Deck 8: The Nurse-Patient Relationship and Therapeutic Communication

Question 1

Which actions made by the nurse best exemplify the orientation phase of the nurse-patient therapeutic relationship? Select all that apply.

A) Assessing the patient's limitations
B) Clarifying the patient's expectations for care
C) Educating the patient about the patient's health problem
D) Identifying resources that will be used in the first interaction
E) Reviewing the patient's history in the patient's medical record

Answer 1

Assessing the patient's limitations
Educating the patient about the patient's health problem

Question 2

The nurse is establishing a therapeutic environment with a newly admitted patient with a severe mental illness. Which statement best demonstrates empathetic communication?

A) "I feel really bad that you have this disorder."
B) "You appear upset. Do you want to talk about it?"
C) "You appear upset. Why do you feel this way?"
D) "Many people have this disorder. You will feel better in no time."

Answer 2

"You appear upset. Do you want to talk about it?"

Question 3

A novice nurse is learning how to effectively communicate within a therapeutic nurse-patient relationship. What struggle is most harmful when the nurse is new to therapeutic relationships?

A) Feeling uncomfortable with the relationship
B) Feeling anxious about developing the relationship
C) Falling back on knowledge learned from nursing school and not accounting for practical knowledge
D) Falling back on relationship skills learned in friendships, family relationships, or other personal relationships

Answer 3

Falling back on relationship skills learned in friendships, family relationships, or other personal relationships

Question 4

A novice nurse caring for patients with mental illness wants to use empathy as a therapeutic tool. How is empathy used as a therapeutic tool for nurses?

A) To validate the nurse's expertise
B) To validate the nurse's perceptions
C) To validate the nurse-patient relationship
D) To validate the experiences of the patient

Question 5

The nurse understands that health is typically defined as the state of being without illness. What is wrong with this definition?

A) It suggests that being healthy is difficult to achieve.
B) It suggests that all who are without illness are healthy.
C) It suggests that health and illness correlate with one another.
D) It suggests that individuals diagnosed with illness cannot possibly be healthy.

Question 6

The novice nurse is learning about the use of boundaries in the therapeutic nurse-patient relationship. What examples will the nurse recognize as boundary violations? Select all that apply.

A) Sexual misconduct
B) Last-minute appointment changes
C) Inappropriate self-disclosure
D) Giving or receiving small gifts
E) Disclosing bits of personal information

Question 7

The nurse is developing a plan of care for a patient. Which intervention must the nurse be careful to avoid?

A) Discussing expectations with the patient
B) Identifying the patient's perception of the problem
C) Addressing issues related to the patient's past experiences
D) Performing actions that conflict with the patient's value system

Question 8

The nurse validates the patient's response to an intervention prior to documenting in the progress note. What does validation ensure?

A) The patient's request is clarified.
B) The patient's affect is appropriate to the situation.
C) The patient's need for further intervention is understood.
D) The patient's perception of the response is communicated.

Question 9

What is the key concept that allows the nurse to maintain professional boundaries when first developing the nurse-patient relationship?

A) Intentional development of the relationship
B) Use of caring in the relationship
C) Shared goals of the relationship
D) Shared knowledge occurring in the relationship

Question 10

The psychiatric-mental health novice nurse asks "What is mental health?" Which qualities will her superior include when describing mental health? Select all that apply.

A) The ability to give and receive love
B) Having a sense of purpose in life
C) The ability to make important decisions
D) The ability to experience emotions
E) The ability to give and receive criticism

Question 11

The nurse is caring for a patient who is experiencing dysfunctional grieving following the traumatic death of spouse due to an automobile accident. The nurse also experienced the death of a loved one in the same manner. What statement made by the nurse best exemplifies the nurse using empathy toward the patient?

A) "Many people may feel angry when faced in this situation. How do you feel?"
B) "Many people may feel angry when faced in this situation. I know I felt very angry."
C) "I am so sorry you feel angry about this situation. How do you diffuse your anger?"
D) "I am so sorry you feel angry about this situation. I feel bad you have to experience this."

Question 12

The nurse manager is meeting with a staff nurse on the inpatient mental health unit for an annual employee review. When discussing the nurse's current concerns, the nurse tells the manager, "I am having trouble sleeping at night thinking about that patient we had who was hospitalized for several weeks. I got so close to that patient and I wonder how she is doing." What is the manager most concerned about regarding the nurse's statement?

A) The nurse is experiencing burnout.
B) The nurse is experiencing insomnia.
C) The nurse has crossed professional boundaries.
D) The nurse has compromised his or her professional license.

Question 13

A patient experiencing psychosis tells the nurse, "I am in charge. Who are you and why are you here?" What is the most therapeutic response by the nurse?

A) "You know who I am."
B) "You don't know who I am?"
C) "You are not in charge; you are a patient in the hospital."
D) "I am your nurse and I will be here to help you until dinner."

Question 14

During the first interaction with a client, the nurse makes an introduction and identifies the purpose of the interaction. This serves to accomplish which stage of the nurse-patient relationship?

A) Orienting
B) Evaluating
C) Identifying
D) Implementing

Question 15

Which aspect of nonverbal communication conveys the nurse's positive attitude toward the patient? Select all that apply.

A) Leaning slightly forward
B) Orienting to face the patient
C) Maintaining physical proximity
D) Formulating a reply while the patient is speaking
E) Maintaining good eye contact while the patient is speaking

Question 16

The novice nurse is learning about the various types of relationships and how these affect the role of the nurse when providing care to patients with mental illness. What tool do therapeutic relationships use that is not used in social relationships?

A) Shared interest
B) Shared power
C) The process of communication
D) The process of interaction

Question 17

The psychiatric-mental health nurse is receiving a report on a patient who is being transferred to the hospital from a local emergency department (ED) after expressing suicidal ideations. The ED nurse tells the psychiatric-mental health nurse that the patient is "crazy, just like my aunt!" Which quality that commonly occurs in the pre-interaction stage of the nurse-patient relationship does the ED nurse's statement demonstrate?

A) Transference
B) Ethnocentrism
C) Cultural relativism
D) Countertransference

Question 18

The nurse is planning care for a newly admitted patient. Which concepts are considered essential in establishing a therapeutic nurse-patient relationship? Select all that apply.

A) An emphasis on patient-centered care
B) The nurse's view of health and mental health
C) The nurse's ability to sympathize with the patient
D) Unconditional positive regard for the patient and family
E) The nurse's ability to make judgments regarding the patient's condition

Question 19

What process is used as a tool in developing a therapeutic relationship but is not used in developing a social relationship?

A) Interaction
B) Equal sharing
C) Mutual knowledge
D) The process of intimate disclosures

Question 20

The nurse is caring for a patient with schizophrenia who is admitted to the hospital after being found incoherent and combative at a local grocery store. The patient tells the nurse that he has not taken his medications for over two weeks. The nurse is assessing the patient's needs, symptoms, and strengths. What stage of the nurse-patient relationship is being demonstrated?

A) Working
B) Orientation
C) Identification
D) Pre-orientation

Question 21

Which intervention promotes mindful listening in any health care setting?

A) Telling the patient to get off the phone
B) Turning off the television before interviewing the patient
C) Encouraging family to step outside before assessing the patient
D) Offering the patient a choice of drink when taking a medication

Question 22

The nurse is learning about active listening techniques that will improve nurse-patient relationships. What is active listening's influence on communication?

A) It acknowledges the nurse's interest in a nonjudgmental attitude.
B) It facilitates spontaneous responses and interactive conversation.
C) It offers a way to hear, observe, and understand what patients communicate.
D) It offers a way to seek information or clarification of the patient's thoughts or ideas.

Question 23

During a group session, a patient expresses anger at the nurse. The nurse sits tensely with arms and legs crossed while verbally agreeing that the patient's point of view is correct. What message is being sent by the nurse?

A) Tolerance
B) Empathy
C) Incongruence
D) Compassion

Question 24

The nurse is meeting with a patient and says, "I would love to hear how you are feeling today." While the patient speaks, the nurse yawns, looks at her watch, and folds her arms over her chest. What do the nurse's words and actions best indicate?

A) Disinterest in the patient's answers
B) Boredom with the therapy session
C) Incongruence of verbal and nonverbal communication
D) Incongruence of nonverbal communication and meta-communication

Question 25

The psychiatric-mental health nurse is learning about various tools that can be used to help the nurse establish a therapeutic nurse-patient relationship. The nurse learns that taping offers what advantage to establishing a therapeutic relationship?

A) Assists the nurse in memorizing useful habits and mannerisms.
B) Assists the nurse in identifying communication habits and mannerisms.
C) Offers a way for feedback on communication skills and dynamics to be provided when direct observation is not an option.
D) Offers a way for feedback on communication skills and dynamics to be provided when indirect observation is not an option.

Question 26

The novice nurse is learning about the barriers to communication within the therapeutic nurse-patient relationship and the various types of communication that block the therapeutic relationship. What will the nurse recognize as a barrier to the therapeutic relationship?

A) Giving advice
B) Voicing doubt
C) Giving information
D) Seeking clarification

Question 27

A patient tells the nurse, "I don't think I can deal with feeling so sad much longer." What is the nurse's best response?

A) "We all have times of sadness."
B) "Are you saying you feel sad?"
C) "Tell me about your feelings of sadness."
D) "Is there a history of depression in your family?"

Question 28

The novice nurse is attempting to incorporate both verbal and nonverbal communication to her practice. What does the nurse recognize as the best definition of the purpose of verbal communication?

A) To establish and maintain relationships
B) To establish and maintain interactions
C) To communicate information about external events
D) To communicate information about internal events

Question 29

A novice nurse is learning about various tools that nurses may use to aid in therapeutic communication in the nurse-patient relationship. What does the nurse recognize as true regarding the concept of process recording?

A) The purpose is to record the nurse-patient interaction and provide a guideline for therapeutic care.
B) The purpose is to allow the patient to actually hear what the nurse stated in the nurse-patient interaction.
C) The purpose is to allow the nurse to actually hear what the patient heard in the nurse-patient interaction.
D) The purpose is to reflect on and evaluate the dynamics of a specific interaction and to provide a sample of interaction for consideration in supervision or consultation with others.

Question 30

The psychiatric-mental health nurse wishes to build upon the professional skill of using therapeutic communication during the nurse-patient relationship. Using the acronym RULE, which action by the nurse will best demonstrate active listening?

A) Conveying sympathy
B) Accepting the patient
C) Conveying empathy
D) Validating the patient

Question 31

What is the purpose of the nurse using nonverbal communication in a therapeutic relationship with a patient?

A) Enhance verbal messages.
B) Detract from verbal messages
C) Avoid the use of verbal messages.
D) Terminate the therapeutic relationship.

Question 32

The nurse is caring for a patient who has been diagnosed with postpartum depression. The patient tells the nurse, "I can't seem to get out of bed and take care of my baby." Which responses by the nurse best demonstrate therapeutic communication? Select all that apply.

A) "It sounds like you are having a hard time."
B) "The baby blues are normal for every woman after birth."
C) "Have you felt like this before, after the birth of your oldest child?"
D) "Would I be correct in saying that you are sleeping more than usual?"
E) "I had this condition after my son's birth. It is best to seek help from family members."

Question 33

A psychiatric-mental health nurse is learning about effective ways to clarify patient's responses. What is the best example of clarifying a patient's verbal response?

A) "See, the medicine does work."
B) "Everything seems to work out eventually."
C) "I knew it would work for you; it just takes time."
D) "Are you saying you feel the medicine is helping you?"

Question 34

While reviewing therapeutic communication techniques, a nursing student reviews statements and actions that are nontherapeutic. Which statement best represents nontherapeutic communication?

A) "Why do you think you will never get well?"
B) "How do you feel about being discharged today?"
C) "What are your concerns about your living situation?"
D) "What happened when you quit taking your medications?"

Question 35

Which intervention demonstrates the nurse's sensitivity toward the teen who is admitted with a diagnosis of depression?

A) Listening to the patient's feelings
B) Using closed-ended questions with the patient
C) Asking for details to demonstrate interest in the patient
D) Avoiding the use of silence with the patient to decrease anxiety

Question 36

A nurse tells the patient that meeting new people sometimes makes the nurse feel anxious. What is the nurse demonstrating by acknowledging feelings to the patient?

A) Empathy
B) Sympathy
C) Genuineness
D) Superficiality