Question 1

Which issues should a nurse address during the first interview with a patient with a psychiatric disorder?

Accepted Answer

A)  Trust,congruence,attitudes,and boundaries. 
B)  Goals,resistance,unconscious motivations,and diversion. 
C)  Relationship parameters,the contract,confidentiality,and termination. 
D)  Transference,countertransference,intimacy,and developing resources. 
A)  Trust,congruence,attitudes,and boundaries. 
B)  Goals,resistance,unconscious motivations,and diversion. 
C)  Relationship parameters,the contract,confidentiality,and termination. 
D)  Transference,countertransference,intimacy,and developing resources.

Question 2

A nurse assesses an elderly patient who was found wandering and confused.The nurse feels sad and reflects,"She's like my grandmother…so helpless." Which term best applies to the nurse's response?

Accepted Answer

A)  Rapport 
B)  Transference 
C)  Countertransference 
D)  Defensive coping reaction 
A)  Rapport 
B)  Transference 
C)  Countertransference 
D)  Defensive coping reaction

Question 3

A nurse provided psychiatric home care services to a patient for 6 months,but now the patient will begin a psychosocial rehabilitation program.On the nurse's final home visit,the patient gives the nurse a gold angel pin and says,"Thank you for being my guardian angel when I needed help." Select the nurse's best response.

Accepted Answer

A)  "I'm happy you have made so much improvement.Thank you for the pin." 
B)  "Our agency's policies and procedures prohibit me from accepting your gift." 
C)  "All nurses care.It's rewarding when patients recognize how hard we work." 
D)  "I'm glad you've made progress and that I helped,but I cannot accept the gift." 
A)  "I'm happy you have made so much improvement.Thank you for the pin." 
B)  "Our agency's policies and procedures prohibit me from accepting your gift." 
C)  "All nurses care.It's rewarding when patients recognize how hard we work." 
D)  "I'm glad you've made progress and that I helped,but I cannot accept the gift."

Question 4

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)  Neither person is correct. 
C)  The statements reflect differing values. 
D)  The nurse has responded therapeutically. 
A)  The patient is correct. 
B)  Neither person is correct. 
C)  The statements reflect differing values. 
D)  The nurse has responded therapeutically.

Question 5

How should the nurse respond if a patient says,"Please don't share information about me with the other people"?

Accepted Answer

A)  "I cannot tell anyone about you.We can help each other by keeping it between us." 
B)  "I won't share information with your family or friends without your permission,but I will share information with other staff." 
C)  "It 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 other staff." 
D)  "Therapeutic relationships are between the nurse and the patient.It's up to you to tell others what you want them to know." 
A)  "I cannot tell anyone about you.We can help each other by keeping it between us." 
B)  "I won't share information with your family or friends without your permission,but I will share information with other staff." 
C)  "It 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 other staff." 
D)  "Therapeutic relationships are between the nurse and the patient.It's up to you to tell others what you want them to know."

Question 6

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

Accepted Answer

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

Question 7

Which action by a nurse shows positive regard?

Accepted Answer

A)  Making rounds according to the daily assignment. 
B)  Administering daily medication as prescribed. 
C)  Examining own feelings about a patient. 
D)  Staying with a patient who is crying. 
A)  Making rounds according to the daily assignment. 
B)  Administering daily medication as prescribed. 
C)  Examining own feelings about a patient. 
D)  Staying with a patient who is crying.

Question 8

As a patient with mental illness is discharged from a facility,the nurse invites the patient to the annual staff holiday party.Select 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 9

The nurse tells a peer,"I feel very uncomfortable with a patient and find myself wanting to avoid both informal contacts and scheduled sessions." Without supervision,which outcome is likely?

Accepted Answer

A)  Growing interest and mutuality 
B)  Mutual withdrawal 
C)  Positive regard 
D)  Trust 
A)  Growing interest and mutuality 
B)  Mutual withdrawal 
C)  Positive regard 
D)  Trust

Question 10

Which remark by a patient indicates movement 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 talking about things twice a week can help." 
D)  "I want to find ways to deal with my anger without blowing up." 
A)  "I don't have any problems." 
B)  "It is so difficult for me to talk about problems." 
C)  "I don't know how talking about things twice a week can help." 
D)  "I want to find ways to deal with my anger without blowing up."

Question 11

Which nursing actions demonstrate consistency and reliability? (Select all that apply. )

Accepted Answer

A)  Providing a schedule of daily activities. 
B)  Offering solutions to a patient's problems. 
C)  Having the same nurse care for a patient daily. 
D)  Setting a time for regular sessions with a patient. 
E)  Encouraging a patient to share initial impressions of staff. 
A)  Providing a schedule of daily activities. 
B)  Offering solutions to a patient's problems. 
C)  Having the same nurse care for a patient daily. 
D)  Setting a time for regular sessions with a patient. 
E)  Encouraging a patient to share initial impressions of staff.

Question 12

Which behavior shows that a nurse values autonomy? The nurse:

Accepted Answer

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

Exam 9: Therapeutic Relationships

Which issues should a nurse address during the first interview with a patient with a psychiatric disorder?

A nurse assesses an elderly patient who was found wandering and confused.The nurse feels sad and reflects,"She's like my grandmother…so helpless." Which term best applies to the nurse's response?

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?

How should the nurse respond if a patient says,"Please don't share information about me with the other people"?

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

Which action by a nurse shows positive regard?

As a patient with mental illness is discharged from a facility,the nurse invites the patient to the annual staff holiday party.Select the best analysis of this scenario.

The nurse tells a peer,"I feel very uncomfortable with a patient and find myself wanting to avoid both informal contacts and scheduled sessions." Without supervision,which outcome is likely?

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

Which nursing actions demonstrate consistency and reliability? (Select all that apply. )

Which behavior shows that a nurse values autonomy? The nurse:

Mental Health and Mental Illness

Relevant Theories and Therapies for Nursing Practice

Biological Basis for Understanding Psychotropic Drugs

Psychiatric Mental Health Nursing in Acute Care Settings

Psychiatric Mental Health Nursing in Community Settings

Cultural Implications for Psychiatric Mental Health Nursing

Legal and Ethical Guidelines for Safe Practice

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

Communication and the Clinical Interview

Understanding Responses to Stress

Anxiety and Anxiety Disorders

Depressive Disorders

Bipolar Disorders

Schizophrenia

Eating Disorders

Cognitive Disorders

Addictive Disorders

Personality Disorders

Sleep Disorders

Sexual Dysfunction and Sexual Disorders

Somatoform, Factitious, and Dissociative Disorders

Crisis and Disaster

Suicide

Anger, Aggression, and Violence

Child, Older Adult, and Intimate Partner Abuse

Sexual Assault

Disorders of Children and Adolescents

Psychosocial Needs of the Older Adult

Serious 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 Care

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