Chapter 10 PrepU

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. defining boundaries b. defining therapy c. letting the client down gently d. reprimanding the client

a. defining boundaries

The nurse has been providing regular care to a client diagnoses with an anxiety-related disorder for the past 2 weeks. Which statement made by the nurse suggests a possible professional boundary issue? a. "I am going to rearrange my schedule today so we can spend more time talking." b. "We can meet at 2:30 pm today to practice stress management techniques." c. "It would be helpful if your family attended your next session with me." d. "It is good to see you smiling today."

a. "I am going to rearrange my schedule today so we can spend more time talking."

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 feel worthless and have no real use in life." b. "I really don't want to talk about that right now." c. "What difference does it make what I say to you?" d. "I know you are busy. I don't have much to say now."

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

Which statement would be an empathetic response in a client interaction? a. "You must have been embarrassed when your father yelled at you in the grocery store." b. "You really should find your own housing and get out of the situation with your father." c. "Well, it sounds like your father has difficulty controlling his temper." d. "Why do you think your father chose that time and place to yell at you?"

a. "You must have been embarrassed when your father yelled at you in the grocery store."

A client says, "It's been so long since I've been with my family." Which statement by the nurse is an example of restating? a. "You say you haven't seen your family in a while." b. "Tell me what happened when you last saw your family." c. "Go on. Tell me more." d. "When was the last time you saw your family?"

a. "You say you haven't seen your family in a while."

The nurse should use clear, concrete messages when working with clients displaying which conditions? SATA a. anxiety b. anorexia c. dementia d. schizophrenia e. illness anxiety disorder

a. anxiety c. dementia d. schizophrenia

The nurse fails to assess personal values surrounding homosexuality before caring for a client who is openly gay. The nurse is most at risk for what when working with this client? a. holding a prejudice toward this client b. neglecting to include the client's desires in the plan of care c. being manipulated by this client d. expressing shock when assessing the client's history

a. holding prejudice toward this client

Nurses develop empathy with their clients while gathering information about the client. Which of the following hinders the development of empathy? a. interjecting personal experiences b. asking the client to restate for clarity c. asking leading questions d. focusing on one issue

a. interjecting personal expriences

A psychiatric-mental health nurse is engaged in communication with a client. Which nonverbal behavior by the nurse would convey a positive message? SATA a. nurse sits at the same eye level as the client b. nurse crosses arms in front of the chest c. nurse leans slightly forward in the chair d. nurse sits upright with back rigidly straight e. nurse stands next to client sitting in a chair

a. nurse sits at the same eye level as the client c. nurse leans slightly forward in the chair

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 am. 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

Which nursing actions, if shared with clients, suggest self-disclosure? SATA a. showing family photos b. taking the elevator c. telling the client the nurse attended a weight loss meeting d. wearing the color blue e. directing the client to the nurse's Facebook page

a. showing family photos c. telling the client the nurse attended a weight loss meeting e. directing the client to the nurse's Facebook page

Which form of nonverbal communication would be least effective for the nurse to engage in to demonstrate interest in and acceptance of the client? a. sitting behind a desk b. leaning slightly forward toward the client c. facing the client at eye level d. keeping arms and legs uncrossed

a. sitting behind a desk

A client diagnoses with borderline personality disorder is pitting one nurse against the other, calling one a best friend and declaring that the other is horrible. The client is using which defense mechanism? a. splitting b. sublimation c. self-observation d. suppression

a. splitting

When engaged in a therapeutic relationship, the nurse's focus is on what? a. the client b. the self c. the environment d. the family

a. the client

An advanced practice nurse has chosen to apply motivational interviewing (MI) in the care of a client who will transition back to the community from inpatient treatment. The nurse should begin to apply this method by a. validating the client's ability to make decisions and effect change b. emphasizing the importance of adhering to the prescribed drug regimen c. reviewing the benefits of the client's treatment to this point d. teaching the client about the concept of recovery and the likelihood of setbacks

a. validating the client's ability to make decisions and effect change

A nurse is assigned to care for a client whose sexual orientation differs from the nurse's sexual orientation. At which time should the nurse seek guidance from the supervisor? a. when the nurse desires to assist the client to change values b. when the nurse wants to discuss goals and the plan of care c. when the nurse begins to empathize with the client d. when the nurse accepts the client's values and sexuality

a. when the nurse desires to assist the client to change values

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

During the working phase of a therapeutic relationship, which action by the nurse would best help the client explore problems? a. comparing past and present coping strategies b. encouraging the client to clarify feelings and behavior c. identifying possible solutions for the client's problems d. referring the client to a self-help group

b. encouraging the client to clarify feelings and behavior

The client tells the nurse, "My mom is coming in to see me today," while sighing and looking out the window. The nurse states, "You don't seem very excited about the visit, is everything OK?" The client affirms. Using therapeutic communication, how should the nurse respond? a. "Why are you sad about your mother's visit?" b. "I'm concerned that you are not excited about your mother's visit. We can talk if you want." c. "I need to know why you are sad." d. "Is your mother giving you trouble for being here?"

b. "I'm concerned that you are not excited about your mother's visit. We can talk if you want."

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. "Don't you think you're ready to be independent?" b. "It can be scary to leave a place that you trust and feel supported." c. "Just think of all of the things you can do in the home that you can't do here." d. "You are more than ready to get out of here. Have faith in your accomplishments."

b. "It can be scary to leave a place that you trust and feel supported."

The nurse is caring for a client with cellulitis. The client responds, "I feel kind of blah," after the nurse asks, "How do you feel?" After the client's reply, the nurse states, "Can you tell me what 'blah' feels like?" the patient responds, "I don't have any energy, and I don't feel like doing anything." Using therapeutic communication, how should the nurse respond? a. "Oh, it is just the infection; in a day or so you'll feel better." b. "Let's talk about infections, and how they heal." c. "Why don't you just rest in bed?" d. "Why don't you call a friend in to watch TV with you?"

b. "Let's talk about infections, and how they heal"

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

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

During the admission interview, the nurse asks the client what led to the patient's hospitalization. The client responds, "They lied about me. They said I murdered my mother. You're the killers. You all killed my mother. She died before I was born." What would be the best initial response by the nurse? a. "I just saw your mother. She's fine." b. "You're having very frightening thoughts." c. "We'll put you in a private room until you're in better control." d. "If your mother, died before you were born, you wouldn't be here."

b. "You're having very frightening thoughts."

A nurse is communicating with a client who is highly anxious. During the conversation, the nurse notices that the nurse's speech is matching the fast pace of the client's speech, and the nurse's heart rate is increasing. The nurse identifies this as a. rapport b. empathetic linkage c. boundary violation d. defense mechanism

b. empathetic linkage

A nurse and client are engaged in a therapeutic relationship. The nurse explains the boundaries of the relationship and clarifies expectations. The nurse and client are in which phase of the nurse-client relationship? a. resolution b. orientation c. working d. withholding

b. orientation

A psychiatric-mental health nurse is developing a therapeutic relationship with a client. The nurse demonstrates acceptance by which action? a. The nurse approves of the demonstration of any inappropriate behavior by the client b. the nurse avoids judgments about the client, no matter what the behavior is c. the nurse implements actions to punish the client for inappropriate behavior d. the nurse communicates perception of the meanings and feelings of the client

b. the nurse avoids judgments about the client, no matter what the behavior is

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. "My father passed away recently. I can understand your problem." b. "I just had a divorce; I can understand how it would be without a partner." c. "I can understand your situation; my cousin lost a spouse a few months ago." d. "I can understand your situation. Medication could be of great help to relieve your depression."

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

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. "I am only trying to help you." c. "Tell me why you are angry about what I just said." d. "If you don't want to continue with me, I'll find someone else."

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

During the mental status assessment, the client expresses the belief that the CIA is stalking the client and plans to kidnap the client. Which would be the best response by the nurse? a. "That makes no sense at all." b. "You can tell me about that after I finish asking these questions." c. "What kinds of things have been happening?" d. "Why would the CIA be interested in you?"

c. "What kinds of things have been happening?"

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. teacher b. advocate c. caregiver d. parent surrogate

c. caregiver

During the termination phase, a client begins to raise old problems that have already been resolved. Which would be appropriate nursing responses? SATA a. immediately stop the client and inform the client that the nurse is running the session b. get angry at the client and ask the client to leave the session c. reassure the client that they already covered their issues d. review with the client the learned methods to control the problems e. do not acknowledge this issue and continue on with the session as planned

c. reassure the client that they already covered these issues d. review with the client the learned methods to control the problems

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

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

The nurse is talking with the client and demonstrates concern for the way the client is feeling by using verbal affirmations and paraphrasing to show understanding. What communication techniques are being used by the nurse? a. empathetic linkages b. self awareness c. self disclosure d. active listening

d. active listening

A nurse is developing a therapeutic relationship with the client. To do this, the nurse must respect the client's religious and spiritual beliefs. Which will occur if the nurse does not show this respect? a. frustration for the client b. longer rehabilitation c. leads to mental health relapse d. eroding trust

d. eroding trust

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. self-disclosure should be used with all clients to some degree c. the more the nurse discloses, the more the client will disclose 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 nurse asks the client, "What was it like for you when you first knew you had no place to go?" The client looks down and pauses for quite some time. Which action by the nurse is most therapeutic? a. change the subject to something the patient will discuss b. encourage the patient to express any unpleasant feelings c. apologize for asking such a personal question d. sit quietly until the patient responds

d. sit quietly until the patient responds

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

d. transitional relationship model