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The nurse is mindful of maintaining relationships with patients that are therapeutic. Certain characteristics of the relationships the nurse will foster include: Select all that apply.
- A. offering sound advice to the patient.
- B. establishing boundaries for both the nurse and patient.
- C. maintaining a patient-focus at all times
- D. sharing personal feelings openly with the patient.
- E. avoiding concern with whether the patient likes the nurse
Correct Answer: B,C,E
Rationale: The therapeutic relationship focuses on the needs, experiences, feelings, and ideas of the client only, with clear boundaries and no concern for whether the client likes the nurse.
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An adolescent patient has just been found to have broken one of the unit rules. The nurse imposes the consequence of losing phone privileges. In this instance, the nurse is acting as
- A. advocate.
- B. caregiver.
- C. teacher.
- D. parent surrogate.
Correct Answer: D
Rationale: The nurse assumes a parental role when setting limits, such as imposing consequences for rule-breaking.
Which of the following statements correctly depict the problem of feeling sympathy toward the client? Select all that apply.
- A. This can cause the nurse to feel sad and be unable to help the client.
- B. When the nurse's behavior is rooted in sympathy, the client finds it easier to manipulate the nurse's feelings.
- C. The client is discouraged from exploring his or her problems, thoughts, and feelings.
- D. The client is discouraged from growth.
- E. The client feels dependent on the nurse.
Correct Answer: B,C,D,E
Rationale: Sympathy can lead to manipulation, discourage exploration and growth, and foster client dependency.
The nurse initiating a therapeutic relationship with a client should explain the purpose, which is to
- A. alleviate stressors in life.
- B. allow the client to know the nurse's feelings.
- C. establish relationships.
- D. facilitate a positive change.
Correct Answer: D
Rationale: The client who has unmet or unsatisfactorily met needs seeks to make changes; the nurse facilitates this desire to change. The focus of the therapeutic relationship is on the client's needs, not the nurse's.
The nurse understands that empathy is essential to the therapeutic relationship. When a patient makes the statement, 'I am just devastated that my marriage is falling apart,' the nurse can best show empathy through which of the following responses?
- A. I feel so bad for what you are going through.
- B. You feel like your world is falling apart right now.
- C. I have been divorced too. I know how hard it is.
- D. It will get better, let's talk about it.
Correct Answer: B
Rationale: Therapeutic communication techniques, such as reflection, restatement, and clarification, help the nurse to send empathetic messages to the client. The nurse must understand the difference between empathy and sympathy (feelings of concern or compassion one shows for another). Sympathy often shifts the emphasis to the nurse's feelings, hindering the nurse's ability to view the client's needs objectively.
A nurse openly admits to not being able to relate to a patient's experience. According to Marshall, this is an example of
- A. The nurse will avoid imposing any values on the patient.
- B. The patient will not trust the nurse's professional abilities.
- C. The nurse will more likely be manipulated by the patient.
- D. The patient will be less likely to self-disclose to the nurse.
Correct Answer: A
Rationale: Marshall added another pattern of knowing called unknowing. For the nurse to admit she or he does not understand the client or the client's subjective world opens the way for a truly authentic encounter.