Which of the following occurrences is considered a breach of professional boundaries?
- A. Patient asking a nurse for her phone number
- B. Refusing a gift from a patient
- C. Changing the subject in response to a patient compliment
- D. Having a lengthy social conversation with a patient
Correct Answer: D
Rationale: Lengthy social conversations erode the professional relationship by shifting focus away from the client's needs.
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A nurse is working with a patient whose background is very different from hers. A good question to ask herself to assure she can be effective working with this patient would be,
- A. Can this person understand me?
- B. Do I understand this patient's expectations of me?
- C. What experiences do I have with people with similar backgrounds?
- D. Is this person going to be able to relate to me?
Correct Answer: C
Rationale: To best assess self-awareness, the nurse should ask 'What experiences have I had with people from ethnic groups, socioeconomic classes, religions, age groups, or communities different from my own?'
The nurse has been working with a patient with an eating disorder for one week. During the morning treatment team meeting, the treatment plan is updated. Which of the following would be appropriate interventions at this time in the nurse/patient relationship? Select all that apply.
- A. Exploring perceptions of reality
- B. Promoting a positive self-concept
- C. Explaining the boundaries of the relationship
- D. Working through resistance
- E. Assisting in identifying problems
Correct Answer: A,B,D
Rationale: Tasks of the working phase include exploring perceptions of reality, promoting a positive self-concept, and working through resistance.
One of the primary differences between social and therapeutic relationships is the
- A. amount of emotion invested.
- B. degree of satisfaction obtained.
- C. kind of information given.
- D. type of responsibility involved.
Correct Answer: D
Rationale: The nurse has the responsibility for the therapeutic relationship, which focuses on the client's needs.
A nurse is using the Johari window to identify the degree to which he feels comfortable communicating with others. After completing the exercise, the nurse discovers that quadrant 1 has the longest list of qualities. This indicates which of the following about the nurse?
- A. The nurse conceals personal information about himself.
- B. The nurse needs to increase insight into his own characteristics.
- C. The nurse is open to others.
- D. The patient is sharing more than the nurse in the therapeutic relationship.
Correct Answer: C
Rationale: When using the Johari window, if quadrant 1 is the largest, this indicates that the nurse is open to others.
The client tells the nurse, 'I don't think you can help me. Every time I talk to you, I am reminded of my mother, and I hated her.' The nurse should recognize this as
- A. confrontation.
- B. countertransference.
- C. incongruence.
- D. transference.
Correct Answer: D
Rationale: Transference occurs when the client unconsciously transfers to the nurse feelings he or she has for significant others.
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