Deck 11: The Therapeutic Relationship

Question 1

A female client is admitted with suicidal tendencies.The client is placed in suicide precautions for the first 24 hours of her stay.Ensuring client safety is included in the therapeutic role of:

A)Change agent
B)Teacher
C)Therapist
D)Technician

Answer 1

Technician

Question 2

During the preparation phase of a therapeutic relationship with a client,what is the main task to be completed by the nurse?

A)To establish with the client the purpose of the relationship
B)To gather and review all possible information regarding the client
C)To build trust with the client
D)To obtain agreement from the client to work in conjunction with the nurse

Answer 2

To gather and review all possible information regarding the client

Question 3

The nurse is attempting to develop trust with a newly admitted female client for the purpose of establishing a therapeutic relationship.The nurse is currently administering medications to all clients on the unit.The newly admitted client asks the nurse to sit and talk with her for a while.What is the nurse's best response?

A)"I am busy right now,but I will come back later."
B)"Give me just a few more minutes to finish passing medication to the other clients."
C)"I will return in 20 minutes so we can talk."
D)"I have to finish giving all the clients their medications,but I will then come back so we can talk."

Answer 3

"I have to finish giving all the clients their medications,but I will then come back so we can talk."

Question 4

The new nurse confides to his supervisor,"I am feeling frustrated.Mr.J has been doing so well in dealing with his issues over the last month,and today he refused to discuss anything productive in our session." What is the most appropriate response?

A)"You are still in the preparation phase and need to check the medical record for information."
B)"The orientation phase is a time where the client is building trust and testing you."
C)"During the working phase the client may have growth and resistance."
D)"The termination phase is a difficult one for both nurse and client."

Question 5

The nurse is preparing an adult male client,who has been successfully treated for a social phobia,for the termination phase of the therapeutic relationship.During their last meeting,the client told the nurse that he noticed he has developed a nervous habit that started a few days ago of checking his door at home several times a day to be sure it is locked.This client is exhibiting the client response to termination known as:

A)Continuation
B)Regression
C)Withdrawal
D)Confabulation

Question 6

The characteristic of genuineness helps in establishing a therapeutic relationship with a client.Which nurse response is the best example of a display of genuineness to a client who is going through a difficult divorce?

A)"I know exactly how you feel.My husband and I divorced 2 years ago because of his infidelity."
B)"Divorcing my husband was the best thing I ever did."
C)"I have friends who have gone through a divorce.It must be difficult for you."
D)"I am sorry that you have to go through this difficult time."

Question 7

As the nurse begins to discuss discharge plans for a 45-year-old female client hospitalized for anxiety,the client states,"You never really cared whether I get better! Why not stop this charade?" The nurse recognizes this to be

A)Transference
B)Secondary gain
C)Countertransference
D)Insecurity

Question 8

The nurse is caring for a female client with a diagnosis of severe bipolar disorder.Out of many treatment methods,the one treatment that the client and the team have found to be most effective is the medication lithium.The client voices concern about her future with this diagnosis.Which nurse response best represents the concept of hope?

A)"You need to take your lithium unless you want to relapse."
B)"You are doing so well that there is nothing you can't do if you put your mind to it."
C)"You are doing very well since we found that lithium helps.You should do well as long as you continue your therapy and medication."
D)"A lot of people are much worse off than you are,so you should be thankful that you are doing as well as you are."

Question 9

A 22-year-old woman with depression misses her scheduled meeting with the nurse.Although they have established a contract to meet on an agreed upon schedule,the nurse understands that the client is still testing the relationship and working on trusting her care provider.This behavior usually manifests itself during which phase of the therapeutic relationship?

A)Termination
B)Orientation
C)Working
D)Preparation

Question 10

The nurse who is caring for a client begins to have very protective feelings toward the client that are interfering with the therapeutic relationship between the nurse,the client,and the client's family.This is an example of a problem that is encountered in some therapeutic relationships and is known as:

A)An environmental problem
B)Resistance
C)Transference
D)Countertransference

Question 11

A male client is being discharged from a mental health facility and is worried about what to tell his friends and co-workers regarding his time away.The nurse helps the client plan what to say to others about his disease.The nurse is functioning in the role of:

A)Change agent
B)Teacher
C)Therapist
D)Technician

Question 12

A 19-year-old male client is being treated for a drug addiction.He continually voices his dread of being discharged because he knows he will have to live with his parents and follow their rules until he can earn enough money to live on his own.He is showing increasing resistance to treatment measures,such as attending group sessions,and is refusing to acknowledge that he has an addiction or that he needs treatment.Which behavior is the client demonstrating?

A)Transference
B)Primary resistance
C)Secondary resistance
D)Tertiary resistance

Question 13

A male client with schizophrenia has lost his job and home and has been living in a homeless shelter.He voluntarily admits himself into a mental health treatment facility.The client's current living situation and lack of a job at this time likely will contribute to his having difficulty with which dimension of hope?

A)Affective
B)Contextual
C)Temporal
D)Affiliative

Question 14

A nurse is working with a male client in a mental health outpatient clinic.The client voices a desire to become more autonomous.Which goal will assist the client in becoming more autonomous?

A)The client will check his calendar each night to plan for commitments scheduled on the following day.
B)The nurse will remind the client weekly of his appointment at the clinic for the following week.
C)The client will ask the nurse to call him to remind him of his appointment.
D)The nurse will complete the client's calendar of daily commitments scheduled for the week.

Question 15

When a caregiver becomes a role model for a client during a therapeutic relationship,the caregiver is functioning in the role of a:

A)Teacher
B)Therapist
C)Technician
D)Change agent

Question 16

A female client with obsessive-compulsive disorder is undergoing treatment in an outpatient setting and is attending group therapy sessions.She is working on controlling the compulsion of touching her head three times every time she talks.To maintain the therapeutic relationship established with the client,by which action can the nurse show acceptance?

A)Ignoring the compulsion during the group therapy session and talking with the client privately about the behavior
B)Asking the group to remind the client every time she touches her head to help her consciously stop the compulsion
C)Pointing out the compulsion to the group each time the client exhibits the behavior
D)Asking the client to stop talking during the group session until she has learned to control her compulsion

Question 17

When should the nurse begin preparations for the termination phase of a therapeutic relationship?

A)During the orientation phase
B)Prior to the last meeting
C)During the last meeting
D)After all goals have been met

Question 18

Which of the following actions indicates that the nurse has gone beyond the boundaries of the client-caregiver relationship?

A)The nurse consciously focuses on the client during meetings.
B)The nurse works to establish a trusting relationship with the client.
C)The nurse instills a sense of hope in the client.
D)The nurse defends the client to her family and the staff.

Question 19

A client response to the termination phase of the therapeutic relationship is withdrawal.This response most often is manifested by client behaviors such as:

A)Bringing up new problems
B)Being absent from appointments
C)Returning to maladaptive behavior
D)Having increased anxiety

Question 20

An important aspect of developing a therapeutic relationship with a mental health client is for the nurse to show that she cares about the client.The nurse who is working on an inpatient unit can show signs of caring by:

A)Telling a client several times a day that he or she cares about him or her
B)Asking a client what his or her favorite movie is and then showing that movie during a movie night on the unit
C)Giving a client a card that has a sentiment that says the nurse cares about him or her
D)Telling a client that he or she is the favorite client

Question 21

For which roles is the caregiver responsible in a therapeutic relationship? (Select all that apply. )

A)Teacher
B)Therapist
C)Technician
D)Friend
E)Change agent

Question 22

Which of the following are characteristics of a therapeutic relationship? (Select all that apply. )

A)Acceptance
B)Rapport
C)Problem solving
D)Genuineness
E)Therapeutic use of self

Question 23

__________ refers to the ability of the nurse to establish a meaningful connection with a client.

Question 24

A therapeutic relationship has four phases.Place these phases in proper order.

A)Orientation
B)Termination
C)Preparation
D)Working

Question 25

The acronym TEACH represents the components of a therapeutic relationship: __________,__________,__________,__________,and __________.