psych prep u chp 5 therapeutic relationships
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."
A psychiatric-mental health client tells the nurse, "The doctor hates me. The doctor promised to come check on me after dinner yesterday but never came." What is the nurse's most therapeutic response?
"I don't know why the doctor didn't check on you yesterday, but I think it's unlikely that the doctor hates you."
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 but I will not accept these gifts because they extend over our discussed boundaries."
The client presents with signs and symptoms of anxiety. What conversation initiated by the nurse demonstrates an ineffective therapeutic use of self?
"What types of dresses do you like wearing?"
What should the nurse avoid when demonstrating genuine interest for a client by making a self-disclosure?
shifting the emphasis to the nurse
The nurse maintains a therapeutic relationship until the client is successfully transferred to another facility. What is the nurse demonstrating?
transitional relationship model
A nurse is engaging in an interpersonal interaction with a young adult client who is admitted to the hospital with suicidal ideation. The client states, "I am really not good at anything." How should the nurse respond to the client's statement?
"I have a really difficult time believing that."
A client explains feelings of sadness and loss after the death of a close friend. Which nursing statement best demonstrates empathy?
"I see this is hard for you. How can I help?"
A nurse is meeting with a client prior to discharge from the hospital. The client tells the nurse he is "really worried about returning home." Which response indicates the nurse is employing therapeutic communication?
"Please share with me what is worrying you right now."
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?
"Tell me why you are angry about what I just said."
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?
"Your hard work and determination has helped you recover."
A client has recently been diagnosed with cancer. The client says, "What did I do wrong to get such a disease?" Which nonverbal processes, along with the client's statement, would convey a congruent message? Select all that apply.
A sad facial expression A fearful tone of voice
A client with depression has been admitted to the mental health unit and is attending group therapy sessions as part of the treatment. The client asks the nurse leading the group if the nurse is married or has a girlfriend. The nurse responds, "I am curious what made you ask this question; however, what is important is how you are feeling today." The nurse's response is what?
Appropriate, because the focus of the therapeutic relationship is the client, not the nurse.
Which term is used to describe general feelings or a frame of reference around which a person organizes knowledge about the world?
Attitudes
A client expresses to the nurse that the client has been unable to sleep due to work. The nurse asks the client, "Do you mean that the work in the office is causing stress, which is why you are not able to sleep?" Which type of therapeutic communication technique is this conversation indicative of?
Consensual validation
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?
Countertransference
A client who is schizophrenic is catatonic and has a mask-like face. Which facial expression is being exhibited?
Impassive
Which is an inaccurate statement regarding a preconception?
It enables the nurse to get an accurate picture of the client's problems.
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
Which is not a goal of the working phase of the therapeutic relationship?
Reducing the client's anxieties
A client describes panic attacks during which the client rushes to the emergency department with a feeling that death may be imminent. The nurse discloses having had panic attacks during which the nurse also felt very fearful. Which statement about the nurse's self-disclosure is accurate?
Self-disclosure can help normalize the client's experience.
Which would indicate that the nurse-client relationship has passed from the orienting phase to the working phase?
The client recognizes feelings of anger and expresses them appropriately.
A nurse understands that giving positive regard to the client helps in building trust for the nurse. Which actions are appropriate while conveying positive regard? Select all that apply.
The nurse should address the client by name. The nurse should respond openly to the client. The nurse should actively listen to the client.
Which situation would most likely indicate a violation of professional boundaries? Select all that apply.
The nurse strongly defends a client's behavior during a staff meeting. A nurse tells other staff that the nurse is the only one who understands the client. A nurse begins to spend increasing amounts of time with one client on the unit.
A nursing student is working with a client who has a history of abusing alcohol. Although the nurse has an aversive feeling toward people who abuse alcohol, the nurse feels that the client is worthy of respect and attention regardless of the nurse's own personal feelings. Which correctly describes the nurse's response to the client?
Unconditional positive regard
During which phase of the nurse-client relationship does the client identify and explore specific problems?
Working
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?
perception of the problem
A student nurse is preparing for a clinical placement in a psychiatric-mental health context. In order to best prepare to engage in therapeutic communication with clients, the student should:
reflect critically on the student's own life experiences, perspectives, and characteristics.
The nurse wears a cross and has a Facebook page displaying pictures of the family, home and updates on what the nurse is currently doing. These actions are examples of what?
self-disclosure
A nurse reviews a client's psychiatric and medical history before approaching the client for an assessment. The history reveals the client has a history of sexual abuse from a caregiver in early adolescence. Which zone would be the best place for the nurse to sit the nurse to begin the assessment?
social
During which phase of the nurse-client relationship does the client identify and explore specific problems?
working
