RNSG VNSG 1201-Chapter 11: The Therapeutic Relationship Morrison-Valfre: Foundations of Mental Health Care, 6th Edition

RNSG VNSG 1201-Chapter 11: The Therapeutic Relationship Morrison-Valfre: Foundations of Mental Health Care, 6th Edition MULTIPLE CHOICE 1. The nurse is attempting to develop trust with a newly admitted female client for the purpose of establishing a therapeutic relationship. The nurse is currently administering medications to all clients on the unit. The newly admitted client asks the nurse to sit and talk with her for a while. What is the nurse’s best response? a. “I am busy right now, but I will come back later.” b. “Give me just a few more minutes to finish passing medication to the other clients.” c. “I will return in 20 minutes so we can talk.” d. “I have to finish giving all the clients their medications, but I will then come back so we can talk.” ANS: D This is an honest statement that lets the client know exactly what the nurse is doing and helps to build trust in that the nurse is not making up excuses or making false promises. The nurse’s statement that she is busy right now would make the client feel unimportant. The nurse would be making false promises if she were to say that she will be back in only a few minutes or even in 20 minutes, because most likely it will take more than this amount of time to finish giving out medications. PTS: 1 DIF: Cognitive Level: Application REF: pp. 116-117 OBJ: 2 TOP: Trust KEY: Nursing Process Step: Intervention MSC: Client Needs: Psychosocial Integrity 2. A nurse is working with a male client in a mental health outpatient clinic. The client voices a desire to become more autonomous. Which goal will assist the client in becoming more autonomous? a. The client will check his calendar each night to plan for commitments scheduled on the following day. b. The nurse will remind the client weekly of his appointment at the clinic for the following week. c. The client will ask the nurse to call him to remind him of his appointment. d. The nurse will complete the client’s calendar of daily commitments scheduled for the week. ANS: A Autonomy refers to the ability to direct and control one’s activities and destiny. Working toward this goal is a simple way to begin to develop control over one’s life. Reminding the client and completing the client’s calendar are nursing goals rather than client goals. If the client asks the nurse to call him to remind him, no responsibility is placed on the client. PTS: 1 DIF: Cognitive Level: Application REF: p. 118 OBJ: 2 TOP: Autonomy KEY: Nursing Process Step: Planning MSC: Client Needs: Psychosocial Integrity 3. An important aspect of developing a therapeutic relationship with a mental health client is for the nurse to show that she cares about the client. The nurse who is working on an inpatient unit can show signs of caring by: a. Telling a client several times a day that he or she cares about him or her b. Asking a client what his or her favorite movie is and then showing that movie during a movie night on the unit c. Giving a client a card that has a sentiment that says the nurse cares about him or her d. Telling a client that he or she is the favorite client ANS: B Showing a favorite movie is a safe way of showing the client that you are aware of him or her as an individual, rather than as just another client. If the nurse only tells the client that she cares about him or her, it does not prove to the client that the nurse cares. Giving a client a card or telling the client that he or she is a favorite is too personal and may mislead the client regarding the development of a social relationship. PTS: 1 DIF: Cognitive Level: Application REF: p. 118 OBJ: 2 TOP: Caring KEY: Nursing Process Step: Intervention MSC: Client Needs: Psychosocial Integrity 4. The nurse is caring for a female client with a diagnosis of severe bipolar disorder. Out of many treatment methods, the one treatment that the client and the team have found to be most effective is the medication lithium. The client voices concern about her future with this diagnosis. Which nurse response best represents the concept of hope? a. “You need to take your lithium unless you want to relapse.” b. “You are doing so well that there is nothing you can’t do if you put your mind to it.” c. “You are doing very well since we found that lithium helps. You should do well as long as you continue your therapy and medication.” d. “A lot of people are much worse off than you are, so you should be thankful that you are doing as well as you are.” ANS: C This option is realistic and provides hope without providing false hope. Stating that the client will relapse if she discontinues medication suggests that the nurse is threatening the client, which provides no hope. Telling the client that “there is nothing that you can’t do” may be providing false hope. Reminding the client that others are worse off is disregarding the client’s feelings. PTS: 1 DIF: Cognitive Level: Application REF: p. 118 OBJ: 2 TOP: Hope KEY: Nursing Process Step: Intervention MSC: Client Needs: Psychosocial Integrity 5. A male client with schizophrenia has lost his job and home and has been living in a homeless shelter. He voluntarily admits himself into a mental health treatment facility. The client’s current living situation and lack of a job at this time likely will contribute to his having difficulty with which dimension of hope? a. Affective b. Contextual c. Temporal d. Affiliative ANS: B Although all the dimensions of hope listed in these options may be difficult for this client, the dimension that is representative of the living a