Varcarolis: Essentials of Psychiatric Mental Health Nursing: A Communication Approach to Evidence-Based Care, 4th Edition Terms in this set (30)Which issues should a nurse address during the first interview with a patient diagnosed with a psychiatric disorder? Sets with similar termsSets found in the same folderOther sets by this creatorRecommended textbook solutions
RQ4. Which of the following statements are true regarding the differences between a social relationship and a therapeutic relationship? A. In a social relationship, both parties' needs are met; in a therapeutic relationship, only the patient's needs are to be considered. 2,3 Cognitive Level: Analyzing Question 8
Terms in this set (59)The nurse has a client who seems like the nurse's sister, with whom the nurse has a close and positive relationship. This phenomenon is best characterized by which term? Free association Countertransference Which statement would indicate that the nurse has a non-judgmental attitude? "I think the client is exaggerating her feelings so she can leave work early." "The client has struggled with her life circumstance of living with a man who beats her, and she is trying very hard to make the changes necessary to help herself." A nurse notices that a neighbor has been admitted to an inpatient psychiatric unit. The nurse understands that the nurse may not discuss this with any of the nurse's family or neighbors, because doing so would breach the client's confidentiality. Confidentiality is a component of which element of the therapeutic relationship? Trust Trust A 35-year-old was discharged from care after recovery from depression. The nurse therapist and the client spent many hours working through issues related to the depression. Six months later, the client is admitted again for depression associated with issues similar to those that were previously addressed in the client's therapy. The nurse therapist says to a coworker, "This is unbelievable; we're back at square one again. The client should know better at this point." The nurse's comments reflect what? A judgmental attitude A judgmental attitude During an individual therapy session, a nurse is listening to a client describe the client's drug addiction. The client says, "I know I am doing the wrong thing for my kids, but I just can't stop using drugs." The nurse maintains eye contact and nods occasionally. The nurse responds by saying, "You're going through a difficult time." The nurse's actions and words are an example of: nontherapeutic communication. empathy. When comparing social interactions with therapeutic interactions, the nurse understands that therapeutic interactions do what? Involve doing favors for others Encourage personal goal setting
A nurse interviews a new client in the day room of the psychiatric unit. The nurse is wearing a jacket and a bag and frequently asks the client to repeat the last statement. The nurse's demeanor with the client is reflective of what? Lacking genuine interest Lacking genuine interest A client tells the mental health nurse that the client is taking a sewing class to cope with the client's son's move to another state. The use of this adaptive coping skill is an example of which aspect in the therapeutic relationship? Respect Client self-exploration A client with a diagnosis of bipolar I disorder has been presented with a coping strategy by the therapist that may help the client manage behavior during manic episodes. The client has responded to the therapist's suggestion by saying, "What's the use? I don't ever see this changing." The client's statement is suggestive of a potential problem with what factor that influences communication? Knowledge Attitude Which clinical situation provides an example of transference? -A
client mirrors the nursing student's nervousness and hesitancy during assessment. A female client with a history of sexual abuse exhibits a profound mistrust of male caregivers. In what phase of the therapeutic relationship does the assessment process begin? During the working phase During the initiating or orienting phase Termination takes place during the resolution phase of a nurse-client relationship. During the termination process, a client brings up resolved problems and presents them as new issues to work toward. The nurse interprets the client's action as indicating what? The client: is unhappy that the therapy was ineffective. is attempting to prolong the nurse-client relationship. A nurse is engaged in a therapeutic nurse-client relationship. The relationship is in the working phase. What does this involve? Select all that apply. Testing the relationship Testing new ways for problem solving A client with depression has been admitted to the mental health unit and is attending group therapy sessions as part of the treatment. The client asks the nurse leading the group if the nurse is married or has a girlfriend. The nurse responds, "I am curious what made you ask this question; however, what is important is how you are feeling today." The nurse's response is what?
Inappropriate, because the client was just making small talk about the nurse's personal situation to get to know the nurse better. Appropriate, because the focus of the therapeutic relationship is the client, not the nurse. A client treated for depression is ready for discharge from the hospital and tells the nurse, "It would be great if we could meet for coffee should I start feeling low again." Which statement indicates that the nurse understands the boundaries of the therapeutic relationship? "That would be fine as long as we go to a public place. Where would you like to meet?" "Before you leave the hospital, I will make sure you have information about the crisis center." When engaged in a therapeutic relationship, the nurse's focus is on what? The family The client A psychiatric-mental health nurse has developed a therapeutic relationship with a client. Which action would alert the nurse to the possibilty that the relationship may be moving outside professional boundaries? Select all that apply. -The nurse tells a friend that the nurse is
the only one who truly understands this client. - The client brings the nurse a baked item for their
lunch. During the termination phase, a client begins to raise old problems that have already been resolved. Which would be appropriate nursing responses? Select all that apply. Review with the client the learned methods to control the problems. -Reassure the client that they already covered these issues.
What activity should be included in the first step of self-reflection? determining whether you actually possess qualities that you are unaware of identifying one's own values, attitudes, strengths and weakness During the working phase, a client demonstrates open hostility in reaction to the nurse's last question. Which response should the nurse make to avoid countertransference? "I am only trying to help you." "Tell me why you are angry about what I just said." During a first meeting a client asks that information shared will not be relayed to immediate family members. Which should the nurse say in response? "I cannot promise that. Your family may ask me questions and I will need to answer truthfully." "Any information is only shared with other professionals involved in your care." Which theorist was most widely known for the belief that the cornerstone of all nursing care is the therapeutic relationship? Jean Watson Hildegard Peplau A psychiatric nurse tells a client that the nurse will return in 15 minutes to talk with the client. The nurse goes to a meeting that runs overtime and returns in an hour, apologizing for being late. This behavior may have an impact between the nurse and the client in the area of ... -establishing boundaries on the therapeutic relationship. establishing trust in the introductory phase of the relationship. The client tells the nurse, "I am regularly doing my sitting breathing exercises. Why do I still feel breathless while walking?" The nurse replies, "Sitting breathing exercises alone may not achieve the desired effects. You also should perform daily deep breathing exercises while walking. This should help you to reduce breathlessness while walking." According to Peplau's model, the nurse and client are in which phase? Working Working A nurse is meeting a client for the first time. The nurse observes that the client smiles appropriately but is using rambling speech while answering the nurse's questions. Which would most likely be the reason for this behavior? The
client is attempting to engage in a social relationship. The client is nervous and insecure. After meeting with a client experiencing extreme anxiety the nurse notes personal feelings of nervousness. Which action should the nurse take first to address these feelings? analyze the source of the feelings analyze the source of the feelings The psychiatric nurse recognizes that excessive social communication with a client is to be avoided primarily due to which reason? To avoid making the
client feel that the client's problems are not viewed as being serious To prevent the client from viewing the nurse as a friend rather than health care provider A 68-year-old parent is the sole care provider for a 39-year-old child who has a diagnosis of bipolar disorder. The 39-year-old has been experiencing worsening of the illness over several years. The nurse should recognize that the parent is at risk for what? Failure to thrive Compassion fatigue
The mental health nurse is responsible for maintaining professional boundaries. Which would be an example of a professional boundary violation? -Exhibiting confidentiality Giving personalized gifts to a client At the end of a 12-hour shift, the nurse overhears that a client that the nurse has cared for before is being readmitted to the mental health facility. The nurse says to the charge nurse, "I better stay around for a couple of hours. I am the only one the client will talk to." This is a warning sign that the nurse is experiencing which obstacle to establishing a therapeutic relationship? Judgmental attitudes Lack of self-awareness A nurse is interacting with a client who is expressing feelings about the client's child's insensitive behavior. Which statement made by the nurse indicates the nurse is empathizing with the client? Choose the best answer. "It sounds like this is very difficult for you, I can see why it causes you stress." "It sounds like this is very difficult for you, I can see why it causes you stress." A client tells the nurse, "I had to slap my child, I couldn't help that." Which response of the nurse indicates that the nurse is in the state of unknowing? "I really feel sorry for your child." "What was going on for you when this happened?" The nurse and client are discussing discharge plans. Which statement should the nurse make that demonstrates empathy for the client's fear of returning to a group home environment? "Just think of all of the things you can do in the home that you can't do here." "It can be scary to leave a place that you trust and feel supported." The nurse and client are entering the orientation phase of a relationship. Which is the goal for the client during this phase? resolve pressing problems
develop a sense of trust in the nurse A nursing student is working with a client who has a history of abusing alcohol. Although the nurse has an aversive feeling toward people who abuse alcohol, the nurse feels that the client is worthy of respect and attention regardless of the nurse's own personal feelings. Which correctly describes the nurse's response to the client? Unconditional positive regard Unconditional positive regard Which statement would indicate that the nurse has a non-judgmental attitude? "The client has struggled with her life circumstance of living with a man who beats her, and she is trying very hard to make the
changes necessary to help herself." The client has struggled with her life circumstance of living with a man who beats her, and she is trying very hard to make the changes necessary to help herself." Which role of the nurse-client relationship is being exhibited when the nurse informs the client and then supports the client in whatever decision the client makes? Advocate Advocate It is the nurse's responsibility to define the boundaries of the relationship during which phase of the nurse-client relationship? Working Orientation A 35-year-old was discharged from care after recovery from depression. The nurse therapist and the client spent many hours working through issues related to the depression. Six months later, the client is admitted again for depression associated with issues similar to those that were previously addressed in the client's therapy. The nurse therapist says to a coworker, "This is unbelievable; we're back at square one again. The client should know better at this point." The nurse's comments reflect what? Countertransference A judgmental attitude During an individual therapy session, a nurse is listening to a client describe the client's drug addiction. The client says, "I know I am doing the wrong thing for my kids, but I just can't stop using drugs." The nurse maintains eye contact and nods occasionally. The nurse responds by saying, "You're going through a difficult time." The nurse's actions and words are an example of: sympathy. empathy. When comparing social interactions with therapeutic interactions, the nurse understands that therapeutic interactions do what? Encourage personal goal setting Encourage personal goal setting A client with a diagnosis of bipolar I disorder has been presented with a coping strategy by the therapist that may help the client manage behavior during manic episodes. The client has responded to the therapist's suggestion by saying, "What's the use? I don't ever see this changing." The client's statement is suggestive of a potential problem with what factor that influences communication? Attitude Attitude Which clinical situation provides an example of transference? -A nurse asks for clarification from a colleague when explaining a coping strategy to a client. A female client with a history of sexual abuse exhibits a profound mistrust of male caregivers. Which statement is the most empathic response to a client's disclosure that the client's father abandoned the family when the client was a young child? "You will find that one of the constants in life is that people will often let you down." "That must have been terribly hurtful experience for you." A client with depression has been admitted to the mental health unit and is attending group therapy sessions as part of the treatment. The client asks the nurse leading the group if the nurse is married or has a girlfriend. The nurse responds, "I am curious what made you ask this question; however, what is important is how you are feeling today." The nurse's response is what? -Inappropriate, because the nurse should have answered to establish a therapeutic relationship. Appropriate, because the focus of the therapeutic relationship is the client, not the nurse. The client presents with signs and symptoms of anxiety. What conversation initiated by the nurse demonstrates an ineffective therapeutic use of self? "How did the pain start?" "What types of dresses do you like wearing?" A nurse is caring for a client on an inpatient mental health unit of a hospital. The nurse tells the client, "You are scheduled to attend therapy sessions every morning at 9:00 a.m. Please make sure that you complete your morning routine, such as using the restroom, bathing, and eating breakfast, before you come for the sessions." Which phase of the nurse-client relationship does this communication indicate, according to the Peplau's model? Termination phase Orientation phase The nurse is caring for a client with schizophrenia. The client tells the nurse, "My dead mother is calling me, I will finally be with her tonight. Please do not tell anyone." What is the most appropriate nursing response? "Don't worry; I will keep this secret to myself." "I cannot keep this a secret. I will ensure that the staff helps keep you safe." A client is engaged in a nurse-client relationship that is in the orientation phase. With which activity would the client be involved? Establishing boundaries Seeking assistance During the termination phase, a client begins to raise old problems that have already been resolved. Which would be appropriate nursing responses? Select all that apply. Do not acknowledge this issue and continue on with the session as planned. -Reassure the client that they already
covered these issues. A psychiatric-mental health nurse is conducting a self-examination of beliefs and values to develop self-awareness. Asking which question would be appropriate for the nurse to determine the fundamental personal attitudes about people of diverse cultures? -What kinds of experiences have you had with people of other cultures? While a child, what attitudes did your family express about other cultures? The nurse maintains a therapeutic relationship until the client is successfully transferred to another facility. What is the nurse demonstrating? -motivational
interviewing transitional relationship model During a first meeting a client asks that information shared will not be relayed to immediate family members. Which should the nurse say in response? "Any information is only shared with other professionals involved in your care." "Any information is only shared with other professionals involved in your care." A healthcare organization is increasing the use of telecommunication to reach clients located in remote areas. Which avenue should the nurse question before establishing a therapeutic relationship with a client? videoconferencing A psychiatric nurse tells a client that the nurse will return in 15 minutes to talk with the client. The nurse goes to a meeting that runs overtime and returns in an hour, apologizing for being late. This behavior may have an impact between the nurse and the client in the area of ... -getting through the working phase of the relationship. -establishing confidentiality. ... A nurse interviews a new client in the day room of the psychiatric unit. The nurse is wearing a jacket and a bag and frequently asks the client to repeat the last statement. The nurse's demeanor with the client is reflective of what? Confidentiality ... In what phase of the therapeutic relationship does the assessment process begin? -After the initiating or orienting phase has been completed ... Termination takes place during the resolution phase of a nurse-client relationship. During the termination process, a client brings up resolved problems and presents them as new issues to work toward. The nurse interprets the client's action as indicating what? The client: -is angry that the nurse is abandoning the client.
... What activity should be included in the first step of self-reflection? asking others to share their perceptions of you -determining whether you actually possess qualities that you are unaware of ... Other sets by this creatorOSTEOMYELITIS34 terms Courtney_LeValley1 adult health muscoskeletal31 terms Courtney_LeValley1 Chapter 9,10,11,1268 terms Courtney_LeValley1 MH10, Mental health ch 9,10,11,12 vocabulary22 terms Courtney_LeValley1 Verified questionsQUESTION Briefly explain how the concepts below could be used to help a child stop throwing temper tantrums. • Extinction (operant conditioning) • Positive reinforcement • Modeling • Negative reinforcement • Shaping • Extinction (classical conditioning) Verified answer
PSYCHOLOGY Match the term below with its correct definition. depressant A. breathing interruption that occurs during sleep B. the inability to sleep C. drug that increases the activity of the nervous system D. drug that slows the activity of the nervous system E. a system that provides information about something happening in the body F. sleep stage characterized by irregular breathing increased blood pressure, and faster heart rate G. method some people use to try to narrow their consciousness so that stresses of the outside world fade away H. a state of consciousness in which a person's sense of self or sense of the world changes I. awareness of things inside and outside ourselves J. the removal of a harmful substance from the body K. after a person takes a drug for a while, the body craves it to feel normal L. a feeling of great happiness or well-being Verified answer PSYCHOLOGY Describe the social learning theory. Verified answer PSYCHOLOGY What pre-research decisions must a psychologist make? Verified answer Recommended textbook solutionsSocial Psychology10th EditionElliot Aronson, Robin M. Akert, Samuel R. Sommers, Timothy D. Wilson 525 solutions
Consumer Behavior: Buying, Having, Being13th EditionMichael R Solomon 449 solutions HDEV56th EditionSpencer A. Rathus 380 solutions
Myers' Psychology for AP2nd EditionDavid G Myers 900 solutions Which behavior indicates that the nurse may be experiencing countertransference with a client?Boredom. Due to the client's behavior, the nurse is at risk to experience a variety of countertransference reactions. If the client gives repeated uninteresting information and uses an offensive style of communication, the nurse may develop boredom and become uninterested in talking to and interacting with the client.
What is an example of countertransference in nursing?Frequently the patient's transference evokes countertransference in the nurse. For example, it is normal to feel angry when attacked persistently, annoyed when frustrated unreasonably, or flattered when idealized. A nurse might feel extremely important when depended on exclusively by a patient.
When a nurse feels like she is the only one who understands the patient what is that called?Nursing empathy could be characterized by nurses' ability to understand the feeling, experiences or psychosocial ability of their patients [3].
Which behavior by the nurse most clearly demonstrates promoting a social relationship instead of a therapeutic nurse client relationship?A nurse who talks about a frustrating day at work is focusing on his or her own needs, which imparts a social relationship rather than a therapeutic relationship. A nurse can share a brief story about his or her own personal life, as long as the conversation and interaction remains focused on the client.
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Which behavior indicates that the nurse may be experiencing countertransference with a client quizlet?
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