily deep breathing exercises while walking. This should help you to reduce breathlessness while walking." According to the Peplau model, in which phase of the nurse-client relationship would this conversation occur? A. Identification phase B. Exploitation phase C. Orientation phase D. Termination phase

A. Identification phase

Which statement is true of empathy? Select all that apply. A. It is developed by gathering information from the client. B. It results in negative therapeutic outcomes. C. The client must learn to develop empathy for the nurse. D. It involves interjecting the nurse's personal experiences and interpretations of the situation. E. It is the ability to place oneself into the experience of another for a moment in time.

A. It is developed by gathering information from the client. E. It is the ability to place oneself into the experience of another for a moment in time.

When interacting with a client for the first time, which information would be appropriate for the nurse to disclose? Select all that apply. A. Level of education B. Family members C. Home address D. Reason for being on the unit E. Name

A. Level of education D. Reason for being on the unit E. Name

It is the nurse's responsibility to define the boundaries of the relationship during which phase of the nurse-client relationship? A. Orientation B. Problem identification C. Working D. Termination

A. Orientation

The nurse is reviewing the client's history, identifies themes, and considers how the nurse can be most therapeutic to a client who was recently admitted to a psychiatric unit. The nurse is functioning in which phase of the therapeutic relationship? A. Orientation B. Withholding C. Working D. Resolution

A. Orientation

A nurse is caring for a client on an inpatient mental health unit of a hospital. The nurse tells the client, "You are scheduled to attend therapy sessions every morning at 9:00 a.m. Please make sure that you complete your morning routine, such as using the restroom, bathing, and eating breakfast, before you come for the sessions." Which phase of the nurse-client relationship does this communication indicate, according to the Peplau's model? A. Orientation phase B. Identification phase C. Exploitation phase D. Termination phase

A. Orientation phase

While in the day room of the psychiatric unit, the nurse notices a client sitting quietly alone, eyes downcast, and looking sad. The nurse says to the client, "You look like something is bothering you." Which pattern of knowing did the nurse use to respond to the client? A. Personal knowing B. Ethical knowing C. Aesthetic knowing D. Empirical knowing

A. Personal knowing

The nurse is caring for a client recently diagnosed with a psychiatric illness. Which key areas should the nurse focus on while caring for this client? Select all that apply. A. Promoting physical health B. Personal safety C. Ensuring adequate sedation with medication D. Promoting mental health E. Preventing deterioration of mental status

A. Promoting physical health D. Promoting mental health E. Preventing deterioration of mental status

A nurse is conducting a 6-week social skills training program. A young adult with schizophrenia asks the nurse to call the client on the weekends so the client has someone to talk to who really cares. Which action should the nurse take? A. Remind the client about the importance of boundaries to keep the relationship therapeutic B. Call the client once each weekend to build trust C. Tell the client the nurse will call once per week during office hours so that the client can practice phone skills D. Tell the client to call the office answering service in case of an emergency

A. Remind the client about the importance of boundaries to keep the relationship therapeutic

Which behavior by the nurse demonstrates positive regard? Select all that apply. A. Responding openly B. Considering the client's ideas and preference when planning care C. Communicating judgments about the client's behavior D. Calling the client by name E. Spending time with the client

A. Responding openly B. Considering the client's ideas and preference when planning care D. Calling the client by name E. Spending time with the client

A nurse and client are in the orientation phase of the nurse-client relationship. Which behavior would occur during this phase? Select all that apply. A. Reviewing the client history B. Explanation of the purpose of the relationship C. Discussion of client's expectations D. Strengthening of relationships E. Exploration of problems

A. Reviewing the client history B. Explanation of the purpose of the relationship C. Discussion of client's expectations

A client describes panic attacks during which the client rushes to the emergency department with a feeling that death may be imminent. The nurse discloses having had panic attacks during which the nurse also felt very fearful. Which statement about the nurse's self-disclosure is accurate? A. Self-disclosure can help normalize the client's experience. B. Self-disclosure allows the client to see the nurse as a real human being. C. Self-disclosure can help the client feel like a friend. D. Self-disclosure should be detailed so the client doesn't feel unimportant or devalued.

A. Self-disclosure can help normalize the client's experience.

Which problems can arise during the working phase of a nurse-client relationship that serve to impair the therapeutic work? Select all that apply. A. The client demonstrates dependence on the group B. The client demonstrates aggressive behavior towards the nurse C. The nurse believes that the relationship has not been productive D. The nurse demonstrates evidence of countertransference E. The client struggles with expressing feelings

A. The client demonstrates dependence on the group D. The nurse demonstrates evidence of countertransference E. The client struggles with expressing feelings

A nurse is caring for a client with posttraumatic stress disorder. Which behavior of the client indicates the resolution phase? A. The client is able to independently express feelings and emotions with the client's friends. B. The client explores the emotions and feelings related to the traumatic experience. C. The client becomes more expressive about the client's feelings to the nurse. D. The client tries different coping strategies to deal with stress.

A. The client is able to independently express feelings and emotions with the client's friends.

Which statements correctly depict the problem of feeling sympathy toward the client? Select all that apply. A. The client is discouraged from growth. B. When the nurse's behavior is rooted in sympathy, the client finds it easier to manipulate the nurse's feelings. C. The client is discouraged from exploring his or her problems, thoughts, and feelings. D. The client feels dependent on the nurse. E. The nurse may feel sad and be unable to help the client.

A. The client is discouraged from growth. B. When the nurse's behavior is rooted in sympathy, the client finds it easier to manipulate the nurse's feelings. C. The client is discouraged from exploring his or her problems, thoughts, and feelings. D. The client feels dependent on the nurse.

Which would indicate that the nurse-client relationship has passed from the orienting phase to the working phase? A. The client recognizes feelings of anger and expresses them appropriately. B. The client has revitalized the relationship with the client's sister. C. The client expresses a desire to be mothered and pampered. D. The nurse has designated a specific time each day to interact with the client.

A. The client recognizes feelings of anger and expresses them appropriately.

A nurse is assessing an adolescent client who has recently been self-mutilating. The nurse asks the client questions that seek to uncover the motivation underlying the behavior. The nurse's approach best reflects what? A. The exploration of behaviors to uncover the client perspective B. The use of unconditional positive regard C. The therapeutic use of self D. A demonstration of genuine interest

A. The exploration of behaviors to uncover the client perspective

Avoiding which outcome is the primary reason for establishing professional boundaries with clients? A. The loss of therapeutic effectiveness B. The possibility of inappropriate sexual tension developing C. The possibility of losing control of the milieu D. The likelihood of a client becoming too dependent on the nurse

A. The loss of therapeutic effectiveness

Which observation should lead the nurse manager to recognize that countertransference is affecting the therapeutic effectiveness of an individual nurse on the unit? A. The nurse frequently refers to an elderly, cognitively impaired client as "my granny" B. The nurse is referred to as being in a relationship with a client by that client, and the client wants the nurse to accompany the client to the prom C. The nurse asks to be transferred to another unit to avoid burnout and to work with different disorders D. The nurse begins to experience the symptoms of depression and calls out sick

A. The nurse frequently refers to an elderly, cognitively impaired client as "my granny"

Which is a nurse's primary tool for treating clients with mental disorders? A. The therapeutic use of self B. Family education and therapy C. Self-help groups D. Psychotropic medications

A. The therapeutic use of self

The nurse-client relationship is classified as which type of relationship? A. Therapeutic B. Friendly C. Social D. Intimate

A. Therapeutic

A care area is implementing motivational interviewing. What skills will be implemented by the nurse for this technique to be successful? Select all that apply. A. self-awareness B. active listening C. use of a variety of defense mechanisms D. strong communication E. empathetic linkages

A. self-awareness B. active listening D. strong communication E. empathetic linkages

A nurse notices that a neighbor has been admitted to an inpatient psychiatric unit. The nurse understands that the nurse may not discuss this with any of the nurse's family or neighbors, because doing so would breach the client's confidentiality. Confidentiality is a component of which element of the therapeutic relationship? A. Trust B. Genuine interest C. Caring D. Positive regard

A. Trust

During which phase of the nurse-client relationship does the client identify and explore specific problems? A. Working B. Debriefing C. Orientation D. Resolution

A. Working

After meeting with a client experiencing extreme anxiety the nurse notes personal feelings of nervousness. Which action should the nurse take first to address these feelings? A. analyze the source of the feelings B. investigate transferring to another care area C. plan sessions to occur after the client receives medication D. suggest another nurse meet with client going forward

A. analyze the source of the feelings

The nurse and client are entering the orientation phase of a relationship. Which is the goal for the client during this phase? A. develop a sense of trust in the nurse B. resolve pressing problems C. work through problems D. identify potential solutions to issues

A. develop a sense of trust in the nurse

While interviewing a client, the nurse imagines what it would be like to be in the client's situation and how it would feel. What is the nurse demonstrating? A. empathy B. projection C. rapport D. self-awareness

A. empathy

The nurse prepares to assess a client for the first time. Which action should the nurse take to develop a rapport with this client? Select all that apply. A. establish professional boundaries B. explain what confidential information will be shared with others C. listen intently to the client explain problems and issues D. compliment the client regarding clothing selection E. suggest that another nurse meet with the client because of arriving late

A. establish professional boundaries B. explain what confidential information will be shared with others C. listen intently to the client explain problems and issues

What are possible warnings or signals of abuse of the nurse-client relationship? Select all that apply. A. inappropriate conversations in the nurse-client relationship B. talking to team members about clients C. keeping secrets D. nurse making exceptions for client E. accepting behavior

A. inappropriate conversations in the nurse-client relationship C. keeping secrets D. nurse making exceptions for client

An adolescent client has just been found to have broken one of the unit rules. The nurse imposes the consequence of losing phone privileges. In this instance, the nurse is acting as ... A. parent surrogate. B. advocate. C. caregiver. D. teacher.

A. parent surrogate.

The nurse maintains a therapeutic relationship until the client is successfully transferred to another facility. What is the nurse demonstrating? A. transitional relationship model B. mutual withdrawal C. motivational interviewing D. avoid and ignore

A. transitional relationship model

When a client states, "I will solve my own problems without asking my family for help," which response by the nurse demonstrates a therapeutic use of self? A. "How do you plan to manage your problems without help?" B. "Asking for help from those who care about us isn't a sign of weakness." C. "Your family would want to help if you had a problem." D. "Being self-sufficient is a sign of mental health stability."

B. "Asking for help from those who care about us isn't a sign of weakness."

The manager determines that a nurse is using motivational interviewing when talking with a client. Which statment made by the nurse did the manager observe to make this clinical determination? A. "Now that you are here, drinking will not be an issue." B. "How important is it to you to stop drinking?" C. "We need to work on your drinking problem together." D. "That ticket that you got should be your motivator to quit." E. "Everyone drinks now and then, I don't see it as a problem."

B. "How important is it to you to stop drinking?"

The nurse is caring for a client with schizophrenia. The client tells the nurse, "My dead mother is calling me, I will finally be with her tonight. Please do not tell anyone." What is the most appropriate nursing response? A. "Who has influenced you with these ideas?" B. "I cannot keep this a secret. I will ensure that the staff helps keep you safe." C. "I will speak with the health care provider about the possible use of physical restraints for you tonight." D. "Don't worry; I will keep this secret to myself."

B. "I cannot keep this a secret. I will ensure that the staff helps keep you safe."

Which statement by the nurse demonstrates acceptance to the client who has made a sexually inappropriate comment? A. "That type of talk is inappropriate and won't be tolerated." B. "Our relationship is one of a professional nature." C. "Why do you think making that comment is appropriate?" D. "How would you feel if someone said that to you?"

B. "Our relationship is one of a professional nature."

A nurse and client are engaged in a discussion. The client says, "I feel really close to you. You are the only true friend I have." Which response by the nurse would be most therapeutic? A. "We are definitely not friends. This is strictly professional." B. "Since ours is a professional relationship, let's explore other opportunities in your life for friendship." C. "I am sure there are other people in your life who are your friends; besides, we just met." D. "It makes me feel good that you trust me so much; it is important for the work we are doing together."

B. "Since ours is a professional relationship, let's explore other opportunities in your life for friendship."

During the working phase, a client demonstrates open hostility in reaction to the nurse's last question. Which response should the nurse make to avoid countertransference? A. "I am only doing my job." B. "Tell me why you are angry about what I just said." C. "I am only trying to help you." D. "If you don't want to continue with me, I'll find someone else."

B. "Tell me why you are angry about what I just said."

Which statement would indicate that the nurse has a non-judgmental attitude? A. "I think the client is exaggerating her feelings so she can leave work early." B. "The client has struggled with her life circumstance of living with a man who beats her, and she is trying very hard to make the changes necessary to help herself." C. "People who are mentally ill have basically weak characters." D. "Mental illnesses are, for the most part, all in your head and could be solved more easily if people were forced to continue with their daily activities, instead of listening to their complaints."

B. "The client has struggled with her life circumstance of living with a man who beats her, and she is trying very hard to make the changes necessary to help herself."

A nurse is speaking to a client with a soft smile and eye contact. Which statement said by the nurse would indicate a congruent message? A. "I know you are in pain. Please wait until the medication shows its effect." B. "Your hard work and determination has helped you recover." C. "Please don't disturb the other clients in the ward." D. "Please listen to the instructions carefully before starting the exercises."

B. "Your hard work and determination has helped you recover."

A client arrives for a scheduled meeting with the nurse. Which statement should the nurse make that indicates the working phase of the relationship? A. "I do not give out my cell phone number to clients." B. "Your idea would help prevent this from happening again." C. "You have learned how to handle that problem already." D. "Thank you for arriving on time."

B. "Your idea would help prevent this from happening again."

A nurse administrator is observing the behavior of nurses in the hospital. Which behaviors would the nurse administrator consider inappropriate? Select all that apply. A. A nurse speaking to a client at a distance of 4 feet B. A nurse speaking to a depressed client in a very strict, disciplinarian tone C. A nurse holding the hand of a client who is depressed because of the client's child's chronic illness. D. A nurse hugging a client who had come in for an initial visit E. A nurse palpating the neck of a client during the assessment

B. A nurse speaking to a depressed client in a very strict, disciplinarian tone D. A nurse hugging a client who had come in for an initial visit

A client with depression has been admitted to the mental health unit and is attending group therapy sessions as part of the treatment. The client asks the nurse leading the group if the nurse is married or has a girlfriend. The nurse responds, "I am curious what made you ask this question; however, what is important is how you are feeling today." The nurse's response is what? A. Appropriate, because the nurse is not in a relationship or married. B. Appropriate, because the focus of the therapeutic relationship is the client, not the nurse. C. Inappropriate, because the client was just making small talk about the nurse's personal situation to get to know the nurse better. D. Inappropriate, because the nurse should have answered to establish a therapeutic relationship.

B. Appropriate, because the focus of the therapeutic relationship is the client, not the nurse.

The nurse learns that a new client is a former significant other and an initial session is scheduled for early in the afternoon. Which action should the nurse take to maintain professional boundaries? A. Meet for the first session but explain that another nurse will be assigned going forward. B. Ask to be reassigned because of having a prior personal relationship with the client. C. Ask another nurse to attend the meetings to ensure boundaries are not crossed. D. Plan to meet the client since the personal relationship ended.

B. Ask to be reassigned because of having a prior personal relationship with the client.

A 68-year-old parent is the sole care provider for a 39-year-old child who has a diagnosis of bipolar disorder. The 39-year-old has been experiencing worsening of the illness over several years. The nurse should recognize that the parent is at risk for what? A. Failure to thrive B. Compassion fatigue C. Bipolar disorder D. Decompensation

B. Compassion fatigue

A nurse is engaged in a therapeutic nurse-client relationship. The relationship is in the working phase. The nurse recognizes the client should be involved with which actions? Select all that apply. A. Testing the relationship B. Discussing problems related to needs C. Testing new ways for problem solving D. Examining personal issues E. Beginning to identify a need

B. Discussing problems related to needs C. Testing new ways for problem solving D. Examining personal issues

At the end of a 12-hour shift, the nurse overhears that a client that the nurse has cared for before is being readmitted to the mental health facility. The nurse says to the charge nurse, "I better stay around for a couple of hours. I am the only one the client will talk to." This is a warning sign that the nurse is experiencing which obstacle to establishing a therapeutic relationship? A. Excessive probing B. Lack of self-awareness C. Partnership D. Judgmental attitudes

B. Lack of self-awareness

A nurse interviews a new client in the day room of the psychiatric unit. The nurse is wearing a jacket and a bag and frequently asks the client to repeat the last statement. The nurse's demeanor with the client is reflective of what? A. Confidentiality B. Lacking genuine interest C. Unknowing D. Professionalism

B. Lacking genuine interest

The nurse is mindful of maintaining relationships with clients that are therapeutic. Which characteristic would be most important for the nurse to foster? Select all that apply. A. Offering sound advice to the client. B. Maintaining a client focus at all times. C. Sharing personal feelings openly with the client. D. Establishing boundaries for both the nurse and client. E. Avoiding concern with whether the client likes the nurse.

B. Maintaining a client focus at all times. D. Establishing boundaries for both the nurse and client. E. Avoiding concern with whether the client likes the nurse.

When the nurse helps the cognitively impaired client bathe and dress, what role is the nurse assuming? A. Caregiver B. Parent surrogate C. Advocate D. Teacher

B. Parent surrogate

The nurse has been working with a client with an eating disorder for 1 week. During the morning treatment team meeting, the treatment plan is updated. Which would be appropriate interventions at this time in the nurse-client relationship? Select all that apply. A. Explaining the boundaries of the relationship B. Promoting a positive self-concept C. Addressing testing behaviors D. Working through resistance E. Exploring perceptions of reality

B. Promoting a positive self-concept D. Working through resistance E. Exploring perceptions of reality

Which is not a goal of the working phase of the therapeutic relationship? A. Identifying past behaviors that have been ineffective for coping with the focal problem B. Reducing the client's anxieties C. Developing a plan of action, practicing it, and evaluating its effectiveness D. Increasing hopefulness for the future

B. Reducing the client's anxieties

During the termination phase, a client begins to raise old problems that have already been resolved. Which would be appropriate nursing responses? Select all that apply. A. Immediately stop the client and inform the client that the nurse is running the session. B. Review with the client the learned methods to control the problems. C. Reassure the client that they already covered these issues. D. Do not acknowledge this issue and continue on with the session as planned. E. Get angry at the client and ask the client to leave the session.

B. Review with the client the learned methods to control the problems. C. Reassure the client that they already covered these issues.

A client is engaged in the orientation phase of the nurse-client relationship. The client should be involved in which activity? A. Establishing boundaries B. Seeking assistance C. Discussing underlying needs D. Testing new ways to solve problems

B. Seeking assistance

When engaged in a therapeutic relationship, the nurse's focus is on what? A. The family B. The client C. The self D. The environment

B. The client

A nurse is meeting a client for the first time. The nurse observes that the client smiles appropriately but is using rambling speech while answering the nurse's questions. Which would most likely be the reason for this behavior? A. The client is experiencing symptoms of a disorder. B. The client is nervous and insecure. C. The client is attempting to engage in a social relationship. D. The client is demonstrating a normal reaction.

B. The client is nervous and insecure.

A nurse recently began working with a client in the community. The client arrived 15 minutes late for the last appointment and did not show up for today's scheduled appointment, despite confirming the day before. How should the nurse best interpret this client's behavior? A. The client mistrusts the nurse's ability to promote recovery. B. The client is testing the parameters of the relationship. C. The client's illness is being treated by another clinician. D. The client is in denial about the severity of the illness.

B. The client is testing the parameters of the relationship.

A nurse is reading a journal article about the therapeutic relationship. The nurse demonstrates understanding of the information when the nurse identifies which aspect as the primary difference between social and therapeutic relationships? A. The kind of information given. B. The focus of the relationship. C. The degree of satisfaction obtained. D. The amount of emotion invested.

B. The focus of the relationship.

A nurse understands that giving positive regard to the client helps in building trust for the nurse. Which actions are appropriate while conveying positive regard? Select all that apply. A. The nurse should be available all the time for caring for the client. B. The nurse should address the client by name. C. The nurse should give the responsibility of planning therapy to the client. D. The nurse should actively listen to the client. E. The nurse should respond openly to the client.

B. The nurse should address the client by name. D. The nurse should actively listen to the client. E. The nurse should respond openly to the client.

A nurse is caring for a client experiencing delusions. The client tells the nurse "I am sure my brother has plans to kill me. But I am ready; I will be killing him before he tries to reach me." What is the appropriate action of the nurse in this situation? A. The nurse should inform that severe actions would be taken if the client repeats it. B. The nurse should notify to the primary healthcare provider. C. The nurse should sedate the client. D. The nurse should advise the client not to think this way.

B. The nurse should notify to the primary healthcare provider.

A psychiatric-mental health nurse has developed a therapeutic relationship with a client. Which action would alert the nurse to the possibilty that the relationship may be moving outside professional boundaries? Select all that apply. A. The nurse informs the supervisor that the client asked the nurse to "keep a secret from the rest of the staff." B. The nurse tells a friend that the nurse is the only one who truly understands this client. C. The nurse objectively contributes to the team meeting about behaviors the client is displaying. D. The nurse is spending more time with the client than the others in the group. E. The client brings the nurse a baked item for their lunch.

B. The nurse tells a friend that the nurse is the only one who truly understands this client. D. The nurse is spending more time with the client than the others in the group. E. The client brings the nurse a baked item for their lunch.

While the nurse and client are interacting during a therapy session, the nurse openly admits to not being able to relate to a client's experience. According to Munhall, this will most likely have what influence on the therapeutic relationship? A. The client will not trust the nurse's professional abilities. B. The nurse will avoid imposing any values on the client. C. The nurse will more likely be manipulated by the client. D. The client will be less likely to self-disclose to the nurse.

B. The nurse will avoid imposing any values on the client.

What would be the most appropriate action by the student nurse when the client asked the student nurse to keep it a secret that the client plans to kill a family member? A. The student nurse must tell the client that the student nurse will keep the secret and then tell the instructor and/or staff members. B. The student nurse must tell the client that the student nurse cannot keep that secret and then report it to the instructor and/or staff members. C. The student nurse must tell the instructor and then ask the instructor to keep it secret. D. The student nurse must respect the client's privacy and not tell anyone.

B. The student nurse must tell the client that the student nurse cannot keep that secret and then report it to the instructor and/or staff members.

The nurse must be able to make decisions that are based on the principles of right and wrong. What is the standard for establishing such a code of conduct for living? A. Empathy B. Values C. Acceptance D. Positive regard

B. Values

The client tells the nurse, "I am regularly doing my sitting breathing exercises. Why do I still feel breathless while walking?" The nurse replies, "Sitting breathing exercises alone may not achieve the desired effects. You also should perform daily deep breathing exercises while walking. This should help you to reduce breathlessness while walking." According to Peplau's model, the nurse and client are in which phase? A. Orientation B. Working C. Resolution D. Termination

B. Working

A nurse in the geri-psych unit witnessed another nurse violate the boundaries of the professional relationship with a client. The nurse takes what role when speaking to the supervisor about the situation? A. parent surrogate B. advocate C. care giver D. teacher

B. advocate

During an individual therapy session, a nurse is listening to a client describe the client's drug addiction. The client says, "I know I am doing the wrong thing for my kids, but I just can't stop using drugs." The nurse maintains eye contact and nods occasionally. The nurse responds by saying, "You're going through a difficult time." The nurse's actions and words are an example of: A. sympathy. B. empathy. C. nontherapeutic communication. D. apathy.

B. empathy.

A care area is having difficulty implementing the transitional care model. Which observation should the nurse manager address to help facilitate this process? Select all that apply. A. implementing educational modules B. focusing on preexisting conflicts C. over-reliance on the process D. nurses feeling overwhelmed E. recognizing on-site champions

B. focusing on preexisting conflicts C. over-reliance on the process D. nurses feeling overwhelmed

What activity should be included in the first step of self-awareness? A. determining whether you actually possess qualities that you are unaware of B. identifying one's own values, attitudes, strengths and weakness C. asking others to share their perceptions of you D. categorizing your qualities as being either public or hidden

B. identifying one's own values, attitudes, strengths and weakness

The manager schedules a staff nurse to attend a motivational interviewing training session. Which nurse behavior caused the manager to make this decision? Select all that apply. A. asking the client to clarify a particular issue B. interrupting the client C. arguing with a client over agreed upon plans D. restating the client's perception of a problem E. minimizing the client's concerns

B. interrupting the client C. arguing with a client over agreed upon plans E. minimizing the client's concerns

The most important tool of psychiatric nursing is the: A. nurse. B. self. C. environment. D. physician.

B. self.

The client tells the nurse, "I don't think you can help me. Every time I talk to you, I am reminded of my mother, and I hated her." The nurse should recognize this as: A. incongruence. B. transference. C. countertransference. D. confrontation.

B. transference.

The nurse is concerned that a relationship with a client is not therapeutic. Which behaviors demonstrated by the nurse support this concern? Select all that apply. A. establishes goals for the upcoming week B. varies the length of meeting times from session to session C. remains aloof for several sessions D. becomes frustrated during the meetings E. discusses topics without consistency

B. varies the length of meeting times from session to session C. remains aloof for several sessions D. becomes frustrated during the meetings E. discusses topics without consistency

What occurs during the working phase of the nurse-client relationship? A. Discussion regarding termination of the relationship B. Rejection of client needs C. Evaluation of mutually identified goals D. Discussion of expectations of the relationship

C. Evaluation of mutually identified goals

A client treated for depression is ready for discharge from the hospital and tells the nurse, "It would be great if we could meet for coffee should I start feeling low again." Which statement indicates that the nurse understands the boundaries of the therapeutic relationship? A. "That would be fine as long as we go to a public place. Where would you like to meet?" B. "We could go to the gym together. Exercise can be very therapeutic for clients with depression." C. "Before you leave the hospital, I will make sure you have information about the crisis center." D. "I often meet people after they are discharged. Sometimes it is difficult to deal with situations after you leave the hospital."

C. "Before you leave the hospital, I will make sure you have information about the crisis center."

The nurse is working with a client who has quit several jobs and no longer sends financial support to the client's two children living with their other parent. This behavior is in conflict with the nurse's values concerning responsible parenting. When discussing family roles with the client, the nurse shows positive regard through which statement? A. "How do you expect your kids to be provided for?" B. "Can the children's other parent get by for a while until you get better?" C. "How is not working right now affecting you?" D. "You need to somehow find a way to support your children."

C. "How is not working right now affecting you?"

A client being discharged appears angry with the nurse when the nurse attempts to review discharge instructions with the client. The nurse can best assist the client in this stage of the relationship with which response? A. "You should be able to regulate your feelings better by now. Why are you angry?" B. "We have to go over these instructions before you can go. Please try to listen." C. "I can sense you are angry this morning. Tell me how you feel about being discharged today." D. "Would you rather not be discharged today?"

C. "I can sense you are angry this morning. Tell me how you feel about being discharged today."

The nurse is meeting with a client experiencing a mood disorder. Which client statement indicates that the nurse-client relationship has been established? A. "I know you are busy. I don't have much to say now." B. "What difference does it make what I say to you?" C. "I feel worthless and have no real use in life." D. "I really don't want to talk about that right now."

C. "I feel worthless and have no real use in life."

A client explains feelings of sadness and loss after the death of a close friend. Which nursing statement best demonstrates empathy? A. "Maybe it will be better for your friend." B. "I'm sorry for your loss." C. "I see this is hard for you. How can I help?" D. "It's hard to lose someone you love."

C. "I see this is hard for you. How can I help?"

When a 23-year-old client is admitted to the psychiatric unit after a suicide attempt, the client states the client is willing to speak to the nurse but only if the conversation remains confidential. Which is the nurse's best response? A. "Without your permission I can't give any information to anyone." B. "You know that I can't keep secrets from your health care team." C. "Will this conversation involve your desire to harm yourself?" D. "Don't you trust me to respect your right to confidentiality?"

C. "Will this conversation involve your desire to harm yourself?"

The nurse recognizes that a client is experiencing the avoiding and ignoring phase of a deteriorating relationship. Which statement made by the client supports this assessment? A. "You are always there for me, I love these sessions." B. "This situation is just so frustrating, nobody gets it." C. "You are not hearing me, just listen to what I am saying." D. "I am useless to my family, I can't even hold a job."

C. "You are not hearing me, just listen to what I am saying."

The nurse understands that empathy is essential to the therapeutic relationship. When a client makes the statement, "I am just devastated that my marriage is falling apart," the nurse can best show empathy through which response? A. "I feel so bad for what you are going through." B. "It will get better; let's talk about it." C. "You feel like your world is falling apart right now." D. "I have been divorced, too. I know how hard it is."

C. "You feel like your world is falling apart right now."

Which clinical situation provides an example of transference? A. A nurse asks for clarification from a colleague when explaining a coping strategy to a client. B. A client mirrors the nursing student's nervousness and hesitancy during assessment. C. A female client with a history of sexual abuse exhibits a profound mistrust of male caregivers. D. A nurse implements the same interventions with multiple clients despite their personal differences.

C. A female client with a history of sexual abuse exhibits a profound mistrust of male caregivers.

A 35-year-old was discharged from care after recovery from depression. The nurse therapist and the client spent many hours working through issues related to the depression. Six months later, the client is admitted again for depression associated with issues similar to those that were previously addressed in the client's therapy. The nurse therapist says to a coworker, "This is unbelievable; we're back at square one again. The client should know better at this point." The nurse's comments reflect what? A. Exploitation B. Poor boundaries C. A judgmental attitude D. Countertransference

C. A judgmental attitude

During the orientation phase of a nurse-client relationship, the nurse notes a change in the client's behavior. The client has forgotten a scheduled session and then accuses the nurse of breaking confidentiality. The nurse interprets this as suggesting what? A. Lack of understanding of the plan B. Rejection of the nurse C. Acting out D. Dissatisfaction with the care

C. Acting out

Which is not considered a step in the values clarification process? A. Acting B. Choosing C. Assessing D. Prizing

C. Assessing

Which term is used to describe general feelings or a frame of reference around which a person organizes knowledge about the world? A. Beliefs B. Values C. Attitudes D. Self-awareness

C. Attitudes

A client tells the mental health nurse that the client is taking a sewing class to cope with the client's son's move to another state. The use of this adaptive coping skill is an example of which aspect in the therapeutic relationship? A. Empathy B. Self-disclosure C. Client self-exploration D. Respect

C. Client self-exploration

The nurse has a client who seems like the nurse's sister, with whom the nurse has a close and positive relationship. This phenomenon is best characterized by which term? A. Reaction formation B. Transference C. Countertransference D. Free association

C. Countertransference

Which occurs when the nurse responds to the client based on personal unconscious needs and conflicts? A. Self-disclosure B. Exploration C. Countertransference D. Transference

C. Countertransference

A client who had been in a substance abuse treatment program asks the nurse for a date after the client is discharged. The nurse talks to the client about the importance of a therapeutic relationship and its characteristics. The nurse is using which technique? A. Reprimanding the client B. Letting the client down gently C. Defining boundaries D. Defining therapy

C. Defining boundaries

While providing care to a client with psychosis, the psychiatric nurse uses communication initially for which reason? A. Facilitating the assessment process and the collection of a database B. Providing the client contact with a caring professional health care provider C. Eliciting the client's cooperation through the establishment of trust D. Establishing mutual expectations for nursing interventions

C. Eliciting the client's cooperation through the establishment of trust

A nursing instructor is teaching a class on empathy. The instructor determines that the class needs additional education when the students identify that empathy involves what? A. Careful listening B. Having insight into the meaning of clients' thoughts, feelings, and behaviors C. Feeling the same emotions that the client is feeling at a given time D. Being in touch with what the client is saying

C. Feeling the same emotions that the client is feeling at a given time

Which theorist was most widely known for the belief that the cornerstone of all nursing care is the therapeutic relationship? A. Clara Barton B. Jean Watson C. Hildegard Peplau D. Florence Nightingale

C. Hildegard Peplau

A nurse is in the orientation phase of the nurse-client relationship with a client diagnosed with a mental disorder. When interviewing the client during this first encounter, which information about the client would be most important for the nurse to obtain? A. Family history B. Known allergies C. Perception of the problem D. Recent hospitalizations

C. Perception of the problem

A nursing instructor is describing the nurse-client relationship to a group of nursing students. Which would the instructor emphasize as most important to establishing and maintaining the relationship? A. Rapport B. Values C. Self-awareness D. Empathy

C. Self-awareness

Which is not a primary behavior of caring, one of the core values of nursing? A. Meeting the client's needs in a timely manner B. Providing comfort measures to clients and their families C. Setting boundaries within the relationship D. Giving of the self

C. Setting boundaries within the relationship

A client expresses frustration and believes the nurse does not want to help the client achieve wellness. Which phase of the deteriorating relationship is the client describing? A. Ignoring B. Withholding C. Struggling with D. Avoiding

C. Struggling with

A client expresses worry about the client's child's aggressive behavior. The nurse says "You are in a very challenging situation. Your child's aggressive behavior is very stressful for you, is this correct?" What does this nurse's statement indicate? A. The nurse is showing genuine interest in the client. B. The nurse is sympathizing with the client. C. The nurse is empathizing with the client. D. The nurse is comforting the client.

C. The nurse is empathizing with the client.

A client reveals in a therapy session that the client has thought about killing a neighbor. What is the therapist's obligation regarding this revelation? A. The therapist must keep the comment confidential, because the disclosure is protected by therapist-client confidentiality. B. The therapist must meet with an ethics committee to determine the course of action. C. The therapist must notify authorities and the potential victim. D. The therapist must evaluate the threat and notify authorities if it meets credibility criteria.

C. The therapist must notify authorities and the potential victim.

Which is one of the most common reasons clients are often concerned about confidentiality of treatment for mental health problems? A. They do not understand that most people will not know what a mental health problem is. B. They lack health care coverage for the treatment. C. They are worried about the opinions of people who know them outside the hospital, due to shame produced by societal views of mental illness. D. They are concerned about receiving their next paycheck when they return to work.

C. They are worried about the opinions of people who know them outside the hospital, due to shame produced by societal views of mental illness.

A nurse is caring for a client with hemiplegia who has been depressed. The client tells the nurse, "I don't feel I would ever be independent again. I would be a burden to everybody in my house." The nurse responds by stating, "Your family misses you a lot and wants you home as soon as possible. The rehab team is very confident about your progress." Which phase of nurse-client relationship is occurring? A. Mutual withdrawal B. Orientation C. Working D. Resolution

C. Working

A client recently experienced a panic attack. A nurse has worked with the client to redirect the client's thoughts and to aid in calming the situation even though it is past the nurse's shift. This is an example of which pattern of knowing? A. aesthetic B. empirical C. ethical D. personal

C. ethical

The nurse is initiating a therapeutic relationship with a client. Which information would the nurse most likely include when explaining the purpose of this relationship? A. allowing the client to know the nurse's feelings. B. establishing a friendship C. facilitating a positive change. D. alleviating stressors in life.

C. facilitating a positive change.

Which nursing intervention demonstrates congruence in a therapeutic nurse-client relationship? A. implementing restatement as a therapeutic communication method B. discussing the client's request for additional privileges with the treatment team C. getting an appointment with the client at the time previously agreed upon D. sharing examples of stress management techniques

C. getting an appointment with the client at the time previously agreed upon

The manager is reviewing the implementation of the Transitional Relationship Model (TRM) on a care area. Which data should the manager identify that supports the successful implementation of this model? Select all that apply. A. nurse reassignment increased 8% over the last month B. staff attendance at educational programs down 9% over the last month C. number of readmissions down 6% over the last 2 months D. client dissatisfaction with care up 10% over the last month E. discharge of clients 5 days earlier than in the past

C. number of readmissions down 6% over the last 2 months E. discharge of clients 5 days earlier than in the past

What should the nurse avoid when demonstrating genuine interest for a client by making a self-disclosure? A. using situations that have occurred on the unit B. being too general with the details of the story C. shifting the emphasis to the nurse D. providing advice on how to manage a problem

C. shifting the emphasis to the nurse

The nurse and client are entering the resolution phase of the relationship. Which behaviors indicate that the client does not want the relationship to end? Select all that apply. A. lists actions to move forward at the conclusion of the meeting B. asks to keep in touch with the nurse after the relationship ends C. skips the last session D. expresses anger towards the nurse and other clients E. identifies a resolved problem as a new one needing to be addressed

C. skips the last session D. expresses anger towards the nurse and other clients E. identifies a resolved problem as a new one needing to be addressed

Which action by the nurse or client represents the working phase of the therapeutic relationship? A. Reviewing work that has been done B. Communicating interest in the client C. Testing the relationship D. Identifying past ineffective behaviors

D. Identifying past ineffective behaviors

A nurse is caring for a client with depression. The client says that the client cannot stop thinking about the client's dead spouse. Which self-disclosure example given by the nurse is most appropriate? A. "I just had a divorce; I can understand how it would feel to be without a partner." B. "I can understand your situation. Medication could be of great help to relieve your depression." C. "My father passed away recently. I can understand your problem." D. "I can understand your situation; my cousin lost a spouse a few months ago."

D. "I can understand your situation; my cousin lost a spouse a few months ago."

During a regular home health visit to an elderly client, the nurse observes that the client has feelings of hopelessness and despair. The client says, "I'm old, and my life has no purpose anymore. But promise me you won't tell anyone." How should the nurse respond? A. "Let's talk about something to cheer you up." B. "Don't worry, I won't tell anyone else." C. "What can we do to help you feel better? D. "I'm sorry, but I can't keep that kind of secret."

D. "I'm sorry, but I can't keep that kind of secret."

A nurse is interacting with a client who is expressing feelings about the client's child's insensitive behavior. Which statement made by the nurse indicates the nurse is empathizing with the client? Choose the best answer. A. "That is unbelievable. How could you tolerate this behavior?" B. "Don't worry. Your child will be all right." C. "I don't know how you've managed to cope, this is awful." D. "It sounds like this is very difficult for you, I can see why it causes you stress."

D. "It sounds like this is very difficult for you, I can see why it causes you stress."

During the next meeting during the working phase of the relationship the client brings the nurse homemade chocolate chip cookies and a box of chocolates. Which response should the nurse make to the client about these gifts? A. "How did you know that I'm a chocoholic? Will you have a cookie with me while we talk?" B. "Thank you so much. I will share them with the other nurses." C. "They look delicious and I love candy but I'm on a diet and really can't accept them." D. "Thank you but I will not accept these gifts because they extend over our discussed boundaries."

D. "Thank you but I will not accept these gifts because they extend over our discussed boundaries."

A nurse has approached a new client on the psychiatric care unit in order to establish a therapeutic relationship and conduct a focused assessment. As the nurse approaches the client, the client says, "Oh good. Here comes one more person to tell me that I'm crazy." Which of the nurse's following responses would constitute countertransference? A. "Is that a message you've been hearing a lot over the past couple of days?" B. "Actually, I've not come here to tell you that." C. "It sounds like you're exasperated with the caregivers you've interacted with. Is that fair to say?" D. "There's no need to get rude with me. I'm just trying to do my job and to help you out."

D. "There's no need to get rude with me. I'm just trying to do my job and to help you out."

A nurse is speaking to a client who attempted suicide. The client says, "It is my dream to become a doctor, and I failed the entrance exam. I am so mad at myself." Which statement indicates genuine interest by the nurse? A. "What would you gain by killing yourself?" B. "You were killing yourself for this?" C. "It is wrong to commit suicide." D. "You must have been really upset."

D. "You must have been really upset."

Which is an inaccurate statement regarding a preconception? A. It is a way that a person expects another to behave. B. It prevents people from getting to know one another. C. It may prevent the nurse from developing a therapeutic relationship with the client. D. It enables the nurse to get an accurate picture of the client's problems.

D. It enables the nurse to get an accurate picture of the client's problems.

Which role of the nurse-client relationship is being exhibited when the nurse informs the client and then supports the client in whatever decision the client makes? A. Caregiver B. Teacher C. Parent surrogate D. Advocate

D. Advocate

A nurse makes the statement in a treatment team meeting, "It's not worth it to try to teach this client how to make better choices. The client has been here many times before and goes back home and does the same thing." As the supervisor addresses the nurse and the nurse's statement, the supervisor understands the nurse is sharing what? A. Awareness B. Value C. Belief D. Attitude

D. Attitude

The nurse is caring for a client that has a history of being neglected. Which role of the nurse is most likely to create difficulty for the nurse-client relationship if the client confuses physical care with intimacy and sexual interest? A. Advocate B. Teacher C. Parent surrogate D. Caregiver

D. Caregiver

After teaching a class about the phases of the therapeutic relationship, the instructor determines a need for additional education when the class identifies which as a goal of the working phase? A. Identify previous ineffective behaviors for coping with the problem B. Promote a supportive healing process C. Develop a plan of action with appropriate strategies D. Develop a sense of trust within the relationship.

D. Develop a sense of trust within the relationship.

Which is the most important skill the nurse must bring to the therapeutic nurse-client relationship? A. Confrontation B. Reframing C. Humor D. Empathy

D. Empathy

A nurse is caring for a client with anxiety disorder. The nurse knows that the client will have dyspnea and tachycardia if she has an anxiety attack. According to the Carper's patterns of nursing knowledge, which pattern of knowing is this indicative of? A. Personal knowing B. Ethical knowing C. Aesthetic knowing D. Empirical knowing

D. Empirical knowing

The nurse assesses fine hand tremors in a client with a history of heavy alcohol use. If the nurse understands that the tremors are a direct result of alcohol use, the nurse is using which pattern of knowing, according to Carper? A. Aesthetic knowing B. Personal knowing C. Ethical knowing D. Empirical knowing

D. Empirical knowing

During the working phase of a therapeutic relationship, which action by the nurse would best help the client to explore problems? A. Referring the client to a self-help group B. Identifying possible solutions for the client's problems C. Comparing past and present coping strategies D. Encouraging the client to clarify feelings and behavior

D. Encouraging the client to clarify feelings and behavior

A nurse has been working for 15 hours continuously without a break. The nurse administrator insists that the nurse should go home and sleep. According to the Carper's patterns of nursing knowledge, which pattern of knowing is this indicative of? A. Empirical knowing B. Personal knowing C. Aesthetic knowing D. Ethical knowing

D. Ethical knowing

Which is not involved in empathy? A. Having insight into the meaning of clients' thoughts, feelings, and behaviors B. Careful listening C. Being in touch with what clients are saying D. Feeling the same emotions that the client is feeling at a given time

D. Feeling the same emotions that the client is feeling at a given time

The mental health nurse is responsible for maintaining professional boundaries. Which would be an example of a professional boundary violation? A. Exhibiting confidentiality B. Avoiding personal attachment to the client C. Providing a friendly environment D. Giving personalized gifts to a client

D. Giving personalized gifts to a client

A tool the nurse uses to learn more about his or her qualities and communication with others is called? A. Nursing Boundary Index B. Paplau's Preconceptions C. Carper's Pattern D. Johari Window

D. Johari Window

Which statement about the nurse and ethnocentrism is true? A. A nurse must not think of his or her own attitudes and beliefs. B. Ethnocentrism is a desirable trait in a nurse. C. Nurses must deny their ethnocentrism. D. Nurses may have a tendency to inwardly view their own culture as superior to others.

D. Nurses may have a tendency to inwardly view their own culture as superior to others.

A nurse who has worked with a client with post-traumatic stress disorder (PTSD) regularly for several months stares blankly at the nurse for a long time. The nurse understands that the client is dissociating. According to the Carper's patterns of nursing knowledge, which pattern of knowing is this indicative of? A. Ethical knowing B. Empirical knowing C. Aesthetic knowing D. Personal knowing

D. Personal knowing

A nurse is interviewing a client to obtain a health history. Which would be considered a "usual or expected" response during the first session? A. Being confrontational with nurse and other group members B. Bragging about sexual conquests C. Showing up late for the first session D. Rambling due to nervousness

D. Rambling due to nervousness

During a therapeutic communication session, the nurse tells the client of a past experience. Which statement best reflects the nurse's use of self-disclosure? A. It forms the solid foundation for effective communication. B. The more the nurse discloses, the more the client will disclose. C. Self-disclosure should be used with all clients to some degree. D. Self-disclosure on the nurse's part should benefit the client.

D. Self-disclosure on the nurse's part should benefit the client.

The client is getting ready to be discharged from the psychiatry unit. A nurse and client has just completed reviewing the client's take-home medications. The nurse is exemplifying which role during this intervention? A. Advocate B. Caregiver C. Parent surrogate D. Teacher

D. Teacher

Nurses must be aware of the importance of boundaries, not only for the client but also for the nurse. Which occurrence is considered a breach of professional boundaries? A. Client asking a nurse for the nurse's phone number B. The nurse changing the subject in response to a client compliment C. The nurse refusing a gift from a client D. The nurse having a lengthy social conversation with a client

D. The nurse having a lengthy social conversation with a client

It is brought to the nurse administrator's attention that a nurse has developed an intimate relationship with a client. Which behavior indicates the nurse has engaged in an intimate relationship with a client? A. The nurse examines the genital area of a client diagnosed with a sexually transmitted infection. B. The nurse is talking to the spouse of the client regarding the client's condition. C. The nurse speaks on topics like sports while performing assessment on the client. D. The nurse is having dinner with a client outside the hospital premises.

D. The nurse is having dinner with a client outside the hospital premises.

A nurse is using the Johari window to identify the degree to which the nurse feels comfortable communicating with others. After completing the exercise, the nurse discovers that quadrant 1 has the longest list of qualities. This indicates what about the nurse? A. The nurse conceals personal information about the nurse. B. The client is sharing more than the nurse in the therapeutic relationship. C. The nurse needs to increase insight into the nurse's own characteristics. D. The nurse is open to others.

D. The nurse is open to others.

A client forgets to attend a planned session. Which should the nurse conclude about the client's behavior? A. Problems are overwhelming. B. It is time to end the relationship. C. The client does not like the nurse. D. The relationship is being tested.

D. The relationship is being tested.

The psychiatric nurse recognizes that excessive social communication with a client is to be avoided primarily due to which reason? A. To prevent disruption of the time that is to be used for therapeutic communication B. To avoid making the client feel that the client's problems are not viewed as being serious C. To avoid giving the client the impression that the nurse is not interested in providing effective care D. To prevent the client from viewing the nurse as a friend rather than health care provider

D. To prevent the client from viewing the nurse as a friend rather than health care provider

A nurse tells a client that the nurse will come back in 10 minutes to reassess the client's pain. When the nurse returns in 10 minutes, which aspect of the therapeutic relationship is the nurse developing? A. Sympathy B. Closure C. Empathy D. Trust

D. Trust

A nursing student is working with a client who has a history of abusing alcohol. Although the nurse has an aversive feeling toward people who abuse alcohol, the nurse feels that the client is worthy of respect and attention regardless of the nurse's own personal feelings. Which correctly describes the nurse's response to the client? A. Countertransference B. Genuineness C. Partnership D. Unconditional positive regard

D. Unconditional positive regard

A psychiatric-mental health nurse is conducting a self-examination of beliefs and values to develop self-awareness. Asking which question would be appropriate for the nurse to determine the fundamental personal attitudes about people of diverse cultures? A. Did you grow up in a rural or urban community? B. What kinds of experiences have you had with people of other cultures? C. Do you think you hold bias or prejudice attitudes? D. While a child, what attitudes did your family express about other cultures?

D. While a child, what attitudes did your family express about other cultures?

During the first meeting with a client, the nurse explains that the relationship is time limited and will end. Which best explains the reason for the nurse's explanation? A. discussing the role of the nurse B. explaining the purpose of the meetings C. establishing boundaries D. beginning the termination process

D. beginning the termination process

A psychiatric nurse tells a client that the nurse will return in 15 minutes to talk with the client. The nurse goes to a meeting that runs overtime and returns in an hour, apologizing for being late. This behavior may have an impact between the nurse and the client in the area of ... A. establishing confidentiality. B. getting through the working phase of the relationship. C. establishing boundaries on the therapeutic relationship. D. establishing trust in the introductory phase of the relationship.

D. establishing trust in the introductory phase of the relationship.

Termination takes place during the resolution phase of a nurse-client relationship. During the termination process, a client brings up resolved problems and presents them as new issues to work toward. The nurse interprets the client's action as indicating what? The client: A. is unhappy that the therapy was ineffective. B. is angry that the nurse is abandoning the client. C. requires additional therapy. D. is attempting to prolong the nurse-client relationship.

D. is attempting to prolong the nurse-client relationship.

During which phase of the nurse-client relationship does the client identify and explore specific problems? A. orientation B. resolution C. debriefing D. working

D. working