Chapter 2: Therapeutic Nurse-Patient Relationship

Chapter 2: Therapeutic Nurse-Patient Relationship

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

14. A young adult has been receiving treatment for an anxiety disorder. Which statement by the patient confirms that the nurse and patient are most likely entering the terminal phase of the therapeutic relationship?

a.	“My anxiety seems to be a result of having so much to get done.”
b.	“I don’t know whether I’ll be able to handle things alone.”
c.	“I can’t seem to be able to manage going to school and working.”
d.	“I need to find a way that can help me manage my anxiety.”

 

 

ANS:  B

Establishing the reality of separation is difficult for both the nurse and patient. Patients often respond to impending termination with increased anxiety; they may experience negative feelings associated with earlier terminations, and they may regress to previous, less adaptive behaviors in the hope of postponing termination. The expression of the cause of the anxiety is reflective of the working phase while a general statement of the problem is appropriate for the introduction phase. Expressing a need for help is seen in the preinteraction phase.

 

DIF:    Cognitive Level: Application           REF:   Text Page: 21

TOP:   Nursing Process: Planning               MSC:  NCLEX: Psychosocial Integrity

 

15. A psychiatric nurse will recognize which action as demonstration of resistance behavior?

a.	Regularly referring to himself as a “loser”
b.	Becoming tearful during every therapy session about abuse
c.	Asking to postpone a therapy session until after visiting hours
d.	Consistently describing his drug use as starting “a little while ago”

 

 

ANS:  D

Resistance is the patient’s reluctance or avoidance of verbalizing or experiencing troubling aspects of himself or herself. This is often caused by the patient’s unwillingness to change when the need for change is recognized. The remaining options lack the needed reluctance to open communication seen with resistant behaviors.

 

DIF:    Cognitive Level: Application           REF:   Text Page: 39

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Psychosocial Integrity

 

16. During the working phase of the relationship, the nurse assesses that the patient may be demonstrating resistance. The most appropriate way to deal with this would be to:

a.	assist the patient in exploring his or her past for uncovered issues and conflicts.
b.	clarify, share observations, and reflect content and feelings with the patient.
c.	confront the patient with the behavior and state, “You will be expected to work harder.”
d.	avoid mentioning the therapeutic barrier and wait until the patient again indicates readiness.

 

 

ANS:  B

The relationship can become stalled if the nurse is not prepared to deal with the impasse. The nurse may use clarification by saying something such as, “I sense that you’re struggling with yourself and wanting to explore your relationship with your parents, but that you don’t yet want to experience the pain it may bring.”

 

DIF:    Cognitive Level: Application           REF:   Text Page: 40

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

17. A patient reports seeing a “frightening” face on the wall of the dayroom. A nurse attempts to calm her by providing an explanation for the flawed perception of what she saw. The nurse would implement this strategy by stating:

a.	“Let’s see if anyone else has seen those frightening faces on the walls of the dayroom.”
b.	“The shadows of the tree outside the window make strange shapes on the dayroom walls.”
c.	“Have you ever seen frightening faces like that on the dayroom walls before today?”
d.	“Did someone in the dayroom tell you there were frightening faces on the walls?”

 

 

ANS:  B

Perception is the identification and interpretation of a stimulus based on information received through the senses. In this instance the patient has incorrectly interpreted the shadows as a face on the wall. The remaining options do not relate to a misinterpretation of what the patient actually saw.

 

DIF:    Cognitive Level: Application           REF:   Text Page: 26

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

18. A patient says to a nurse, “My spouse and I get along just fine. We usually agree on everything.” The nurse observes nonverbal communication that disagrees with what the patient has verbally communicated. Which of the patient’s actions is incongruent with her statement?

a.	Getting up from her chair while making the statement
b.	Walking toward the nurse while talking about her spouse
c.	Staring down at her shoes during the conversation
d.	Smiling while talking with the nurse

 

 

ANS:  C

Incongruent communication occurs when the verbal content and the nonverbal level of communication are not in agreement. Avoiding eye contact during the statement would demonstrate such a disagreement. The remaining options are not in disagreement and so are not incongruent.

 

DIF:    Cognitive Level: Application           REF:   Text Page: 25

TOP:    Nursing Process: Assessment    MSC:   NCLEX: Psychosocial Integrity