Chapter 6: Relationship Development and Therapeutic Communication

Chapter 6: Relationship Development and Therapeutic Communication

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   What 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.   If a client demonstrates transference toward a nurse, 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, based on the present situation.

 

 

____     3.   What should be the priority nursing action during the orientation (introductory) 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.
4.	Explore how thoughts and feelings about this client may adversely impact nursing care.

 

 

____     4.   Which client action should 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 should 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.”

 

Chapter 6: Relationship Development and Therapeutic Communication

Answer Section

 

MULTIPLE CHOICE

 

1. ANS:  1

Chapter: Chapter 6, Relationship Development and Therapeutic Communication

Objective: Identify and discuss essential conditions for a therapeutic relationship to occur.

Page: 126

Heading: The Therapeutic Use of Self > Therapeutic Use of Self

Integrated Processes: Nursing Process

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Patient-Centered Care

Difficulty: Easy

 

	Feedback
1	The most essential task for a nurse to accomplish prior to forming a therapeutic relationship with a client is to clarify personal attitudes, values, and beliefs. Understanding one’s own attitudes, values, and beliefs is called self-awareness.
2	Obtaining thorough assessment data is not the most important task.
3	Determining the client’s length of stay is not the most important task.
4	Establishing personal goals for the interaction is not the most important task.

 

 

PTS:   1                    CON:  Patient-Centered Care

 

2. ANS:  4

Chapter: Chapter 6, Relationship Development and Therapeutic Communication

Objective: Describe the phases of relationship development and the tasks associated with each phase.

Page: 129

Heading: Phases of a Therapeutic Nurse-Client Relationship > Transference and Countertransference

Integrated Processes: Nursing Process

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Patient-Centered Care

Difficulty: Easy

 

	Feedback
1	This action would not be therapeutic to the client.
2	The nurse should assist the client in separating the past from the present.
3	This option would not be therapeutic to the client, who may continue to displace feelings onto others.
4	The nurse should respond to a client’s transference by clarifying the meaning of the nurse-client relationship based on the present situation. Transference occurs when the client unconsciously displaces feelings about a person from the past toward the nurse.

 

 

PTS:   1                    CON:  Patient-Centered Care

 

3. ANS:  2

Chapter: Chapter 6, Relationship Development and Therapeutic Communication

Objective: Describe the phases of relationship development and the tasks associated with each phase.

Page: 129

Heading: Phases of Therapeutic Nurse-Client Relationship > The Orientation (Introductory) Phase

Integrated Processes: Nursing Process

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Communication

Difficulty: Easy

 

	Feedback
1	Acknowledging the client’s actions and generating alternative behaviors can occur after rapport has been established.
2	The priority nursing action during the orientation phase of the nurse-client relationship should be to establish rapport and develop treatment goals. Rapport implies feelings on the part of both the nurse and the client, based on respect, acceptance, a sense of trust, and a nonjudgmental attitude. It is the essential foundation of the nurse-client relationship.
3	Attempting to find alternative placement can occur after rapport has been established.
4	Exploring how thoughts and feelings about this client may adversely impact nursing care can occur after rapport has been established.

 

 

PTS:   1                    CON:  Communication

 

4. ANS:  1

Chapter: Chapter 6, Relationship Development and Therapeutic Communication

Objective: Describe the phases of relationship development and the tasks associated with each phase.

Page: 129

Heading: Phases of Therapeutic Nurse-Client Relationship > The Working Phase

Integrated Processes: Nursing Process

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Communication

Difficulty: Easy

 

	Feedback
1	The nurse should expect that the client will gain insight and incorporate alternative behaviors during the working phase of the nurse-client relationship.
2	Establishing rapport with the nurse and mutually developing treatment goals occurs before the working phase.
3	Exploring feelings related to reentering the community does not occur during the working phase.
4	Exploring personal strengths and weaknesses that impact behavioral choices does not occur during the working phase.

 

 

PTS:   1                    CON:  Communication

 

5. ANS:  3

Chapter: Chapter 6, Relationship Development and Therapeutic Communication

Objective: Describe the phases of relationship development and the tasks associated with each phase.

Page: 129

Heading: The Working Phase

Integrated Processes: Nursing Process

Client Need: Psychosocial integrity

Cognitive Level: Analysis [Analyzing]

Concept: Communication

Difficulty: Easy

 

	Feedback
1	Stating, “I can’t bear the thought of leaving here and failing,” does not indicate resistance to the therapeutic relationship between the nurse and client.
2	Stating, “I might have a hard time working with you, because you remind me of my mother,” does not indicate resistance to the therapeutic relationship between the nurse and client.
3	The nurse should identify that the client statement, “I really don’t want to talk any more about my childhood abuse,” reflects that the client is in the working phase of the nurse-client relationship. The working phase includes overcoming resistance behaviors on the part of the client as the level of anxiety rises in response to discussion of painful issues.
4	Stating, “I’m not sure that I can count on you to protect my confidentiality,” does not indicate resistance to the therapeutic relationship between the nurse and client.

 

 

PTS:     1          CON:   Communication