Question 1

Which client action should a nurse expect during the working phase of the nurse-client relationship?

Accepted Answer

Rationale: The nurse should expect that that the client will gain insight and incorporate alternative behaviors during the working phase of the nurse-client relationship.The client may also overcome resistance,problem-solve,and continually evaluate progress toward goals.

Question 2

What is a nurse's purpose for providing appropriate feedback?

Accepted Answer

Rationale: The purpose of providing appropriate feedback is to give the client critical information.Feedback should not be used to give advice or evaluate behaviors.

Question 3

Which of the following characteristics should be included in a therapeutic nurse-client relationship? (Select all that apply.)

Accepted Answer

Rationale: The nurse-client therapeutic relationship should include promoting client insight into problematic behavior,collaboration to set appropriate goals,meeting the physical and psychological needs of the client,and ensuring therapeutic termination.Meeting the nurse's psychological needs should never be addressed within the nurse-client relationship.

Question 4

A client diagnosed with post-traumatic stress disorder related to a rape is admitted to an inpatient psychiatric unit for evaluation and medication stabilization.Which therapeutic communication technique might a nurse use that is an example of "broad openings"?

Accepted Answer

Rationale: The nurse's statement,"What would you like to talk about?" is an example of the therapeutic communication technique of a broad opening.Using broad openings allows the client to take the initiative in introducing the topic and emphasizes the importance of the client's role in the interaction.

Question 5

What should be the priority nursing action during the orientation (introductory)phase of the nurse-client relationship?

Accepted Answer

Rationale: The priority nursing action during the orientation phase of the nurse-client relationship should be to establish rapport and develop treatment goals.Rapport implies feelings on the part of both the nurse and the client,based on respect,acceptance,a sense of trust,and a nonjudgmental attitude.It is the essential foundation of the nurse-client relationship.

Question 6

Which client statement should a nurse identify as a typical response to stress most often experienced in the working phase of the nurse-client relationship?

Accepted Answer

Rationale: The nurse should identify that the client statement,"I really don't want to talk any more about my childhood abuse," reflects that the client is in the working phase of the nurse-client relationship.The working phase includes overcoming resistance behaviors on the part of the client as the level of anxiety rises in response to discussion of painful issues.

Question 7

A mother rescues two of her four children from a house fire.In an emergency department,she cries,"I should have gone back in to get them.I should have died,not them." What is the nurse's best response?

Accepted Answer

Rationale: The best response by the nurse is,"You're experiencing feelings of guilt,because you weren't able to save your children." This response uses the therapeutic communication technique of restating what the client has said.This lets the client know whether an expressed statement has been understood or if clarification is necessary.

Question 8

An instructor is correcting a nursing student's clinical worksheet.Which instructor statement is the best example of effective feedback?

Accepted Answer

Rationale: The instructor's statement,"Surely you didn't do this deliberately,but you breeched confidentiality by using names," is an example of effective feedback.Feedback is method of communication for helping others consider a modification of behavior.Feedback should be descriptive,specific,and directed toward a behavior that the person has the capacity to modify and should impart information rather than offer advice.

Question 9

A newly admitted client,diagnosed with obsessive-compulsive disorder (OCD),washes his hands continually.This behavior prevents unit activity attendance.Which nursing statement best addresses this situation?

Accepted Answer

Rationale: The most appropriate statement by the nurse is,"Let's figure out a way for you to attend unit activities and still wash your hands." This statement reflects the therapeutic communication technique of formulating a plan of action.The nurse attempts to work with the client to develop a plan without damaging the therapeutic relationship.

Question 10

Which therapeutic communication technique is being used in the following nurse-client interaction? Client: "When I am anxious,the only thing that calms me down is alcohol."
Nurse: "Other than drinking,what alternatives have you explored to decrease anxiety?"

Accepted Answer

Rationale: The nurse is using the therapeutic communication technique of formulating a plan of action to help the client explore alternatives to drinking.The use of this technique may serve to prevent anger or anxiety from escalating.

Question 11

A nurse says to a client,"Things will look better tomorrow after a good night's sleep." This is an example of which communication technique?

Accepted Answer

Rationale: The nurse's statement,"Things will look better tomorrow after a good night's sleep," is an example of the nontherapeutic communication technique of giving reassurance.Giving reassurance indicates to the client that there is no cause for anxiety,thereby devaluing the client's feelings.

Question 12

What is the most essential task for a nurse to accomplish prior to forming a therapeutic relationship with a client?

Accepted Answer

Rationale: The most essential task for a nurse to accomplish prior to forming a therapeutic relationship with a client is to clarify personal attitudes,values,and beliefs.Understanding one's own attitudes,values,and beliefs is called self-awareness.

Question 13

On which task should a nurse place priority during the working phase of relationship development?

Accepted Answer

Rationale: The nurse should place priority on promoting the client's insight and perception of reality during the working phase of relationship development.Establishing a contract for intervention would occur in the orientation phase.Examining feelings about working with a client should occur in the pre-interaction phase.Establishing a plan for aftercare would occur in the termination phase.

Question 14

When an individual is "two-faced," which characteristic essential to the development of a therapeutic relationship should a nurse identify as missing?

Accepted Answer

Rationale: When an individual is "two-faced," which means double-dealing or deceitful,the nurse should identify that genuineness is missing in the relationship.Genuineness refers to the nurse's ability to be open and honest and maintain congruence between what is felt and what is communicated.When a nurse fails to bring genuineness to the relationship,trust cannot be established.

Question 15

A client exhibiting dependent behaviors says,"Do you think I should move from my parent's house and get a job?" Which nursing response is most appropriate?

Accepted Answer

Rationale: The most appropriate response by the nurse is,"Let's discuss and explore all of your options." In this example,the nurse is encouraging the client to formulate ideas and decide independently the appropriate course of action.

Question 16

The nurse is interviewing a newly admitted psychiatric client.Which of the following nursing statements is an example of offering a "general lead"?

Accepted Answer

Rationale: The nurse's statement,"Yes,I see.Go on," is an example of a general lead.Offering general leads encourages the client to continue sharing information.

Question 17

Which therapeutic communication technique is being used in the following nurse-client interaction? Client: "My father spanked me often."
Nurse: "Your father was a harsh disciplinarian."

Accepted Answer

Rationale: The nurse is using the therapeutic communication technique of restatement.Restatement involves repeating the main idea of what the client has said.It allows the client to know whether the statement has been understood and provides an opportunity to continue.

Question 18

A nurse maintains an uncrossed arm and leg posture when communicating with a client.This nonverbal behavior is reflective of which letter of the SOLER acronym for active listening?

Accepted Answer

Rationale: The nurse should identify that maintaining an uncrossed arm and leg posture is nonverbal behavior that reflects the O in the active-listening acronym SOLER.The acronym SOLER includes sitting squarely facing the client (S),observing and open posture (O),leaning forward toward the client (L),establishing eye contact (E),and relaxing (R).

Question 19

A mother who is notified that her child was killed in a tragic car accident states,"I can't bear to go on with my life." Which nursing statement conveys empathy?

Accepted Answer

Rationale: The nurse's response,"It must be horrible to lose a child,and I'll stay with you until your husband arrives," conveys empathy to the client.Empathy is the ability to see the situation from the client's point of view.Empathy is considered to be one of the most important characteristics of the therapeutic relationship.

Question 20

If a client demonstrates transference toward a nurse,how should the nurse respond?

Accepted Answer

Rationale: The nurse should respond to a client's transference by clarifying the meaning of the nurse-client relationship based on the present situation.Transference occurs when the client unconsciously displaces feelings about a person from the past toward the nurse.The nurse should assist the client in separating the past from the present.

Quiz 6: Relationship Development and Therapeutic Communication