Chapter 6
Which is the primary nursing goal when establishing a therapeutic relationship with a client?
A. To promote client growth
B. To develop the nurse’s personal identity
C. To establish a purposeful social interaction
D. To develop communication skills
What is to promote client growth?
Correct Answer: A
The goal of a therapeutic nursing interaction is to promote client insight and behavioral change directed toward client growth.
The unit manager needs to meet with a client who is exhibiting escalating hostility. Which would be the most appropriate location for the nurse to meet with this client?
A. The client’s room with the door shut
B. A quiet corner of the day room
C. The nurses’ station
D. The unit’s treatment room
What is a quiet corner of the day room?
Correct Answer: B
A quiet corner of the day room provides for some privacy in a neutral space while not limiting access to help if safety issues arise.
A patient expresses a desire to begin attending the self-help group Alcoholics Anonymous (AA). Which nursing response gives the patient pertinent information about this type of group?
A. “In this type of group, membership is always within a fixed time frame.”
B. “Group members receive comfort and advice from others undergoing similar experiences.”
C. “The purpose of this type of group is to convey information to a number of individuals.”
D. “The function of this type of group is to accomplish a specific outcome.”
What is “Group members receive comfort and advice from others undergoing similar experiences.”
Correct Answer: B
§AA is a type of self-help group.
§In this type of group, members share their experiences and strengths and receive comfort and advice from others undergoing similar experiences.
§The nurse is giving the patient pertinent information about AA.
A client threatens to kill himself, his wife, and their children if the wife follows through with divorce proceedings. During the preinteraction phase of the nurse-patient relationship, which interaction should the nurse employ?
A. Acknowledging the patient’s actions and encouraging alternative behaviors
B. Establishing rapport and developing treatment goals
C. Providing community resources on aggression management
D. Exploring personal thoughts and feelings that may adversely impact the provision of care
What is exploring personal thoughts and feelings that may adversely impact the provision of care?
Correct Answer: D
In the pre-interaction phase, the nurse must clarify personal attitudes, values, and beliefs to become aware of how these might affect the nurse’s ability to care for various patients. This occurs before the nurse meets the patient.
As the move-out date to leave the shelter gets closer, a battered wife states, “I’m afraid to leave here. I’m afraid for my safety and the safety of my children.” Which nursing statement is most supportive?
A. “This is a difficult transition. Let’s formulate a plan to keep you all safe in the community.”
B. “It’s the policy that patients can only live here for 30 days. Maybe we can ask for more time.”
C. “You’ve had a month to come up with a plan for keeping you and your family safe.”
D. “Hopefully, your husband has been in counseling. I’m sure this will work out fine.”
What is “This is a difficult transition. Let’s formulate a plan to keep you all safe in the community.”?
Correct Answer: A
The nurse is using the therapeutic techniques of “reflection” and “formulating a plan of action.” The use of these communication facilitators indicates that the nurse is supportive of the patient’s feelings and appreciates the need for a safety plan.
After a supportive-therapeutic group, a nurse hears one patient say to another, “I never thought that other people had the same problems that I have.” The nurse ascertains that this statement represents which curative factor described by Yalom?
A. Catharsis
B. Group cohesiveness
C. Universality
D. Imitative behavior
What is Universality?
Correct Answer: C
According to Yalom, the curative factor of universality occurs when group members realize that they are not alone in their feelings and experiences.
An interaction between two people in which input from both participants contributes to a climate of healing, growth promotion, or illness prevention.
What is a Therapeutic Relationship?
The nurse is performing an initial assessment on a newly admitted patient who is oriented times four. Which of the following communication techniques would best facilitate obtaining accurate and complete patient data?
A. Closed-ended questions
B. Requesting an explanation
C. Open-ended questions
D. Interpreting
What is Open-ended questions?
Correct Answer: C
Open-ended questions are phrased in a way that gathers as much information as possible. By the use of phrases such as “Tell me about…” or “Describe to me…,” a varied and rich body of information can be assessed.
During a group meeting, a patient raises the concern that noise at the nurses’ station keeps him awake at night. The nurse, present in the meeting, interrupts, stating, “I’ll handle this matter. We need to move on.” The nurse is demonstrating which type of leadership style?
A. Democratic
B. Autocratic
C. Laissez-faire
D. Surrogate
What is Autocratic?
Correct Answer: B
This is an example of an autocratic leadership style that restricts patient participation in planning care. The nurse is in control and patient autonomy is limited.
Rapport is one of the many ___ that enhance the achievement of a therapeutic relationship.
What are characteristics?
The four kinds of distance in interpersonal interactions:
What are:
‒Intimate distance
‒Personal distance
‒Social distance
‒Public distance
This type of group conveys knowledge and information to a number of individuals.
What is a teaching group?
The 4 phases of a therapeutic nurse-client relationship:
What are:
Pre-interaction phase
Orientation (Introductory) phase
Working Phase
Termination Phase
This includes caregiver verbal and nonverbal techniques that focus on the care receiver’s needs and advance the promotion of healing and change. It also encourages exploration of feelings and fosters understanding of behavioral motivation.
What is Therapeutic Communication?
The three phases of group development are:
What are:
§Phase I: Initial or Orientation Phase
§Phase II: Middle or Working Phase
§Phase III: Final or Termination Phase