Chapter 6: Relationship Development and Therapeutic Communication. With Answers Explained

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Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. What is the most essential task for a nurse to accomplish prior to forming a therapeutic rela... tionship with a client? 1. Clarify personal attitudes, values, and beliefs. 2. Obtain thorough assessment data. 3. Determine the client’s length of stay. 4. Establish personal goals for the interaction. ____ 2. If a client demonstrates transference toward a nurse, how should the nurse respond? 1. Promote safety and immediately terminate the relationship with the client. 2. Encourage the client to ignore these thoughts and feelings. 3. Immediately reassign the client to another staff member. 4. Help the client to clarify the meaning of the relationship, based on the present situation. ____ 3. What should be the priority nursing action during the orientation (introductory) phase of the nurse-client relationship? 1. Acknowledge the client’s actions, and generate alternative behaviors. 2. Establish rapport and develop treatment goals. 3. Attempt to find alternative placement. 4. Explore how thoughts and feelings about this client may adversely impact nursing care. ____ 4. Which client action should a nurse expect during the working phase of the nurse-client relationship? 1. The client gains insight and incorporates alternative behaviors. 2. The client establishes rapport with the nurse and mutually develops treatment goals. 3. The client explores feelings related to reentering the community. 4. The client explores personal strengths and weaknesses that impact behavioral choices. ____ 5. 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? 1. “I can’t bear the thought of leaving here and failing.” 2. “I might have a hard time working with you, because you remind me of my mother.” 3. “I really don’t want to talk any more about my childhood abuse.” 4. “I’m not sure that I can count on you to protect my confidentiality.” ____ 6. 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? 1. “This situation is very sad, but time is a great healer.” 2. “You are sad, but you must be strong for your other children.” 3. “Once you cry it all out, things will seem so much better.” 4. “It must be horrible to lose a child, and I’ll stay with you until your husband arrives.” ____ 7. When an individual is “two-faced,” which characteristic—essential to the development of a therapeutic relationship—should a nurse identify as missing? 1. Respect 2. Genuineness 3. Sympathy 4. Rapport ____ 8. On which task should a nurse place priority during the working phase of relationship development? 1. Establishing a contract for intervention 2. Examining feelings about working with a particular client 3. Establishing a plan for continuing aftercare 4. Promoting the client’s insight and perception of reality ____ 9. 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.” 1. Restatement 2. Offering general leads 3. Focusing 4. Accepting ____ 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?” 1. Reflecting 2. Making observations 3. Formulating a plan of action 4. Giving recognition ____ 11. The nurse is interviewing a newly admitted psychiatric client. Which of the following nursing statements is an example of offering a “general lead”? 1. “Do you know why you are here?” 2. “Are you feeling depressed or anxious?” 3. “Yes, I see. Go on.” 4. “Can you order the specific events that led to your admission?” ____ 12. 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? 1. The therapeutic technique of giving advice 2. The therapeutic technique of defending 3. The nontherapeutic technique of presenting reality 4. The nontherapeutic technique of giving reassurance ____ 13. A client diagnosed with posttraumatic 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”? 1. “What occurred prior to the rape, and when did you go to the emergency department?” 2. “What would you like to talk about?” 3. “I notice you seem uncomfortable discussing this.” 4. “How can we help you feel safe during your stay here?” ____ 14. 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? 1. S 2. O 3. L 4. E 5. R ____ 15. An instructor is correcting a nursing student’s clinical worksheet. Which instructor statement is the best example of effective feedback? 1. “Why did you use the client’s name on your clinical worksheet?” 2. “You were very careless to refer to your client by name on your clinical worksheet.” 3. “Surely you didn’t do this deliberately, but you breeched confidentiality by using names.” 4. “It is disappointing that after being told you’re still using client names on your worksheet.” ____ 16. What is a nurse’s purpose for providing appropriate feedback? 1. To give the client good advice 2. To advise the client on appropriate behaviors 3. To evaluate the client’s behavior 4. To give the client critical information ____ 17. 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? 1. “It would be best to do that in order to increase independence.” 2. “Why would you want to leave a secure home?” 3. “Let’s discuss and explore all of your options.” 4. “I’m afraid you would feel very guilty leaving your parents.” ____ 18. 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? 1. “The smoke was too thick. You couldn’t have gone back in.” 2. “You’re experiencing feelings of guilt, because you weren’t able to save your children.” 3. “Focus on the fact that you could have lost all four of your children.” 4. “It’s best if you try not to think about what happened. Try to move on.” ____ 19. 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? 1. “Everyone diagnosed with OCD needs to control their ritualistic behaviors.” 2. “It is important for you to discontinue these ritualistic behaviors.” 3. “Why are you asking for help, if you won’t participate in unit therapy?” 4. “Let’s figure out a way for you to attend unit activities and still wash your hands.” Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 20. Which of the following characteristics should be included in a therapeutic nurse-client relationship? (Select all that apply.) 1. Meeting the psychological needs of the nurse and the client 2. Ensuring therapeutic termination 3. Promoting client insight into problematic behavior 4. Collaborating to set appropriate goals 5. Meeting both the physical and psychological needs of the client ____ 21. Which of the following individuals are communicating a message? (Select all that apply.) 1. A mother spanking her son for playing with matches 2. A teenage boy isolating himself and playing loud music 3. A biker sporting an eagle tattoo on his biceps 4. A teenage girl writing, “No one understands me” 5. A father checking for new email on a regular basis Completion Complete each statement. 22. The term ________________________ implies special feelings on the part of both the client and the nurse, based on acceptance, warmth, friendliness, common interest, a sense of trust, and a nonjudgmental attitude. 23. ___________________ refers to a nurse’s behavioral and emotional response to a client. These responses may be related to unresolved feelings toward significant others from the nurse’s past. [Show More]

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