Question 1

A nurse wants to enhance growth of a patient by showing positive regard. The nurse's action most likely to help achieve this goal is which of the following?

Accepted Answer

A)  Making rounds daily 
B)  Staying with a tearful patient 
C)  Administering medication as prescribed 
D)  Examining personal feelings about a patient 
A)  Making rounds daily 
B)  Staying with a tearful patient 
C)  Administering medication as prescribed 
D)  Examining personal feelings about a patient B

Question 2

Which remark by a patient indicates passage from orientation to the working phase of a nurse-patient relationship?

Accepted Answer

A)  "I don't have any problems." 
B)  "It is so difficult for me to talk about problems." 
C)  "I don't know how it will help to talk to you about my problems." 
D)  "I want to find a way to deal with my anger without becoming violent." 
A)  "I don't have any problems." 
B)  "It is so difficult for me to talk about problems." 
C)  "I don't know how it will help to talk to you about my problems." 
D)  "I want to find a way to deal with my anger without becoming violent." D

Question 3

A patient says, "People should be allowed to commit suicide without interference from others." A nurse replies, "You're wrong. Nothing is bad enough to justify death." What is the best analysis of this interchange?

Accepted Answer

A)  The patient is correct. 
B)  The nurse is correct. 
C)  Congruent attitudes are implied. 
D)  Differing values are reflected. 
A)  The patient is correct. 
B)  The nurse is correct. 
C)  Congruent attitudes are implied. 
D)  Differing values are reflected. D

Question 4

A nurse assesses a confused older adult. The nurse experiences sadness and reflects, "The patient is like one of my grandparents-so helpless." Which response is the nurse demonstrating?

Accepted Answer

A)  Transference 
B)  Counter-transference 
C)  Catastrophic reaction 
D)  Defensive coping reaction 
A)  Transference 
B)  Counter-transference 
C)  Catastrophic reaction 
D)  Defensive coping reaction

Question 5

A nurse introduces the matter of a contract during the first session with a new patient because of which of the following?

Accepted Answer

A)  Contracts specify what the nurse will do for the patient. 
B)  Contracts spell out the participation and responsibilities of each party. 
C)  Contracts indicate the feeling tone established between the participants. 
D)  Contracts are binding and prevent either party from prematurely ending the relationship. 
A)  Contracts specify what the nurse will do for the patient. 
B)  Contracts spell out the participation and responsibilities of each party. 
C)  Contracts indicate the feeling tone established between the participants. 
D)  Contracts are binding and prevent either party from prematurely ending the relationship.

Question 6

At what point in the nurse-patient relationship should a nurse plan to first address termination?

Accepted Answer

A)  During the orientation phase 
B)  At the end of the working phase 
C)  Near the beginning of the termination phase 
D)  When the patient initially brings up the topic 
A)  During the orientation phase 
B)  At the end of the working phase 
C)  Near the beginning of the termination phase 
D)  When the patient initially brings up the topic

Question 7

As a patient diagnosed with a mental illness is being discharged from a facility, a nurse invites the patient to the annual staff picnic. What is the best analysis of this scenario?

Accepted Answer

A)  The invitation facilitates dependency on the nurse. 
B)  The nurse's action blurs the boundaries of the therapeutic relationship. 
C)  The invitation is therapeutic for the patient's diversional activity deficit. 
D)  The nurse's action assists the patient's integration into community living. 
A)  The invitation facilitates dependency on the nurse. 
B)  The nurse's action blurs the boundaries of the therapeutic relationship. 
C)  The invitation is therapeutic for the patient's diversional activity deficit. 
D)  The nurse's action assists the patient's integration into community living.

Question 8

A nurse caring for a withdrawn, suspicious patient recognizes development of feelings of anger toward the patient. Which of the following should the nurse do?

Accepted Answer

A)  Suppress the angry feelings 
B)  Express the anger openly and directly with the patient 
C)  Tell the nurse manager to assign the patient to another nurse 
D)  Discuss the anger with a clinician during a supervisory session 
A)  Suppress the angry feelings 
B)  Express the anger openly and directly with the patient 
C)  Tell the nurse manager to assign the patient to another nurse 
D)  Discuss the anger with a clinician during a supervisory session

Question 9

An advanced-practice nurse observes a novice nurse expressing irritability regarding a patient with a long history of alcoholism and suspects the new nurse is experiencing counter-transference. Which comment by the new nurse confirms this suspicion?

Accepted Answer

A)  "This patient continues to deny problems resulting from drinking." 
B)  "My parents were alcoholics and often neglected our family." 
C)  "The patient cannot identify any goals for improvement." 
D)  "The patient said I have many traits like her mother." 
A)  "This patient continues to deny problems resulting from drinking." 
B)  "My parents were alcoholics and often neglected our family." 
C)  "The patient cannot identify any goals for improvement." 
D)  "The patient said I have many traits like her mother."

Question 10

As a nurse discharges a patient, the patient gives the nurse a card of appreciation made in an arts and crafts group. What is the nurse's best action?

Accepted Answer

A)  Recognize the effectiveness of the relationship and patient's thoughtfulness. Accept the card. 
B)  Inform the patient that accepting gifts violates policies of the facility. Decline the card. 
C)  Acknowledge the patient's transition through the termination phase, but decline the card. 
D)  Accept the card and invite the patient to return to participate in other arts and crafts groups. 
A)  Recognize the effectiveness of the relationship and patient's thoughtfulness. Accept the card. 
B)  Inform the patient that accepting gifts violates policies of the facility. Decline the card. 
C)  Acknowledge the patient's transition through the termination phase, but decline the card. 
D)  Accept the card and invite the patient to return to participate in other arts and crafts groups.

Question 11

During which phase of the nurse-patient relationship can the nurse anticipate that identified patient issues will be explored and resolved?

Accepted Answer

A)  Preorientation 
B)  Orientation 
C)  Working 
D)  Termination 
A)  Preorientation 
B)  Orientation 
C)  Working 
D)  Termination

Question 12

Which of the following behaviours shows that a nurse values autonomy?

Accepted Answer

A)  The nurse suggests one-on-one supervision for a patient who has suicidal thoughts. 
B)  The nurse informs a patient that the spouse will not be in during visiting hours. 
C)  The nurse discusses options and helps the patient weigh the consequences. 
D)  The nurse sets limits on a patient's romantic overtures toward the nurse. 
A)  The nurse suggests one-on-one supervision for a patient who has suicidal thoughts. 
B)  The nurse informs a patient that the spouse will not be in during visiting hours. 
C)  The nurse discusses options and helps the patient weigh the consequences. 
D)  The nurse sets limits on a patient's romantic overtures toward the nurse.

Question 13

A patient says, "I'm still on restriction, but I want to attend some off-unit activities. Would you ask the doctor to change my privileges?" What is the nurse's best response?

Accepted Answer

A)  "Why are you asking me when you're able to speak for yourself?" 
B)  "I will be glad to address it when I see your doctor later today." 
C)  "That's a good topic for you to discuss with your doctor." 
D)  "Do you think you can't speak to a doctor?" 
A)  "Why are you asking me when you're able to speak for yourself?" 
B)  "I will be glad to address it when I see your doctor later today." 
C)  "That's a good topic for you to discuss with your doctor." 
D)  "Do you think you can't speak to a doctor?"

Question 14

What is the desirable outcome for the orientation stage of a nurse-patient relationship? The patient will demonstrate behaviours that indicate which of the following?

Accepted Answer

A)  Self-responsibility and autonomy 
B)  A greater sense of independence 
C)  Rapport and trust with the nurse 
D)  Resolved transference 
A)  Self-responsibility and autonomy 
B)  A greater sense of independence 
C)  Rapport and trust with the nurse 
D)  Resolved transference

Question 15

A nurse is talking with a patient, and 5 minutes remain in the session. The patient has been silent most of the session. Another patient comes to the door of the room, interrupts, and says to the nurse, "I really need to talk to you." What should the nurse do?

Accepted Answer

A)  Invite the interrupting patient to join in the session with the current patient. 
B)  Say to the interrupting patient, "I am not available to talk with you at the present time." 
C)  End the unproductive session with the current patient and spend time with the interrupting patient. 
D)  Tell the interrupting patient, "This session is 5 more minutes; then I will talk with you." 
A)  Invite the interrupting patient to join in the session with the current patient. 
B)  Say to the interrupting patient, "I am not available to talk with you at the present time." 
C)  End the unproductive session with the current patient and spend time with the interrupting patient. 
D)  Tell the interrupting patient, "This session is 5 more minutes; then I will talk with you."

Question 16

A novice nurse tells a mentor, "I want to convey to my patients that I am interested in them and that I want to listen to what they have to say." Which behaviours will be helpful in meeting the nurse's goal?

Accepted Answer

A)  Sitting behind a desk, facing the patient 
B)  Introducing self to a patient and identifying own role 
C)  Maintaining control of discussions by asking direct questions 
D)  Using facial expressions to convey interest and encouragement 
E)  Demonstrating attending behaviours 
A)  Sitting behind a desk, facing the patient 
B)  Introducing self to a patient and identifying own role 
C)  Maintaining control of discussions by asking direct questions 
D)  Using facial expressions to convey interest and encouragement 
E)  Demonstrating attending behaviours

Question 17

A nurse explains to the family of a mentally ill patient how a nurse-patient relationship differs from social relationships. Which is the best explanation?

Accepted Answer

A)  "The focus is on the patient. Problems are discussed by the nurse and patient, but solutions are implemented by the patient." 
B)  "The focus shifts from nurse to patient as the relationship develops. Advice is given by both, and solutions are implemented." 
C)  "The focus of the relationship is socialization. Mutual needs are met, and feelings are shared openly." 
D)  "The focus is creation of a partnership in which each member is concerned with growth and satisfaction of the other." 
A)  "The focus is on the patient. Problems are discussed by the nurse and patient, but solutions are implemented by the patient." 
B)  "The focus shifts from nurse to patient as the relationship develops. Advice is given by both, and solutions are implemented." 
C)  "The focus of the relationship is socialization. Mutual needs are met, and feelings are shared openly." 
D)  "The focus is creation of a partnership in which each member is concerned with growth and satisfaction of the other."

Question 18

As a nurse escorts a patient being discharged after treatment for major depression, the patient gives the nurse a necklace with a heart pendant and says, "Thank you for helping mend my broken heart." Which is the nurse's best response?

Accepted Answer

A)  "Accepting gifts violates the policies and procedures of the facility." 
B)  "I'm glad you feel so much better now. Thank you for the beautiful necklace." 
C)  "I'm glad I could help you, but I can't accept the gift. My reward is seeing you with a renewed sense of hope." 
D)  "Helping people is what nursing is all about. It's rewarding to me when patients recognize how hard we work." 
A)  "Accepting gifts violates the policies and procedures of the facility." 
B)  "I'm glad you feel so much better now. Thank you for the beautiful necklace." 
C)  "I'm glad I could help you, but I can't accept the gift. My reward is seeing you with a renewed sense of hope." 
D)  "Helping people is what nursing is all about. It's rewarding to me when patients recognize how hard we work."

Question 19

A nurse wants to demonstrate genuineness with a patient diagnosed with schizophrenia. Which of the following should the nurse do?

Accepted Answer

A)  Restate what the patient says. 
B)  Use congruent communication strategies. 
C)  Use self-revelation in patient interactions. 
D)  Consistently interpret the patient's behaviours. 
A)  Restate what the patient says. 
B)  Use congruent communication strategies. 
C)  Use self-revelation in patient interactions. 
D)  Consistently interpret the patient's behaviours.

Question 20

A nurse ends a relationship with a patient. Which actions by the nurse should be included in the termination phase?

Accepted Answer

A)  Focus dialogues with the patient on problems that may occur in the future. 
B)  Help the patient express feelings about the relationship with the nurse. 
C)  Help the patient prioritize and modify socially unacceptable behaviours. 
D)  Reinforce expectations regarding the parameters of the relationship. 
E)  Help the patient to identify strengths, limitations, and problems. 
A)  Focus dialogues with the patient on problems that may occur in the future. 
B)  Help the patient express feelings about the relationship with the nurse. 
C)  Help the patient prioritize and modify socially unacceptable behaviours. 
D)  Reinforce expectations regarding the parameters of the relationship. 
E)  Help the patient to identify strengths, limitations, and problems.

Exam 9: Therapeutic Relationships

A nurse wants to enhance growth of a patient by showing positive regard. The nurse's action most likely to help achieve this goal is which of the following?

Which remark by a patient indicates passage from orientation to the working phase of a nurse-patient relationship?

A patient says, "People should be allowed to commit suicide without interference from others." A nurse replies, "You're wrong. Nothing is bad enough to justify death." What is the best analysis of this interchange?

A nurse assesses a confused older adult. The nurse experiences sadness and reflects, "The patient is like one of my grandparents-so helpless." Which response is the nurse demonstrating?

A nurse introduces the matter of a contract during the first session with a new patient because of which of the following?

At what point in the nurse-patient relationship should a nurse plan to first address termination?

As a patient diagnosed with a mental illness is being discharged from a facility, a nurse invites the patient to the annual staff picnic. What is the best analysis of this scenario?

A nurse caring for a withdrawn, suspicious patient recognizes development of feelings of anger toward the patient. Which of the following should the nurse do?

An advanced-practice nurse observes a novice nurse expressing irritability regarding a patient with a long history of alcoholism and suspects the new nurse is experiencing counter-transference. Which comment by the new nurse confirms this suspicion?

As a nurse discharges a patient, the patient gives the nurse a card of appreciation made in an arts and crafts group. What is the nurse's best action?

During which phase of the nurse-patient relationship can the nurse anticipate that identified patient issues will be explored and resolved?

Which of the following behaviours shows that a nurse values autonomy?

A patient says, "I'm still on restriction, but I want to attend some off-unit activities. Would you ask the doctor to change my privileges?" What is the nurse's best response?

What is the desirable outcome for the orientation stage of a nurse-patient relationship? The patient will demonstrate behaviours that indicate which of the following?

A nurse is talking with a patient, and 5 minutes remain in the session. The patient has been silent most of the session. Another patient comes to the door of the room, interrupts, and says to the nurse, "I really need to talk to you." What should the nurse do?

A novice nurse tells a mentor, "I want to convey to my patients that I am interested in them and that I want to listen to what they have to say." Which behaviours will be helpful in meeting the nurse's goal?

A nurse explains to the family of a mentally ill patient how a nurse-patient relationship differs from social relationships. Which is the best explanation?

As a nurse escorts a patient being discharged after treatment for major depression, the patient gives the nurse a necklace with a heart pendant and says, "Thank you for helping mend my broken heart." Which is the nurse's best response?

A nurse wants to demonstrate genuineness with a patient diagnosed with schizophrenia. Which of the following should the nurse do?

A nurse ends a relationship with a patient. Which actions by the nurse should be included in the termination phase?

Mental Health and Mental Illness

Historical Overview of Psychiatric Mental Health Nursing

Overview of Psychiatric Mental Health Nursing Care Within Various Settings

Relevant Theories and Therapies for Nursing Practice

Understanding Responses to Stress

The Nursing Process and Standards of Care for Psychiatric Mental Health Nursing

Ethical Responsibilities and Legal Obligations for Psychiatric Mental Health Nursing Practice

Cultural Considerations for Psychiatric Mental Health Nursing

Communication and the Clinical Interview

Psychotropic Drugs

Anxiety and Related Disorders

Depressive Disorders

Bipolar Disorders

Schizophrenia Spectrum and Other Psychotic Disorders

Eating and Feeding Disorders

Neurocognitive Disorders

Psychoactive Substance Use and Treatment

Personality Disorders

Sleepwake Disorders

Crisis and Disaster

Suicide and Nonsuicidal Self-Injury

Anger, Aggression, and Violence

Interpersonal Violence: Child, Older Adult, and Intimate Partner Abuse

Sexual Assault

Sexuality and Gender

Disorders of Children and Adolescents

Psychosocial Needs of the Older Adult

Living With Recurrent and Persistent Mental Illness

Psychological Needs of Patients With Medical Conditions

Care for the Dying and for Those Who Grieve

Forensic Psychiatric Nursing

Therapeutic Groups

Family Interventions

Integrative and Complimentary Therapies

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