Question 1

An experienced nurse is describing the characteristics of a therapeutic one-to-one relationship to a nursing student. Which of the following is the most accurate description?

Accepted Answer

The essential feature of a therapeutic one-to-one relationship is a therapeutic alliance, which is the mutual understanding, respect, and trust that develops between the nurse and client. The relationship is focused on the client's needs and goals, and the nurse helps the client achieve these through collaborative problem-solving and reflection. While the nursing process may be used to guide the relationship, it is not the cornerstone of the relationship. The relationship is not typically reciprocal, as the nurse is in a position of power and responsibility. While the nurse does aim to meet the client's needs, this is not the defining characteristic of the relationship.

Question 2

A client states that she is unhappy and miserable in her marriage and has been for several years. Which of the following responses indicates the nurse is tuning in to the process of the client's interaction rather than the content?

Accepted Answer

Option C reflects the nurse's ability to tune in with the client's emotional state rather than just focusing on the factual information. It shows empathy and understanding. The other options focus on the content of the conversation rather than the emotional state of the client.

Question 3

The nurse suspects a client is unwilling to demonstrate self-sufficiency or independence in the therapeutic relationship when the client says, "You are the only person I can talk to or trust. Let's go out to dinner tonight so we can spend more time together." Which one of the following nurse responses is most appropriate in this situation?

Accepted Answer

The most appropriate response is C because it addresses the client's dependency on the nurse in a professional manner, encouraging the client to explore their feelings without crossing professional boundaries. Responses A and B are inappropriate as they do not address the underlying issue of dependency in a therapeutic manner, and D is inappropriate as it encourages boundary crossing.

Question 4

A client who grew up with alcoholic parents is reluctant to discuss thoughts, feelings, and self-defeating behaviors with the nurse. Which of the following responses by the nurse would be most helpful?

Accepted Answer

This response shows empathy and understanding of the client's past experiences, while also gently encouraging them to reflect on how their upbringing has impacted them. It allows the client to choose whether or not to disclose their feelings while still acknowledging their importance. This approach can help build trust and rapport with the client, creating a safe space for them to eventually open up about their thoughts and emotions.

Question 5

A client states that he is unhappy in his marriage and has felt miserable for several years. Which of the following client responses would indicate that the nurse's response to the "theme" of marital distress was most effective?

Accepted Answer

The client's response indicates that the nurse's response to the "theme" of marital distress was most effective because it demonstrates that the client is able to identify and express their feelings of depression and hopelessness. This suggests that the nurse has been able to establish a therapeutic relationship with the client and that the client is beginning to feel comfortable discussing their marital problems.

Question 6

A client who is being discharged offers the nurse a ceramic bowl made during hospitalization as a symbol of the open "vessel" the client has become for accepting new ideas. What is the best response by the nurse?

Accepted Answer

Option A validates the client's progress and acknowledges the symbol's significance. It also shows gratitude for the client's thoughtful gesture. Option B makes the bowl a display object rather than a personal gift. Option C detracts from the client's satisfaction by replacing their gesture with payment. Option D is a cold response that lacks understanding and sympathy. Therefore, option A is the best response.

Question 7

The nurse is establishing a therapeutic alliance with a new client. Which of the following behaviors would enhance the development of a therapeutic one-to-one relationship?

Accepted Answer

Assisting the client to identify thoughts and feelings is a key aspect of developing a therapeutic relationship, as it helps build trust and empathy between the nurse and client. Eagerly encouraging communication on a superficial level, sharing personal experiences, and defining goals for the client may not be appropriate at the initial stages of a therapeutic relationship and could hinder its development.

Question 8

Establishing and maintaining the therapeutic nurse-client relationship differs according to the client's cultural background. The nurse is guided by the knowledge that:

Accepted Answer

The answer of Establishing and maintaining the therapeutic nurse-client relationship...

Question 9

Which of the following objectives is indicative of the working phase?

Accepted Answer

The objective of analyzing client behaviors and response patterns is indicative of the working phase. This is when the therapist and client are actively working together to address the client's issues and behaviors, and analyzing their responses can help the therapist make adjustments to the treatment plan as necessary. The other objectives listed are more indicative of the initial or termination phases of therapy.

Question 10

A client appears unwilling to explore a specific topic during the working phase of the therapeutic relationship, demonstrating a strong sense of self-sufficiency. Which of the following nursing strategies would be most helpful?

Accepted Answer

The answer of A client appears unwilling to explore a...

Question 11

Which of the following professionals would be most helpful in providing interdisciplinary supervision regarding specific culture-bound syndromes that interfere with the therapeutic nurse-client relationship?

Accepted Answer

An ethnic consultant would be most helpful in providing interdisciplinary supervision regarding specific culture-bound syndromes that interfere with the therapeutic nurse-client relationship since they have expertise in the cultural nuances and beliefs of the specific ethnic group. Psychiatrists, psychologists, and religious consultants may not necessarily have the same level of expertise in this area.

Question 12

During the orientation phase of the nurse-client relationship, the client presents the nurse with a framed picture that was painted during recreational therapy. What is the best response by the nurse?

Accepted Answer

The nurse should accept the gift graciously and put it in a place where everyone can enjoy it. This will help to build rapport with the client and show that the nurse is interested in their well-being.

Question 13

The nurse is explaining the nurse-client relationship to a client in their first formal counseling session. Which of the following characteristics should the nurse describe as part of this one-to-one relationship?
Select all that apply.

Accepted Answer

The nurse-client relationship should be mutually defined, meaning that the nurse and client work together to establish goals and a plan of care. It should also be goal directed, meaning that the relationship focuses on achieving specific outcomes related to the client's needs. Additionally, the relationship is characterized by shared dignity, as both the nurse and client have value and worth as individuals. The relationship should not necessarily be described as harmonious or sympathetic, as these terms do not fully encompass the nature of the therapeutic relationship.

Question 14

Which of the following statements by the nurse may prevent successful separation between client and nurse at the end of a therapeutic one-to-one relationship?

Accepted Answer

The statement "I'm skeptical of your ability to assert yourself when new conflicts occur in future relationships, so be careful." may create doubt in the client's mind about their abilities and create dependence on the nurse, preventing successful separation at the end of the therapeutic relationship. The other options provide options for the client to continue to grow and develop on their own while offering reassurance and support if needed.

Question 15

A client familiar to the nurse is grief-stricken and in tears after learning that his wife has decided to file for divorce and sue for full custody of their children. Which of the following actions by the nurse are appropriate?
Select all that apply.

Accepted Answer

Holding the client's hand with permission and asking if it is okay to give a hug are appropriate actions as they respect the client's personal space and consent.

Question 16

Which of the following nursing diagnoses would not originate from a client's regressive behavior during the termination phase?

Accepted Answer

A client's regressive behavior during the termination phase may result in feelings of powerlessness or difficulty completing tasks independently, leading to a nursing diagnosis of Self-care Deficit. However, a Knowledge Deficit nursing diagnosis would not be directly related to regressive behavior during termination.

Question 17

A client has demonstrated unwillingness to change self-defeating behaviors. Which of the following phenomena are forms of client resistance?
Select all that apply.

Accepted Answer

The answer of A client has demonstrated unwillingness to change...

Question 18

During the initial interview with a client, the nurse notices that the client changes the topic when the subject of the client's marital relationship is approached. The nurse is guided by the knowledge that:

Accepted Answer

When a client avoids or omits information, it is often a signal that the topic is sensitive or difficult for them to discuss. It is important for the nurse to recognize this and explore the topic further in a therapeutic manner. This can help uncover important information that may be essential to the client's care.

Question 19

Which of the following client behaviors signals the start of the termination phase?

Accepted Answer

The start of the termination phase is often signaled by the client's ability to use effective problem-solving strategies on a daily basis, indicating they have internalized the skills necessary for independent functioning outside of therapy.

Question 20

Which of the following behaviors indicate that a client is ready to terminate the therapeutic nurse-client relationship?
Select all that apply.

Accepted Answer

The answer of Which of the following behaviors indicate that...

Quiz 4: Vulnerable Populations