mental health ch 8 therapeutic relationships

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

therapeutic relationship

focuses on pt. needs, thoughts, feelings, and goals

social relationships

friendship, socialization, enjoyment, or accomplishment of a task

factors vital for establishing a therapeutic relationship

genuineness, empathy, and positive regard

A client states "That nurse never seems comfortable being with me." The nurse can be described as

not seeming genuine to the client.

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?

"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!"

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?

"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."

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?

"That must have been such a hard situation for you to deal with."

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?

"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."

A term is a synonym for the characteristic of genuineness?

Authentic

Therapeutic use of self

Creative use of unique personality traits and talents to promote healing and form positive bonds with others.

The outcome of the nurse's expressions of sympathy instead of empathy toward the client often leads to which outcome?

Decreased client communication

The nurse would address which of the following goals in attempting to establish a therapeutic nurse-client relationship?

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 .

Which of the following statements are true regarding the differences between a social relationship and a therapeutic relationship?

In a social relationship, both parties' needs are met; in a therapeutic relationship, only the patient's needs are to be considered. Giving advice is done in social relationships; in therapeutic relationships giving advice is not usually therapeutic. 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.

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

Orientation

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?

Positive transference

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

Termination phase

When a nurse and client meet informally or have an otherwise limited but helpful relationship, what term is used to identify this relationship?

Therapeutic encounter

What is the primary difference between a social and a therapeutic relationship?

Type of responsibility involved

Peplau's Phases of the Nurse-Client Relationship

preorientation, orientation, working, termination