Ch 8

A client tells the nurse "I really feel close to you. You are like the friend I never had." The nurse can assess this statement as indicating the client may be experiencing which unconscious emotion? A Congruence B Empathetic feelings C Countertransference D Positive transference

D

A client states "That nurse never seems comfortable being with me." The nurse can be described as A not seeming genuine to the client. B transmitting fear of clients. C unfriendly and aloof. D controlling.

A

The nurse is finding it difficult to provide structure and set limits for a client. The nurse should self-evaluate for which characteristic of a dysfunctional nurse-patient relationship? A Boundary blurring B Value dissonance C Covert anger D Empathy

A

The nurse would address which of the following goals in attempting to establish a therapeutic nurse-client relationship? A Helping patients examine self-defeating behaviors and test alternatives B Promoting self-care and independence C Providing the client with opportunities to socialize D Assisting patients with problem solving to help facilitate activities of daily living E Facilitating communication of distressing thoughts and feelings

ABDE

Which of the following statements are true regarding the differences between a social relationship and a therapeutic relationship? A In a social relationship, both parties' needs are met; in a therapeutic relationship, only the patient's needs are to be considered. B A social relationship is instituted for the main purpose of exploring one member's feelings and issues; a therapeutic relationship is instituted for the purpose of friendship. C Giving advice is done in social relationships; in therapeutic relationships giving advice is not usually therapeutic. D In a social relationship, both parties come up with solutions to problems and solutions may be implemented by both (a friend may lend the other money, etc.); in a therapeutic relationship, solutions are discussed but are only implemented by the patient. E In a social relationship, communication is usually deep and evaluated; in a therapeutic relationship, communication remains on a more superficial level, allowing patients to feel comfortable.

ACD

A nurse on the psychiatric unit has a past history of alcoholism and has regular meetings with a mentor. Which statement made to the nurse's mentor would indicate the presence of countertransference? A "My patient is being discharged tomorrow. I provided discharge teaching and stressed the importance of calling the help line number should she become suicidal again." B "My patient has been abusing alcohol. I told her that the only way to recover was to go 'cold turkey' and to get away from her dysfunctional family and to do it now!" C "My patient started drinking after 14 years of sobriety. We are focusing on his treatment plan of attending AA (Alcoholics Anonymous) meetings five times a week after discharge." D "My patient, is an elderly woman with depression. She calls me by her daughter's name because she says I remind her of her daughter."

B

During what stage of the therapeutic nurse-client relationship is a formal or informal contract between the nurse and client established? A Preorientation B Orientation C Working D Termination

B

When a nurse and client meet informally or have an otherwise limited but helpful relationship, what term is used to identify this relationship? A Crisis intervention B Therapeutic encounter C Autonomous interaction D Preorientation phenomenon

B

A patient who recently loss a parent begins crying during a one-to-one session with the nurse. Which of the following responses by the nurse illustrates empathy? A "I'm so sorry. My father died 2 years ago, so I know how you are feeling." B "You need to focus on yourself right now. You deserve to take time just for you." C "That must have been such a hard situation for you to deal with." D "I know that you will get over this. It just takes time."

C

A term is a synonym for the characteristic of genuineness? A Respect B Empathy C Authentic D Positive regard

C

What is the primary difference between a social and a therapeutic relationship? A Type of information exchanged B Amount of satisfaction felt C Type of responsibility involved D Amount of emotion invested

C

A client has been admitted to your inpatient psychiatric unit with suicidal ideation. In a one-to-one session with the nurse, he shares the terrible guilt he feels over sexually abusing his stepdaughter and wanting to die because of it. Which of the following responses you could make reflects a helpful trait in a therapeutic relationship? "It's good that you feel guilty. That means you still have a chance of being helped." "Of course you feel guilty. You did a horrendous thing. You shouldn't even forget what you did." "The biggest question is, will you do it again? You will end up having even worse guilt feelings because you hurt someone again." "You are suffering with guilt over what you did. Let's talk about some goals we could work on that may make you want to keep living."

D

Consider the nurse-patient relationship on an inpatient psychiatric unit. Which of the following statements made by the nurse reflects an accurate understanding of when the issue of termination should first be discussed? A "You are being discharged today, so I'd like to bring up the subject of termination—discussing your time here and summarizing what coping skills you have attained." B "I haven't met my new patient yet, but I am working through my feelings of anxiety in dealing with a patient who wanted to kill herself." C "Now that we are working on your problem-solving skills and behaviors you'd like to change, I'd like to bring up the issue of termination." D "Now that we've discussed your reasons for being here and how often we will meet, I'd like to talk about what we will do at the time of your discharge."

D

The outcome of the nurse's expressions of sympathy instead of empathy toward the client often leads to which outcome? A Enhanced client coping B Lessening of client emotional pain C Increased hope for client improvement D Decreased client communication

D

Which phase of the nurse-client relationship may cause client anxieties to reappear and past losses to be reviewed? A Preorientation phase B Orientation phase C Working phase D Termination phase

D