Chapter 9: Therapeutic Relationships and the Clinical Interview

Chapter 9: Therapeutic Relationships and the Clinical Interview

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse assesses a confused older adult. The nurse experiences sadness and reflects, “The patient is like one of my grandparents…so helpless.” What feelings does the nurse describe?

a.	Transference
b.	Countertransference
c.	Catastrophic reaction
d.	Defensive coping reaction

 

 

ANS:  B

Countertransference is the nurse’s transference or response to a patient that is based on the nurse’s unconscious needs, conflicts, problems, or view of the world.

 

DIF:    Cognitive Level: Comprehension     REF:   Page: 138       TOP:   Nursing Process: Evaluation

MSC:  NCLEX: Psychosocial Integrity

 

2. Which statement shows a nurse has empathy for a patient who made a suicide attempt?

a.	“You must have been very upset when you tried to hurt yourself.”
b.	“It makes me sad to see you going through such a difficult experience.”
c.	“If you tell me what is troubling you, I can help you solve your problems.”
d.	“Suicide is a drastic solution to a problem that may not be such a serious matter.”

 

 

ANS:  A

Empathy permits the nurse to see an event from the patient’s perspective, understand the patient’s feelings, and communicate this to the patient. The incorrect responses are nurse centered (focusing on the nurse’s feelings rather than the patient’s), belittling, and sympathetic.

 

DIF:    Cognitive Level: Application           REF:   Page: 139|Page: 144

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

 

3. After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference?

a.	The patient’s reactions toward the nurse seem realistic and appropriate.
b.	The patient states, “Talking to you feels like talking to my parents.”
c.	The nurse feels oddly happy when the patient’s mood begins to lift.
d.	The nurse develops a trusting relationship with the patient.

 

 

ANS:  C

Strong positive or negative reactions toward a patient or an over-identification with a patient signals possible countertransference. Nurses must carefully monitor their own feelings and reactions to detect countertransference and then seek supervision. Realistic and appropriate reactions from a patient toward a nurse are desirable. One incorrect response suggests transference. A trusting relationship with the patient is desirable.

 

DIF:    Cognitive Level: Application           REF:   Page: 138       TOP:   Nursing Process: Evaluation

MSC:  NCLEX: Psychosocial Integrity

 

4. A patient says, “Please don’t share information about me with the other people.” How should the nurse respond?

a.	“I won’t share information with your family or friends without your permission, but I will share information about you with other staff members.”
b.	“A therapeutic relationship is just between the nurse and the patient. It’s up to you to tell others what you want them to know.”
c.	“It really depends on what you choose to tell me. I will be glad to disclose at the end of each session what I will report to others.”
d.	“I cannot tell anyone about you. It will be as though I am talking about my own problems, and we can help each other by keeping it between us.”

 

 

ANS:  A

A patient has the right to know with whom the nurse will share information and that confidentiality will be protected. Although the relationship is primarily between the nurse and patient, other staff members need to know pertinent data. The other incorrect responses promote incomplete disclosure on the part of the patient, require daily renegotiation of an issue that should be resolved as the nurse-patient contract is established, and suggest mutual problem solving. The relationship must be patient centered.

 

DIF:    Cognitive Level: Application           REF:   Page: 142|Page: 146

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Safe, Effective Care Environment