Chapter 5 - Therapeutic Relationships:
Test Bank for Psychiatric-Mental Health Nursing, 8th Edition
1. The nurse understands that empathy is essential to the therapeutic relationship.
When a patient makes the statement, "I am just devastated that my marriage is
falling apart," the nurse can best show empathy through which of the following
responses?
A) "I feel so bad for what you are going through."
B) "You feel like your world is falling apart right now."
C) "I have been divorced too. I know how hard it is."
D) "It will get better; let's talk about it."
Answer: B
Explanation: Empathy is demonstrated by reflecting the client's feelings and perspective,
which helps the client feel understood. Response B uses reflection to accurately capture the
client's emotional state. The other responses either express sympathy (A), shift the focus to
the nurse (C), or offer false reassurance (D), which are less therapeutic.
2. The nurse is working with a patient who has quit several jobs and no longer
sends financial support to his two children living with their mother. This
behavior is in conflict with the nurse's values concerning responsible parenting.
When discussing family roles with the patient, the nurse shows positive regard
through which statement?
A) "How is not working right now affecting you?"
B) "How do you expect your kids to be provided for?"
C) "You need to somehow find a way to support your children."
D) "Can the children's mother can get by for a while until you get better?"
Answer: A
Explanation: Positive regard involves accepting the client as a worthwhile person without
judgment. Response A maintains a nonjudgmental, client-focused approach, encouraging
self-exploration. The other responses imply judgment, offer advice, or shift focus away from
the client.
3. Which of the following statements is true of the component of a therapeutic
relationship/acceptance?
A) The nurse accepts the behavior of any inappropriate behavior.
B) It is avoiding judgments of the person, no matter what the behavior is.
C) It involves punishment for inappropriate behavior.
, D) It is the ability of the nurse to perceive the meanings and feelings of the client and
to communicate that understanding to the client.
Answer: B
Explanation: Acceptance means valuing the person as worthy of respect, regardless of their
behavior. It does not mean approving of the behavior, punishing the client, or confusing it
with empathy, which is the ability to understand and communicate understanding of the
client's feelings.
4. Which of the following behaviors by the nurse demonstrate positive regard?
Select all that apply.
A) Communicating judgments about the client's behavior
B) Calling the client by name
C) Spending time with the client
D) Responding openly
E) Considering the client's ideas and preference when planning care
Answer: B, C, D, E
Explanation: Positive regard is demonstrated by respectful behaviors such as using the
client's name, spending time with them, listening and responding openly, and incorporating
their preferences into care. Communicating judgments is inconsistent with positive regard.
5. The nurse initiating a therapeutic relationship with a client should explain the
purpose, which is to
A) alleviate stressors in life.
B) allow the client to know the nurse's feelings.
C) establish relationships.
D) facilitate a positive change.
Answer: D
Explanation: The purpose of a therapeutic relationship is to help the client make positive
changes to improve their health and well-being. The focus is on the client's needs, not the
nurse's feelings or the simple establishment of a relationship.
6. Which of the following is the most important skill the nurse must bring to the
therapeutic nurse-client relationship?
A) Confrontation
B) Empathy
C) Humor
D) Reframing
,Answer: B
Explanation: Empathy is the foundational skill for a therapeutic relationship, as it allows the
nurse to understand and validate the client's feelings, fostering trust and openness. While
other skills are useful, they are secondary to empathy.
7. Which is a standard for establishing a code of conduct for living?
A) Acceptance
B) Empathy
C) Values
D) Positive regard
Answer: C
Explanation: Values are abstract standards that provide a sense of right and wrong and guide
behavior. Acceptance, empathy, and positive regard are important relational components but
are not the standards that form a personal code of conduct.
8. A nurse makes the statement in a treatment team meeting, "It's not worth it to
try to teach this patient how to make better choices. He has been here many
times before and goes back home and does the same thing." The nurse is sharing
which of the following?
A) Value
B) Awareness
C) Belief
D) Attitude
Answer: D
Explanation: The nurse is expressing a general feeling or frame of reference about the client's
potential for change, which characterizes an attitude. Values are standards of right and wrong,
beliefs are ideas held to be true, and awareness refers to self-knowledge.
9. The client tells the nurse, "I don't think you can help me. Every time I talk to
you, I am reminded of my mother, and I hated her." The nurse should recognize
this as
A) confrontation.
B) countertransference.
C) incongruence.
D) transference.
Answer: D
, Explanation: Transference occurs when a client unconsciously redirects feelings about a
significant person in their past onto the nurse. Countertransference is the nurse's displacement
of feelings onto the client. Incongruence refers to a mismatch between verbal and nonverbal
communication, and confrontation is a therapeutic technique.
10. When preparing for the first clinical experience with patients on a forensic unit
at a psychiatric hospital, the nursing instructor discusses students' beliefs and
fears surrounding forensic patients. The primary reason for discussing personal
beliefs is to
A) practice reflective communication skills in a role-play situation.
B) assign the most compatible patients to the students.
C) assess the appropriateness of the setting for implementing nursing skills.
D) become aware of possible barriers to developing therapeutic relationships.
Answer: D
Explanation: Self-awareness helps students identify personal biases, fears, or beliefs that
could interfere with forming effective, nonjudgmental therapeutic relationships with clients.
11. A nurse is working with a patient whose background is very different from hers.
A good question to ask herself to assure she can be effective working with this
patient would be,
A) "Can this person understand me?"
B) "Do I understand this patient's expectations of me?"
C) "What experiences do I have with people with similar backgrounds?"
D) "Is this person going to be able to relate to me?"
Answer: C
Explanation: Self-awareness involves reflecting on one's own experiences, attitudes, and
potential biases related to people from different backgrounds to ensure they do not negatively
impact the therapeutic relationship.
12. The client says to the nurse, "I feel really close to you. You are the only true
friend I have." The most therapeutic response the nurse can make is,
A) "I am sure there are other people in your life who are your friends; besides, we just
met."
B) "It makes me feel good that you trust me so much; it is important for the work we
are doing together."
C) "Since ours is a professional relationship, let's explore other opportunities in your
life for friendship."
D) "We are not friends. This is strictly professional."
Test Bank for Psychiatric-Mental Health Nursing, 8th Edition
1. The nurse understands that empathy is essential to the therapeutic relationship.
When a patient makes the statement, "I am just devastated that my marriage is
falling apart," the nurse can best show empathy through which of the following
responses?
A) "I feel so bad for what you are going through."
B) "You feel like your world is falling apart right now."
C) "I have been divorced too. I know how hard it is."
D) "It will get better; let's talk about it."
Answer: B
Explanation: Empathy is demonstrated by reflecting the client's feelings and perspective,
which helps the client feel understood. Response B uses reflection to accurately capture the
client's emotional state. The other responses either express sympathy (A), shift the focus to
the nurse (C), or offer false reassurance (D), which are less therapeutic.
2. The nurse is working with a patient who has quit several jobs and no longer
sends financial support to his two children living with their mother. This
behavior is in conflict with the nurse's values concerning responsible parenting.
When discussing family roles with the patient, the nurse shows positive regard
through which statement?
A) "How is not working right now affecting you?"
B) "How do you expect your kids to be provided for?"
C) "You need to somehow find a way to support your children."
D) "Can the children's mother can get by for a while until you get better?"
Answer: A
Explanation: Positive regard involves accepting the client as a worthwhile person without
judgment. Response A maintains a nonjudgmental, client-focused approach, encouraging
self-exploration. The other responses imply judgment, offer advice, or shift focus away from
the client.
3. Which of the following statements is true of the component of a therapeutic
relationship/acceptance?
A) The nurse accepts the behavior of any inappropriate behavior.
B) It is avoiding judgments of the person, no matter what the behavior is.
C) It involves punishment for inappropriate behavior.
, D) It is the ability of the nurse to perceive the meanings and feelings of the client and
to communicate that understanding to the client.
Answer: B
Explanation: Acceptance means valuing the person as worthy of respect, regardless of their
behavior. It does not mean approving of the behavior, punishing the client, or confusing it
with empathy, which is the ability to understand and communicate understanding of the
client's feelings.
4. Which of the following behaviors by the nurse demonstrate positive regard?
Select all that apply.
A) Communicating judgments about the client's behavior
B) Calling the client by name
C) Spending time with the client
D) Responding openly
E) Considering the client's ideas and preference when planning care
Answer: B, C, D, E
Explanation: Positive regard is demonstrated by respectful behaviors such as using the
client's name, spending time with them, listening and responding openly, and incorporating
their preferences into care. Communicating judgments is inconsistent with positive regard.
5. The nurse initiating a therapeutic relationship with a client should explain the
purpose, which is to
A) alleviate stressors in life.
B) allow the client to know the nurse's feelings.
C) establish relationships.
D) facilitate a positive change.
Answer: D
Explanation: The purpose of a therapeutic relationship is to help the client make positive
changes to improve their health and well-being. The focus is on the client's needs, not the
nurse's feelings or the simple establishment of a relationship.
6. Which of the following is the most important skill the nurse must bring to the
therapeutic nurse-client relationship?
A) Confrontation
B) Empathy
C) Humor
D) Reframing
,Answer: B
Explanation: Empathy is the foundational skill for a therapeutic relationship, as it allows the
nurse to understand and validate the client's feelings, fostering trust and openness. While
other skills are useful, they are secondary to empathy.
7. Which is a standard for establishing a code of conduct for living?
A) Acceptance
B) Empathy
C) Values
D) Positive regard
Answer: C
Explanation: Values are abstract standards that provide a sense of right and wrong and guide
behavior. Acceptance, empathy, and positive regard are important relational components but
are not the standards that form a personal code of conduct.
8. A nurse makes the statement in a treatment team meeting, "It's not worth it to
try to teach this patient how to make better choices. He has been here many
times before and goes back home and does the same thing." The nurse is sharing
which of the following?
A) Value
B) Awareness
C) Belief
D) Attitude
Answer: D
Explanation: The nurse is expressing a general feeling or frame of reference about the client's
potential for change, which characterizes an attitude. Values are standards of right and wrong,
beliefs are ideas held to be true, and awareness refers to self-knowledge.
9. The client tells the nurse, "I don't think you can help me. Every time I talk to
you, I am reminded of my mother, and I hated her." The nurse should recognize
this as
A) confrontation.
B) countertransference.
C) incongruence.
D) transference.
Answer: D
, Explanation: Transference occurs when a client unconsciously redirects feelings about a
significant person in their past onto the nurse. Countertransference is the nurse's displacement
of feelings onto the client. Incongruence refers to a mismatch between verbal and nonverbal
communication, and confrontation is a therapeutic technique.
10. When preparing for the first clinical experience with patients on a forensic unit
at a psychiatric hospital, the nursing instructor discusses students' beliefs and
fears surrounding forensic patients. The primary reason for discussing personal
beliefs is to
A) practice reflective communication skills in a role-play situation.
B) assign the most compatible patients to the students.
C) assess the appropriateness of the setting for implementing nursing skills.
D) become aware of possible barriers to developing therapeutic relationships.
Answer: D
Explanation: Self-awareness helps students identify personal biases, fears, or beliefs that
could interfere with forming effective, nonjudgmental therapeutic relationships with clients.
11. A nurse is working with a patient whose background is very different from hers.
A good question to ask herself to assure she can be effective working with this
patient would be,
A) "Can this person understand me?"
B) "Do I understand this patient's expectations of me?"
C) "What experiences do I have with people with similar backgrounds?"
D) "Is this person going to be able to relate to me?"
Answer: C
Explanation: Self-awareness involves reflecting on one's own experiences, attitudes, and
potential biases related to people from different backgrounds to ensure they do not negatively
impact the therapeutic relationship.
12. The client says to the nurse, "I feel really close to you. You are the only true
friend I have." The most therapeutic response the nurse can make is,
A) "I am sure there are other people in your life who are your friends; besides, we just
met."
B) "It makes me feel good that you trust me so much; it is important for the work we
are doing together."
C) "Since ours is a professional relationship, let's explore other opportunities in your
life for friendship."
D) "We are not friends. This is strictly professional."
