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Question 1

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51s Report this Question

Which statement would indicate that the nurse has a non-judgmental attitude? You Selected:



"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."

Correct response:



"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."

Explanation:

The statement about the client who is trying to make the individual changes necessary is void of personal opinion and value judgments. It is a neutral statement of client data. Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 90. Chapter 5: Therapeutic Relationships - Page 90

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Question 2

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34s Report this Question

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? You Selected:



Countertransference

Correct response:



Countertransference

Explanation: Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 90. Chapter 5: Therapeutic Relationships - Page 90

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Question 3

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55s Report this Question

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 Selected:



“What do you think motivated your father to do that.”

Correct response:



“That must have been terribly hurtful experience for you.”

Explanation: Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 81. Chapter 5: Therapeutic Relationships - Page 81

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Question 4

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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 the Peplau model, in which phase of the nurse-client relationship would this conversation occur? You Selected:



Exploitation phase

Correct response:



Identification phase

Explanation: Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 90. Chapter 5: Therapeutic Relationships - Page 90

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Question 5

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23s Report this Question

The nurse is reviewing the client's history, identifies themes, and considers how the nurse can be most therapeutic to a client who was recently admitted to a psychiatric unit. The nurse is functioning in which phase of the therapeutic relationship? You Selected:



Working

Correct response:



Orientation

Explanation: Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 90. Chapter 5: Therapeutic Relationships - Page 90

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Question 6

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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? You Selected:



The client is experiencing symptoms of a disorder.

Correct response:



The client is nervous and insecure.

Explanation: Remediation:

Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 88. Chapter 5: Therapeutic Relationships - Page 88

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Question 7

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During which phase of the nurse–client relationship does the client identify and explore specific problems? You Selected:



Working

Correct response:



Working

Explanation: Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 90. Chapter 5: Therapeutic Relationships - Page 90

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Question 8

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1m 4s Report this Question

A nurse is interviewing a client to obtain a health history. Which would be considered a “usual or expected” response during the first session?

You Selected:



Rambling due to nervousness

Correct response:



Rambling due to nervousness

Explanation: Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 88. Chapter 5: Therapeutic Relationships - Page 88

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Question 9

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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? You Selected:



“Tell me why you are angry about what I just said.”

Correct response:



“Tell me why you are angry about what I just said.”

Explanation: Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 90.

Chapter 5: Therapeutic Relationships - Page 90 Add a Note

Question 10

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1m 9s Report this Question

The nurse learns that a new client is a former significant other and an initial session is scheduled for early in the afternoon. Which action should the nurse take to maintain professional boundaries? You Selected:



Ask to be reassigned because of having a prior personal relationship with the client.

Correct response:



Ask to be reassigned because of having a prior personal relationship with the client.

Explanation: Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 82. Chapter 5: Therapeutic Relationships - Page 82

Question 1

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1m 18s Report this Question

Which theorist was most widely known for the belief that the cornerstone of all nursing care is the therapeutic relationship? You Selected:



Hildegard Peplau

Correct response:



Hildegard Peplau

Explanation:

Peplau's theory is based on the nurse-client relationship as a therapeutic tool. Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 86. Chapter 5: Therapeutic Relationships - Page 86

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Question 2

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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? You Selected:



Unconditional positive regard

Correct response:



Unconditional positive regard

Explanation:

The nurse needs to treat each person with respect and dignity, regardless of personal value conflicts. Remediation:

Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 82. Chapter 5: Therapeutic Relationships - Page 82

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Question 3

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Which is a nurse's primary tool for treating clients with mental disorders? You Selected:



The therapeutic use of self

Correct response:



The therapeutic use of self

Explanation:

Through the therapeutic use of self, via therapeutic relationships and communication, nurses help people adapt, change, and grow. Medications and education will influence and enhance growth, but the therapeutic use of self is the nurse's primary tool. Self-help groups do not involve health care professionals. Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, pp. 83-84. Chapter 5: Therapeutic Relationships - Page 83-84

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Question 4 25s

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A client reveals in a therapy session that the client has thought about killing a neighbor. What is the therapist's obligation regarding this revelation? You Selected:



The therapist must notify authorities and the potential victim.

Correct response:



The therapist must notify authorities and the potential victim.

Explanation:

As a result of the Tarasoff decision, it is mandatory in most (but not all) states to report any clear threats that psychiatric clients make to harm specific people. Psychiatrists, psychotherapists, and other mental health care providers must warn authorities (if specified by law) and potential victims of possible dangerous actions of their clients, even if the clients protest. Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 89. Chapter 5: Therapeutic Relationships - Page 89

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Question 5

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When comparing social interactions with therapeutic interactions, the nurse understands that therapeutic interactions do what? You Selected:



Encourage personal goal setting

Correct response:



Encourage personal goal setting

Explanation:

Therapeutic interactions are designed specifically to encourage the client to engage in personal goal setting. Personal and intimate activities, favors for others, and constructive dependencies are all inappropriate activities for the nurse–client relationship. Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 86. Chapter 5: Therapeutic Relationships - Page 86

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Question 6

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Which clinical situation provides an example of transference? You Selected:



A client mirrors the nursing student's nervousness and hesitancy during assessment.

Correct response:



A female client with a history of sexual abuse exhibits a profound mistrust of male caregivers.

Explanation:

Transference or parataxic distortion occurs when a client exhibits the same attitudes and behaviors with a caregiver as with a significant, seemingly similar person in the client's life. Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 90. Chapter 5: Therapeutic Relationships - Page 90

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Question 7

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1m 21s Report this Question

During which phase of the nurse–client relationship does the client identify and explore specific problems? You Selected:



working

Correct response:



working

Explanation:

During the working phase, the client uses the relationship to examine specific problems and learn new ways of approaching them. Debriefing is not a phase of the nurse–client relationship. During the orientation phase the nurse and client get to know each other. The final phase, resolution, is the termination stage of the relationship and lasts from the time the problems are resolved to the close of the relationship. Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 90. Chapter 5: Therapeutic Relationships - Page 90

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Question 8 28s

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The most important tool of psychiatric nursing is the: You Selected:



self.

Correct response:



self.

Explanation:

The most important tool of psychiatric nursing is the self. Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 83. Chapter 5: Therapeutic Relationships - Page 83

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Question 9

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When the nurse helps the cognitively impaired client bathe and dress, what role is the nurse assuming? You Selected:



Parent surrogate

Correct response:



Parent surrogate

Explanation:

The nurturing needs of clients who are unable to carry out simple tasks are met by the subrole of the parent surrogate. This not the focus of the other roles.

Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 93. Chapter 5: Therapeutic Relationships - Page 93

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Question 10

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The nurse and client are entering the orientation phase of a relationship. Which is the goal for the client during this phase? You Selected:



identify potential solutions to issues

Correct response:



develop a sense of trust in the nurse

Explanation:

The orientation phase is the phase during which the nurse and client get to know each other. During this phase, the client develops a sense of trust in the nurse. In the working phase, the client works through problems and identifies potential solutions to issues. During the termination phase, problems are resolved. Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 86. Chapter 5: Therapeutic Relationships - Page 86

Question 1 39s

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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? You Selected:



Advocate

Correct response:



Advocate

Explanation:

In the advocate role, the nurse informs the client and then supports the client in whatever decision the client makes. The primary caregiving role in mental health settings is the implementation of the therapeutic relationship to build trust and explore feelings. In the teacher role, the nurse instructs the client about the client's medication regimen. In the role of the parent surrogate, the nurse may be tempted to assume a parental role. Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 93. Chapter 5: Therapeutic Relationships - Page 93

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Question 2

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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: You Selected:



empathy.

Correct response:



empathy.

Explanation:

Being empathetic is an active process requiring careful listening and attending to the client. Direct eye contact, a concerned expression, occasional head nods, and a lean forward while listening are nonverbal communication skills that convey empathy. Empathetic responses, such as “You're going through a difficult time,” can provide clients with an opportunity to listen to themselves and gain self-awareness. Remediation: Reference:



Videbeck, S. Psychiatric-Mental Health Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 5: Therapeutic Relationships, p. 81. Chapter 5: Therapeutic Relationships - Page 81

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Question 3

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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? You Selected:



Compassion fatigue

Correct response:



Compassion fatigue

Explanation:

Compassion fatigue, also referred to by many as burnout, may occur when one provides care ...