Question 1

What is the main goal of the working phase of the nurse-client therapeutic relationship?

Accepted Answer

The main goal of the working phase of the nurse-client therapeutic relationship is to work together to identify and explore problems, develop and implement solutions, and evaluate progress towards resolution of problems. Role modeling, therapeutic communication, and helping the client access outpatient treatment are all important aspects of the therapeutic relationship, but they are not the main goal of the working phase.

Question 2

A client diagnosed with paranoid schizophrenia becomes agitated when asked to play a game. The client responds, "Do you want to be my girlfriend?" Which nursing response is most appropriate?

Accepted Answer

This response acknowledges the client's statement while also setting appropriate boundaries and reminding them of the professional relationship. It also allows for further exploration of any discomfort the client may be experiencing. Option A dismisses the client's feelings and option C may be seen as confrontational, while option D may not address the immediate issue at hand.

Question 3

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

C

Question 4

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

Accepted Answer

During the orientation phase of the nurse-client relationship, the priority nursing action is to establish rapport and develop treatment goals. This phase is crucial in establishing trust and a therapeutic relationship between the client and nurse. Acknowledging the client's actions and generating alternative behaviors, attempting to find alternative placement, and exploring how thoughts and feelings about this client may adversely impact care are actions that may occur at later phases of the relationship.

Question 5

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

Accepted Answer

During the working phase of relationship development, the nurse should prioritize promoting the client's insight and perception of reality. This involves helping the client to identify and explore their thoughts, feelings, and behaviors in order to promote self-understanding and personal growth. Establishing a contract for intervention (A) and establishing a plan for continuing aftercare (C) are important tasks, but they are more relevant during the initial phase and termination phase of the relationship, respectively. Examining feelings about working with a particular client (B) is also important, but it is more relevant during the pre-interaction phase.

Question 6

A hungry, homeless client, diagnosed with schizophrenia, refuses to participate in an admission interview. A nurse streamlines the assessment, verbally assures safety, and provides a warm meal. What is the nurse promoting by these actions?

Accepted Answer

The nurse is promoting trust by verbally assuring safety and providing a warm meal. Trust is important when building a therapeutic relationship with a client, especially one who may have a history of trauma or distrust in medical professionals. The nurse is not promoting sympathy because they are not just feeling sorry for the client without taking any action. Veracity (truthfulness) and manipulation are not applicable in this scenario.

Question 7

According to Peplau, which nursing action demonstrates the nurse's role as a resource person?

Accepted Answer

According to Peplau, the nursing role as a resource person includes sharing information with the client in language that they can understand. This is demonstrated when the nurse explains information related to the client's healthcare.

Question 8

Which is the best nursing action when a client demonstrates transference toward a nurse?

Accepted Answer

Transference occurs when a client unconsciously projects feelings and attitudes toward an individual who resembles someone from their past. It is important for the nurse to recognize and understand transference and help the client to explore and gain insight into these feelings. Terminating the relationship abruptly, encouraging the client to ignore these thoughts, or reassigning them to another staff member may not address the underlying issue and could harm the therapeutic relationship. Therefore, the best nursing action is to help the client clarify the meaning of the current nurse-client relationship.

Question 9

Which client statement may indicate a transference reaction?

Accepted Answer

The statement "I need a real nurse. You are young enough to be my daughter and I don't want to tell you about my personal life" may indicate a transference reaction, as the client is projecting their own feelings and issues onto the nurse based on their relationship dynamics with their own daughter or other significant person in their life.

Question 10

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

Accepted Answer

The nurse should expect that the client would 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 11

A nurse moving out of state speaks to a client about the need to work with a new nurse. The client states, "You're the only one who can make me well." What does this client response indicate to the nurse?

Accepted Answer

The client's response indicates that they are having difficulty accepting the termination of the relationship with the nurse who is moving out of state. The client may feel like the nurse is the only person who can help them, which can lead to feelings of insecurity and a fear of abandonment. This response does not necessarily indicate the use of manipulation, denial, or splitting.

Question 12

What should be the nurse's primary goal during the preinteraction phase of the nurse-client relationship?

Accepted Answer

The nurse's primary goal of the preinteraction phase should be to explore self-perceptions.The nurse should be aware of how any preconceptions may affect his or her ability to care for individual clients.Another goal of the preinteraction phase is to obtain available client information.

Question 13

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

Accepted Answer

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 14

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

Accepted Answer

A two-faced individual lacks genuineness, which is an essential characteristic for developing a therapeutic relationship. Genuineness refers to the nurse's ability to be open, honest, and sincere in their interactions with the patient, and to acknowledge and express their own feelings and thoughts. This helps to establish trust and credibility, which are crucial to building a therapeutic relationship.

Question 15

Which nursing action demonstrates the role of the teacher in a therapeutic milieu?

Accepted Answer

Holding a group meeting to present common side effects of psychiatric medications demonstrates the nurse's role as a teacher in a therapeutic milieu. This supports clients in understanding and managing their medications, which is crucial to their overall recovery. The other options also demonstrate therapeutic interventions, such as building self-esteem (option A), promoting fair play (option C), and modeling coping strategies (option D), but they do not directly focus on education and teaching.

Question 16

According to Peplau, which nursing intervention is most appropriate when the nurse is functioning in the role of a surrogate?

Accepted Answer

According to Peplau,when a client is acutely ill,he or she may incur the role of infant or child,while the nurse is perceived as the mother surrogate.

Question 17

Which phase of the nurse-client relationship begins when the individuals first meet and is characterized by an agreement to continue to meet and work on setting client-centered goals?

Accepted Answer

The orientation phase of the nurse-client relationship is characterized by the initial meeting between the nurse and client, and an agreement to work together to identify client needs and set client-centered goals. The working phase is focused on implementing interventions to achieve these goals, while termination marks the end of the relationship when the goals have been met. The preinteraction phase occurs before the initial meeting and involves preparation and self-reflection by the nurse before interacting with the client.

Question 18

A client has made the decision to leave her alcoholic husband. She is feeling very depressed. Which nontherapeutic statement by the nurse conveys sympathy?

Accepted Answer

This statement by the nurse is using self-disclosure and making it about herself, which is not helpful or therapeutic for the client. It may make the client feel like the nurse is not fully empathizing with her situation.

Question 19

As the client and nurse move from the orientation stage to the working stage of the therapeutic relationship, which is the nurse's most therapeutic statement?

Accepted Answer

This statement acknowledges the client's control and autonomy in the therapeutic process, and allows them to prioritize the most pressing issues to be addressed.

Question 20

A mother 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

Option D shows empathy by acknowledging the mother's feelings and offering support by stating that the speaker will stay with the mother until her husband arrives. It also avoids using cliches or advising the mother on how she should feel or act.

Quiz 7: Relationship Development