Psych Chapter 5 and 6

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? Careful listening Being in touch with what the client is saying Feeling the same emotions that the client is feeling at a given time Having insight into the meaning of clients' thoughts, feelings, and behaviors

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

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? "Any information is only shared with other professionals involved in your care." "Is there some reason why you don't want your family to know your problems?" "I cannot promise that. Your family may ask me questions and I will need to answer truthfully." "It depends upon what they ask me. I might be able to withhold some information, but not all."

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

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? "Asking for help from those who care about us isn't a sign of weakness." "Being self-sufficient is a sign of mental health stability." "Your family would want to help if you had a problem." "How do you plan to manage your problems without help?"

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

The nurse is assessing a client who was recently diagnosed with anxiety disorder. Which question asked by the nurse conveys a concrete message? "If you just learn how to breathe, you can manage better." "When did you last take drugs?" "How can you make your anxiety better?" "At what time did you take the last dose of the antianxiety drugs?"

"At what time did you take the last dose of the antianxiety drugs?"

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? "Don't worry; I will keep this secret to myself." "Who has influenced you with these ideas?" "I will speak with the health care provider about the possible use of physical restraints for you tonight." "I cannot keep this a secret. I will ensure that the staff helps keep you safe."

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

A nurse is assessing an elderly client with a cardiac disorder. Which statement given by the client conveys an abstract message? Choose the best answer. "I don't really know how it all started. It just happened." "The chest pain is severe enough to disable me from doing my work." "I suddenly had dull pain around the jaw and neck region." "The sudden onset of my chest pain got my spouse extremely stressed out."

"I don't really know how it all started. It just happened."

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

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

A client who is experiencing depression states, "I can't seem to do anything to take care of myself, how can I get going?" What is the nurse's best response? "I notice it has been a while since you have had a shower." "I think you need to take a shower." "Don't worry, take as long as you need before you get going." "Why haven't you taken a shower yet?"

"I notice it has been a while since you have had a shower."

Which statement by the nurse is an example of assertive communication? "You are so rude; I just won't tolerate that in my group." "I'm so happy that you finally decided to join us here in group." "Oh, you must be really busy to be this late getting to group." "I understand that group can be difficult to attend but coming late is disruptive."

"I understand that group can be difficult to attend but coming late is disruptive."

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? "Why are you sad about your mother's visit?" "I'm concerned that you are not exicited about your mother's visit, We can talk if you want." "I need to know why you are sad." "Is your mother giving you trouble for being here?"

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

A psychiatric-mental health nurse has been off of work for the past 4 days, as per the normal work schedule on the unit. On the nurse's first day back, a longterm client says, "I haven't seen you around here since Thursday. How was your time off?" What is the nurse's most appropriate response? "I've been off for the past four days. What have you done since I last saw you?" "I'm not at liberty to talk about my personal life outside of work, unfortunately. How have you been?" "How do you like to spend your time when you're able to do whatever you like?" "If you had to guess, what do you think I might have done on my days off?"

"I've been off for the past four days. What have you done since I last saw you?"

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

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

The nurse has entered a client's room and observed that the client has removed the mattress from the bed and is closely scrutinizing the spaces in the bed frame. Which statement is most likely to elicit an explanation of the client's behavior? "What's wrong with your bed?" "It looks like you're searching for something. Is that right?" "What are you looking for in the bed? There's nothing hidden there." "Are you having any delusions or hallucinations right now?"

"It looks like you're searching for something. Is that right?"

A female psychiatric client is talking to the nurse about her reasons for being hospitalized. The client begins to discuss her relationship with her female significant other. She is describing the things in her relationship that are making her uncomfortable, and she asks the nurse, "Should I break up with my partner?" Which response by the nurse would be most effective in building rapport between the client and nurse? "Of course you should; being a lesbian is just not natural." "Yes, I think you should pursue building a relationship with a man." "It sounds like you're beginning to be uncomfortable in this relationship." "You need to focus on yourself rather than the relationship right now."

"It sounds like you're beginning to be uncomfortable in this relationship."

A client says, "Nobody listens to me; even you don't!" Which response is most therapeutic? "Why do you say I don't listen to you?" "It sounds like you're overreacting somewhat." "It sounds like you're feeling unappreciated." "I listen to you."

"It sounds like you're feeling unappreciated."

A client on the psychiatric mental health unit has a care plan that includes a break for cigarettes every hour during the afternoon if the client follows the behavioral plan to attend the morning group on anger management. The client asks, "I couldn't get to my group this morning because I overslept. Can I just this one time go for a cigarette now?" Which response by the nurse is most therapeutic? "No, Joe. Your plan says that you need to attend that group in order to have cigarette breaks." "Well, I know you were tired from last night. You can go at 2 p.m." "Why do you think you should be allowed to go for a break?" "Joe, let's review your care plan and discuss whether or not it needs to be revised."

"No, Joe. Your plan says that you need to attend that group in order to have cigarette breaks."

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

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

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? "Thank you so much. I will share them with the other nurses." "They look delicious and I love candy but I'm on a diet and really can't accept them." "How did you know that I'm a chocoholic? Will you have a cookie with me while we talk?" "Thank you but I will not accept these gifts because they extend over our discussed boundaries."

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

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? "That must have been terribly hurtful experience for you." "I too have been disappointed by important people in my life." "You will find that one of the constants in life is that people will often let you down." "What do you think motivated your father to do that."

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

Which statement would indicate that the nurse has a non-judgmental attitude? "People who are mentally ill have basically weak characters." "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." "I think the client is exaggerating her feelings so she can leave work early." "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."

"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 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? "Is that a message you've been hearing a lot over the past couple of days?" "It sounds like you're exasperated with the caregivers you've interacted with. Is that fair to say?" "Actually, I've not come here to tell you that." "There's no need to get rude with me. I'm just trying to do my job and to help you out."

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

The graduate nurse is working in mental health and is learning about the use of touch with clients that have psychiatric disorders. The seasoned mental health care nurse differentiates information about this part of therapeutic communication by stating which information? "Touch carries different meanings for different individuals." "Touch is used to express interest and warmth." "Touch is used in situations in which the client is unstable." "Touch is best mixed with compassion when dealing with the anxious client."

"Touch carries different meanings for different individuals."

When a novice psychiatric nurse shares with the nurse manager that talking about sexual abuse with clients is very uncomfortable, which would be the most effective response from the nurse manager? "What specifically makes you uncomfortable?" "I can take that client off of your assignment this shift." "It would be great if you could attend an in-service on therapeutic communication." "Have you ever been sexually abused?"

"What specifically makes you uncomfortable?"

Which statement by the nurse reflects the use of a therapeutic statement? "You look upset. Would you like to talk about it?" "I'd like to know more about your children. Tell me about them." "I understand your husband passed away. I couldn't bear that." "You look very sad. How long have you been this way? Have you been taking care of yourself?"

"You look upset. Would you like to talk about it?"

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? "Please don't disturb the other clients in the ward." "Your hard work and determination has helped you recover." "Please listen to the instructions carefully before starting the exercises." "I know you are in pain. Please wait until the medication shows its effect."

"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? "Thank you for arriving on time." "I do not give out my cell phone number to clients." "You have learned how to handle that problem already." "Your idea would help prevent this from happening again."

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

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? Countertransference A judgmental attitude Exploitation Poor boundaries

A judgmental attitude

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 nurse speaking to a client at a distance of 4 feet A nurse hugging a client who had come in for an initial visit A nurse palpating the neck of a client during the assessment A nurse speaking to a depressed client in a very strict, disciplinarian tone A nurse holding the hand of a client who is depressed because of the client's child's chronic illness.

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

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? Plan to meet the client since the personal relationship ended. Ask another nurse to attend the meetings to ensure boundaries are not crossed. Ask to be reassigned because of having a prior personal relationship with the client. Meet for the first session but explain that another nurse will be assigned going forward.

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

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

Attitudes

A nurse engaged in an interaction with a client recognizes body space zones. Which would the nurse identify as the individual's personal zone? Beginning at the boundary of the intimate zone and ending at the social zone Extending outward from the border to the public zone Surrounding and protecting an individual from others, especially outsiders The most distant boundary that can be used for recognizing intruders

Beginning at the boundary of the intimate zone and ending at the social zone

Which verbal cue refers to accents on words or phrases that highlight the subject or give insight on the topic? Emphasis Tone Pitch Intensity

Emphasis

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? Client self-exploration Self-disclosure Empathy Respect

Client self-exploration

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? Bipolar disorder Compassion fatigue Failure to thrive Decompensation

Compassion fatigue

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? Transference Free association Countertransference Reaction formation

Countertransference

A client is speaking to the nurse and expressing dissatisfaction about the care that was provided to the client during a hospital stay. The nurse tells the client, "This is the best hospital in the state. You could not expect better care anywhere else." Which type of communication does this indicate? Agreeing Challenging Defending Belittling

Defending

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

During the initiating or orienting phase

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

Eliciting the client's cooperation through the establishment of trust

When the nurse states, "Tell me more about that," the nurse is utilizing which communication technique? Exploring Focusing Accepting Formulating a plan of action

Exploring

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

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

Which is an example of a nontherapeutic communication technique? Giving approval Summarizing Silence Voicing doubt

Giving approval

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

Hildegard Peplau

A nurse enters the room of a client who has been on the unit for several weeks. The client states, "I haven't seen you for a while. How were your days off?" What is the nurse's most appropriate response? It's important to get a break from time to time. How have the last few days been for you? I'm really not at liberty to talk about my activities outside of work. I hope you understand. I didn't do anything particularly special, but it's always nice to spend time with my family. Well, if you had to guess, what do think that I might do in my time outside of work?

It's important to get a break from time to time. How have the last few days been for you?

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? Confidentiality Professionalism Lacking genuine interest Unknowing

Lacking genuine interest

A client is discussing the client's problems at the workplace. Which nonverbal cues would indicate that the nurse is attentive to the client? Select all that apply. Looking down to the floor Leaning toward the client Mirroring the client's facial expression Maintaining eye contact with the client Sitting with closed arms and crossed legs

Leaning toward the client Maintaining eye contact with the client

The nursing instructor is teaching about the importance of communication in nursing and relates it to the family. Which statement by a student nurse would indicate that the teaching has not been effective? Nonverbal communication is not meaningful. Communication theory concerns the sending and receiving of verbal and nonverbal messages. All communication consists of two levels. Verbal communication is important.

Nonverbal communication is not meaningful.

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? Orientation Working Resolution Withholding

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? Orientation phase Identification phase Exploitation phase Termination phase

Orientation phase

Which form of nonverbal communication would be least effective for the nurse to engage in to demonstrate interest in and acceptance of the client? Sitting behind a desk Leaning slightly forward to the client Facing the client at eye level Keeping arms and legs uncrossed

Sitting behind a desk

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? Ethical knowing Aesthetic knowing Personal knowing Empirical knowing

Personal knowing

A client diagnosed with schizophrenia is hallucinating. Which communication technique may the nurse use to redirect the client? Presenting reality Reflecting Making observations Seeking information

Presenting reality

When providing information about anorexia to a client, the nurse can ensure that the client can accurately comprehend the information by doing what? Presenting the information using language and terms the client will understand Interacting with the client in a nonthreatening, respectful manner Being careful not to overload the client with too much information at one time Giving the client ample opportunity to ask questions

Presenting the information using language and terms the client will understand

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. Personal safety Preventing deterioration of mental status Promoting mental health Promoting physical health Ensuring adequate sedation with medication

Preventing deterioration of mental status Promoting mental health Promoting physical health

During a therapy session, the nurse asks the client, "Tell me more about your relationship with your parents." The nurse is using which therapeutic communication technique? Reflecting Probing Confrontation Clarification

Probing

Which zone is an acceptable distance between a speaker and an audience? Public Intimate Personal Social

Public

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

Rambling due to nervousness

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? Tell the client the nurse will call once per week during office hours so that the client can practice phone skills Remind the client about the importance of boundaries to keep the relationship therapeutic Call the client once each weekend to build trust Tell the client to call the office answering service in case of an emergency

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

A mental health nurse is discussing the schedule of events for the day on the unit with a client. The nurse therapeutically communicates within which zone of distance awareness? Public Social Intimate Personal

Social

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. Immediately stop the client and inform the client that the nurse is running the session. Get angry at the client and ask the client to leave the session. Reassure the client that they already covered these issues. Review with the client the learned methods to control the problems. Do not acknowledge this issue and continue on with the session as planned.

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

A psychiatric-mental health nurse is working to develop a therapeutic relationship with a client. When doing so, which element would the nurse integrate as critical to building this relationship? Self-awareness Communication skills Desire to form friendships Previous social skills

Self-awareness

A client relates that the client has panic attacks and, during the attacks, rushes to the emergency department because the client feels like the client is dying. The nurse discloses that the nurse has had panic attacks during which the nurse also felt very fearful. Which statement represents an accurate statement about this self-disclosure? Self-disclosure can help normalize the client's experience. Self-disclosure allows the client to see the nurse as a real human being. Self-disclosure can help the client feel like a friend. Self-disclosure should be detailed so the client doesn't feel unimportant or devalued.

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

Which would not be considered a goal of therapeutic communication? Self-exploration of feelings by the nurse Establishing rapport Active listening Guiding the client in problem solving

Self-exploration of feelings by the nurse

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

The client

The nurse is working with a client from the Middle East. The nurse maintains a distance of approximately 13 feet from the client while talking. The client says that the client is uncomfortable when the nurse talks to the client from such a long distance. How should the nurse interpret this statement? The client is not maintaining boundaries. The client feels that the nurse is not doing the job properly. The client feels that the nurse is indifferent toward the client. The client feels that the nurse is invading the client's personal zone.

The client feels that the nurse is indifferent toward 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? The client is nervous and insecure. The client is experiencing symptoms of a disorder. The client is demonstrating a normal reaction. The client is attempting to engage in a social relationship.

The client is nervous and insecure.

When engaged in therapeutic communication with a client who has a mental disorder, which is the most important for a nurse to keep in mind? The nurse should self-disclose when indicated. The client is the primary focus of the interaction. The nurse should have an empathetic relationship with the client. The client's conversations should be recorded.

The client is the primary focus of the interaction.

A psychiatric-mental health nurse has entered a client's room, made an introduction, and asked if the nurse and the client could speak for a few minutes. The clients states, "Yep. Glad to talk." However, the nurse observes that the client is looking at the floor and the client's arms and legs are crossed. How should the nurse best interpret this situation? The client may be reluctant to dialogue despite the statement to the contrary The client is eager to dialogue with the nurse but is unsure how best to proceed The client is glad to talk to the nurse because that is what the client stated The disconnect between the client's verbal and nonverbal messages confirms the presence of mental illness

The client may be reluctant to dialogue despite the statement to the contrary

The nurse is sitting behind a table while speaking to a client on the other side of the table. What is the most appropriate reason for this nurse's action? The client can communicate freely. The client can open up easily. The client may have difficulty maintaining spacial boundaries. The client may be physically expressive.

The client may have difficulty maintaining spacial boundaries.

The nurse is caring for a client with severe depression. The client tells the nurse, "I really just want to sleep and not have to wake up." What may the nurse interpret from this covert cue? The client may want to sleep. The client may be extremely fatigued. The client may have suicidal ideations. The client may need a break to reduce stress.

The client may have suicidal ideations.

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

The client struggles with expressing feelings The client demonstrates dependence on the group The nurse demonstrates evidence of countertransference

Which would be the least optimal environment for therapeutic communication for a client who has difficulty maintaining boundaries? The client's room An interview room A conference room The end of a hall

The client's room

A nurse is caring for a client who is experiencing a decline in the client's chronic illness. The nurse feels that the nurse should speak to the client's spouse, who is extremely worried and anxious, and provide the spouse with support. Which setting should the nurse select to speak to the spouse? Choose the best answer. The cafeteria The client's room The hallway The consultation room

The consultation room

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

The loss of therapeutic effectiveness

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? The nurse is comforting the client. The nurse is empathizing with the client. The nurse is sympathizing with the client. The nurse is showing genuine interest in the client.

The nurse is empathizing with the client.

Which is inconsistent with principles of therapeutic communication? The nurse is the primary focus of the relationship. The nurse must maintain client confidentiality. Interventions are implemented from a theoretical base. A professional attitude sets the tone of the therapeutic relationship.

The nurse is the primary focus of the relationship.

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

The therapeutic use of self

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? The therapist must keep the comment confidential, because the disclosure is protected by therapist-client confidentiality. The therapist must evaluate the threat and notify authorities if it meets credibility criteria. The therapist must meet with an ethics committee to determine the course of action. The therapist must notify authorities and the potential victim.

The therapist must notify authorities and the potential victim.

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

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

When speaking with a client who has a diagnosis of major depression, the nurse has placed a hand lightly on the client's shoulder when responding to one of the client's statements of hopelessness. Which principle should underlie the nurse's use of touch when communicating with clients? The nurse should explicitly ask permission before touching a client in any capacity. Physical touch should be used solely with clients of the same gender as the nurse. Touch can be a powerful therapeutic tool, but it must be used with caution. Touching a client is inappropriate and opens the nurse to legal action

Touch can be a powerful therapeutic tool, but it must be used with caution.

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? Positive regard Caring Trust Genuine interest

Trust

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? Orientation Working Resolution Mutual withdrawal

Working

Choose the most therapeutic response to the client's statement, "All I feel like doing is screaming as loudly as I can." "Please calm down; everything is going to be better." "Who has made you so upset?" "I wish you could try to be more positive." " You look like you are very angry this morning."

You look like you are very angry this morning."

While interviewing a client, the nurse imagines what it would be like to be in the client's situation and how it would feel. The nurse is demonstrating: rapport. empathy. self-awareness. projection.

empathy.

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. interrupting the client minimizing the client's concerns asking the client to clarify a particular issue arguing with a client over agreed upon plans restating the client's perception of a problem

interrupting the client arguing with a client over agreed upon plans minimizing the client's concerns

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? empathetic linkages self awareness self disclosure active listening

active listening

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

develop a sense of trust in the nurse

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: empathy. sympathy. apathy. nontherapeutic communication.

empathy.

A nursing student is caring for a client who has been arrested for child abuse. The nurse is very curious about what the client must have done to get into so much trouble, so the nurse asks the client to tell the nurse about the various activities that got the client arrested. This is an example of: lack of awareness. genuineness and caring. gathering assessment data. excessive probing.

excessive probing.

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: is angry that the nurse is abandoning the client. requires additional therapy. is unhappy that the therapy was ineffective. is attempting to prolong the nurse-client relationship.

is attempting to prolong the nurse-client relationship.

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. nurses feeling overwhelmed over-reliance on the process recognizing on-site champions focusing on preexisting conflicts implementing educational modules

nurses feeling overwhelmed over-reliance on the process focusing on preexisting conflicts

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? known allergies recent hospitalizations perception of the problem family history

perception of the problem

A nurse responds to a client's statement with silence based on the rationale that this technique is used primarily to: allow the nurse to determine an appropriate response. permit the client to gather the client's thoughts. encourage self-reflection by the nurse. demonstrate passive listening.

permit the client to gather the client's thoughts.

The most important tool of psychiatric nursing is the: physician. nurse. self. environment.

self

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

shifting the emphasis to the nurse

The nurse is offering an demonstration session on what is done in group. Which client(s) would the nurse determine as conveying a message? Select all that apply. the teenager who writes "No one loves me" in a journal the mother checking her makeup in a mirror the father slapping his son for picking a wallet from a pocket a girl with headphones playing loud music away from everyone else a boy displaying a rainbow tattoo on his arm

the teenager who writes "No one loves me" in a journal the father slapping his son for picking a wallet from a pocket a girl with headphones playing loud music away from everyone else a boy displaying a rainbow tattoo on his arm

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

working