Therap. Relationships - CC

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? Boundary blurring Value dissonance Covert anger Empathy

Boundary blurring Boundary blurring is often signaled by the nurse being either too helpful or not helpful enough. The behavior is not associated with any of the other options.REF: 127

After your first conversation, Becky withdraws from you again before you've even really begun. Which statement will contribute most to establishing Becky's trust? A."Weren't you complying with your medication regimen?" B."It must be discouraging to be readmitted to the hospital so soon." C."Everyone with bipolar disorder ends up in the hospital occasionally." D."You must take your drugs as prescribed or you will be rehospitalized."

B."It must be discouraging to be readmitted to the hospital so soon."

Becky tells you, "I have something secret to tell you, but you can't tell anyone else." The nurse agrees. What is the likely consequence of the nurse's action? Healthy feelings of sympathy by the nurse toward the client. Blurred boundaries in the nurse-client relationship. Improved rapport between the nurse and client. Enhanced trust between the nurse and client.

Blurred boundaries in the nurse-client relationship.

A nurse spends extra time with a client who has personality features similar to the nurse's estranged spouse. Which aspect of countertransference is most likely to result? A.Overinvolvement B.Misuse of honesty C.Indifference D.Rescue

A.Overinvolvement

As Becky is preparing for discharge, she presents you with a handmade card of appreciation for the care you provided. Should you accept the card? A.Yes B.No C.Depends on state laws D.Depends on her illness

A.Yes

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

Authentic Genuineness refers the nurse's ability to be open, honest, and authentic in interactions with patients. It is the ability to meet others person-to-person without hiding behind roles. While positive characteristics, none of the other options related to genuineness.REF: 133

You are about to initiate your first contact with Becky. Which is the most suitable goal in establishing the therapeutic relationship? A.Establish friendship and a sense of fun B.Ensure that mutual needs will be met C.Establish clear boundaries while identifying patient needs D.Ensure two-way communication to give or ask for help

C.Establish clear boundaries while identifying patient needs

You notice that you look forward to talking to Becky because her dark sense of humor reminds you of your best friend in high school. You also begin to make little cynical jokes, hoping to have a good laugh together. What is this relationship showing early signs of? A.Accountability B.Self-reflection C.Transference D.Countertransference

D.Countertransference

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

Decreased client communication Sympathy and the resulting projection of the nurse's feelings limit the client's opportunity to further discuss the problem. The remaining options are positive outcomes.REF: 133

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

Helping patients examine self-defeating behaviors and test alternatives Promoting self-care and independence Assisting patients with problem solving to help facilitate activities of daily living Facilitating communication of distressing thoughts and feelings Addressing the client's need to socialize is not one of the goals of establishing a therapeutic relationship. The other options are goals addressed in a therapeutic relationship.REF: 125

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

Orientation Contracting is part of the orientation phase of the relationship. Establishing the operational "rules" provides a foundation for the relationship. This function is not associated with any of the other options.REF: 130-131

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? Congruence Empathetic feelings Countertransference Positive transference

Positive transference Transference involves the client experiencing feelings toward a nurse that belong to a significant person in the client's past. If a patient is motivated to work with you, completes assignments between sessions, and shares feelings openly, it is likely the patient is experiencing positive transference. The behavior is not associated with any of the other options.REF: 127-128

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

Termination phase Termination, a stage in which the client must face the loss or ending of the therapeutic relationship, often reawakens the pain of earlier losses. This is not generally associated with the other phases.REF: 132-133

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

Therapeutic encounter A therapeutic encounter is a short but helpful interaction between the nurse and client. None of the other options reflect this form of relationship.REF: 126-127

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

Type of responsibility involved In a therapeutic relationship the nurse assumes responsibility for focusing the relationship on the client's needs, facilitating communication, assisting the client with problem-solving, and helping the client identify and test alternative coping strategies.REF: 127-128

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

not seeming genuine to the client. Hiding behind a role, using stiff or formal interactions, and creating distance between self and client suggest a nurse is lacking in genuineness, or the ability to interact in a person-to-person fashion. This characteristic is not associated with the other options.REF: 126-127, 133