Chapter 5: Relationship Development and Therapeutic Communication

Chapter 5: Relationship Development and Therapeutic Communication Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Which is the most essential task for a nurse to accomplish prior to forming a therapeutic relationship 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. The nurse is caring for an older male client who states, “You remind me so much of my late wife.” During subsequent encounters with the client, he expresses overwhelming feelings of affection toward the nurse and states “I don’t know what I would do if you weren’t my nurse. No one cares for me like you do.” 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. ____ 3. The nurse has just met a new client and is beginning to get to know to the client. Which would be the priority nursing action during this 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 for the client. 4. Explore how thoughts and feelings about this client may adversely impact nursing care. ____ 4. Which client action would 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 would 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.” Copyright © 2020 F. A. Davis Company ____ 6. The nurse is caring for a client who lost a child in a car accident. The client states she does not want to go on living. Which nursing statement conveys empathy for the client? 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. The nurse is building a therapeutic relationship with a client. During their interaction, the nurse feels the individual is not always honest or open during their interactions. Which characteristic would a nurse identify as missing? 1. Respect 2. Genuineness 3. Sympathy 4. Rapport ____ 8. On which task would a nurse place highest 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. Restating 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. Encouraging comparison 2. Making observations 3. Formulating a plan of action 4. Giving recognition ____ 11. Which is an example of offering a “general lead” when interviewing a newly admitted psychiatric client? 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?” Copyright © 2020 F. A. Davis Company ____ 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 ____ 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 breached confidentiality by using names.” 4. “It is disappointing that after being told you’re still using client names on your worksheet.” ____ 16. Which type of touch is described as functional-professional? 1. A nurse performing an assessment 2. Shaking the hand of an acquaintance 3. A child laying their head on the mother’s lap 4. Hugging a good friend and former coworker good-bye ____ 17. A client exhibiting dependent behaviors says, “Do you think I should move out of my parents’ 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.” Copyright © 2020 F. A. Davis Company ____ 18. A mother rescues two of her four children from a house fire. The other two children die in the 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 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. Copyright © 2020 F. A. Davis Company