Nurs 343 Ch. 9 – Flashcards

Clinical supervision

Contract

Countertransference

Empathy

Genuineness

Orientation phase

Rapport

Social relationship

Termination phase

Therapeutic encounter

Therapeutic relationship

Therapeutic use of self

Transference

Values

Working phase

Which of the following actions best represents the basis or foundation of all other psychiatric nursing care? 1. The nurse assesses the patient at regular intervals. 2. The nurse administers psychotropic medications. 3. The nurse spends time sitting with a withdrawn patient. 4. The nurse participates in team meetings with other professionals.

A male patient frequently inquires about the female student nurse's boyfriend, social activities, and school experiences. Which of the following initial responses by the student best addresses the issue raised by this behavior? 1. The student requests assignment to a patient of the same gender as the student. 2. She points out to the patient that he is making social inquiries and explores this behavior. 3. She tells him that she cannot talk about her personal life and refocuses on his issues. 4. She explains that if he persists in focusing on her she cannot work with him.

Mary, a patient in the psychiatric unit, had a very rejecting and abusive father and a difficult childhood, but from age 10 on was raised by a very warm and supportive grandmother who recently passed away. Mary frequently comments on how hard her nurse, Jane, works and on how other staff do not seem to care as much about their patients as Jane does. Jane finds herself agreeing with Mary and appreciating her insightfulness, recalling to herself that except for her former head nurse, other staff do not seem to appreciate how hard she works and seem to take her for granted. Jane enjoys the time she spends with Mary and seeks out opportunities to interact with her. What phenomenon is occurring here, and which response by Jane would most benefit her and the patient? 1. Mary is experiencing transference; Jane should help Mary to understand that she is emphasizing in Jane those qualities which were missing in her father. 2. Jane is idealizing Mary, seeing in her strengths and abilities which Mary does not really possess; Jane should temporarily distance herself somewhat from Mary. 3. Mary is overidentifying with Jane, seeing similarities that do not in reality exist; Jane should label and explore this phenomenon in her interactions with Mary. 4. Jane is experiencing countertransference in response to Mary's meeting Jane's needs for greater appreciation; Jane should seek clinical supervision to explore these dynamics.

Which of the following statements would be appropriate during the orientation phase of the nurse-patient relationship? Select all that apply. 1. "My name is Sarah, and I am a student nurse here to learn about mental health." 2. "I will be here each Thursday from 8 am until 12 noon if you would like to talk." 3. "Tell me about what you think would best help you to cope with the loss of your wife." 4. "Let's talk today about how our plan for improving your sleep has been working." 5. "We will meet weekly for 1 hour, during which we will discuss how to meet your goals." 6. "Being home alone while your wife was hospitalized must have been very difficult for you."

A student nurse exhibits the following behaviors or actions while interacting with her patient. Which of these are appropriate as part of a therapeutic relationship? 1. Sitting attentively in silence with a withdrawn patient until the patient chooses to speak. 2. Offering the patient advice on how he could cope more effectively with stress. 3. Controlling the pace of the relationship by selecting topics for each interaction. 4. Limiting the discussion of termination issues so as not to sadden the patient unduly.

The primary difference between a social and a therapeutic relationship is the A. type of information exchanged. B. amount of satisfaction felt. C. type of responsibility involved. D. amount of emotion invested.

A client states "Nurse X always seems as though she is hiding behind her uniform." The nurse hearing this would assess Nurse X as A. not seeming genuine to the client. B. transmitting fear of clients. C. unfriendly and aloof. D. controlling.

The pre-orientation phase of the nurse-client relationship in characterized by a focus on: A. The nurse's self-analysis of strengths, limitations, and feelings B. clarification of the nurse's role C. changing client behavior D. incorporating coping skills into client's routine

The orientation phase of the nurse-client relationship focuses on: A. the nurse identifying personal biases. B. the nurse and client identifying client needs C. overcoming resistance to changing behavior D. reviewing situations that occurred in previous meetings.

Client reactions of intense hostility or feelings of strong affection toward the nurse are common forms of A. resistance. B. transference. C. countertransference. D. emotional abreaction.

The outcome of the nurse's expressions of sympathy instead of empathy towards the client often leads to A. enhanced client coping. B. lessening of client emotional pain. C. increased hope for client improvement. D. decreased client communication.

The use of empathy and support begins in the stage of the nurse-client relationship termed the A. orientation stage. B. working stage. C. identification stage. D. resolution stage.

A client is complaining about her mother-in-law's intrusiveness. The nurse responds "I know how you feel. My mother-in-law is nosy, too." The nurse is most likely A. using self-disclosure in an appropriate way. B. giving the client permission to continue. C. experiencing countertransference. D. using empathy to establish trust.

A client tells the nurse "I really feel close too you. You are like my mother and my big sister rolled into one person." The nurse can assess this statement as indicating the client may be experiencing A. congruence. B. empathetic feelings. C. countertransference. D. positive transference.

The nurse notes that she is finding it difficult to provide structure and set limits for a client. She finds herself thinking "What harm will it do if I cut him a little slack?" The nurse should evaluate her feelings and actions to assess for A. boundary blurring. B. value dissonance. C. covert anger. D. empathy.

The nurse would not adopt which of the following goals when attempting to establish a therapeutic nurse-client relationship: A. assisting client with self care needs when appropriate. B. helping the client identify self defeating behaviors. C. providing the client with opportunities to socialize. D. facilitating communication of disturbing feelings or thoughts.

A technique that is acceptable in a social relationship but not acceptable in a therapeutic relationship is A. giving advice. B. listening actively. C. clarifying feelings. D. giving positive regard.

A synonym for genuineness is A. respect. B. empathy. C. congruence. D. positive regard.

The phase of the nurse-client relationship that may cause anxieties to reappear and past losses to be reviewed is the A. pre-orientation. B. orientation. C. working. D. termination.

The nurse says "I find myself always thinking that Mr. X is really a lowlife, based on the way he treated his wife and children." These thoughts will prevent this nurse from A. assessing client symptoms. B. assessing boundary issues. C. giving the client positive regard. D. engaging in values clarification.

To help a client develop his resources the nurse must first be aware of A. the client's strengths. B. negative transferences. C. countertransferences. D. resistances.

One possible source of boundary violations is A. meeting the nurse's needs. B. client identity disturbances. C. superior client ego strength. D. assessment of client weaknesses.

In the process of trying new values, which step shows the highest commitment to the value? A. Cherishing the value B. Publicly stating affirmation of the value C. Choosing a stand consistent with the value from among several alternatives D. Consistently acting in ways that repeatedly affirm the value

When a nurse and client meet informally or have an otherwise limited but helpful relationship, the relationship is referred to as A. crisis intervention. B. a therapeutic encounter. C. autonomous interaction. D. preorientation phenomenon

During what stage of the therapeutic nurse-client relationship is a formal or informal contract between the nurse and client established? A. Preorientation B. Orientation C. Working D. Termination

Therapeutic nurse-patient relationship has specific goals and functions, including:

Within the context of a therapeutic relationship, the following occur:

It is helpful to realize that our values and beliefs :