NURS 352 Behavioral Health Exam 1
Chapters: 1-9 Questions With 100%
Pass
A nurse assesses a confused older adult. The nurse experiences sadness and
reflects, "This patient is like one of my grandparents ... so helpless."
Which response is the nurse demonstrating?
a. Transference
b. Countertransference
c. Catastrophic reaction
d. Defensive coping reaction
B
Countertransference is the nurse's transference or response to a patient that is based
on the nurse's unconscious needs, conflicts, problems, or view of the world. See
relationship to audience response question.
Which statement shows a nurse has empathy for a patient who made a suicide
attempt?
a. "You must have been very upset when you tried to hurt yourself."
b. "It makes me sad to see you going through such a difficult experience."
c. "If you tell me what is troubling you, I can help you solve your problems."
d. "Suicide is a drastic solution to a problem that may not be such a serious
matter."
A
Empathy permits the nurse to see an event from the patient's perspective, understand
the patient's feelings, and communicate this to the patient. The incorrect responses are
nurse-centered (focusing on the nurse's feelings rather than the patient's), belittling, and
sympathetic.
After several therapeutic encounters with a patient who recently attempted
suicide, which occurrence should cause the nurse to consider the possibility of
countertransference?
a. The patient's reactions toward the nurse seem realistic and appropriate.
b. The patient states, "Talking to you feels like talking to my parents."
c. The nurse feels unusually happy when the patient's mood begins to lift.
d. The nurse develops a trusting relationship with the patient.
,C
Strong positive or negative reactions toward a patient or over-identification with the
patient indicate possible countertransference. Nurses must carefully monitor their own
feelings and reactions to detect countertransference and then seek supervision.
Realistic and appropriate reactions from a patient toward a nurse are desirable. One
incorrect response suggests transference. A trusting relationship with the patient is
desirable. See relationship to audience response question.
A patient says, "Please don't share information about me with the other people."
How should the nurse respond?
a. "I will not share information with your family or friends without your
permission, but I will share information about you with other staff."
b. "A therapeutic relationship is just between the nurse and the patient. It is up to
you to tell others what you want them to know."
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 others."
d. "I cannot tell anyone about you. It will be as though I am talking about my own
problems, and we can help each other by keeping it between us."
A
A patient has the right to know with whom the nurse will share information and that
confidentiality will be protected. Although the relationship is primarily between the nurse
and patient, other staff needs to know pertinent data. The other incorrect responses
promote incomplete disclosure on the part of the patient, require daily renegotiation of
an issue that should be resolved as the nurse-patient contract is established, and
suggest mutual problem solving. The relationship must be patient centered. See
relationship to audience response question.
A nurse is talking with a patient, and 5 minutes remain in the session. The patient
has been silent most of the session. Another patient comes to the door of the
room, interrupts, and says to the nurse, "I really need to talk to you." The nurse
should
a. invite the interrupting patient to join in the session with the current patient.
b. say to the interrupting patient, "I am not available to talk with you at the
present time."
c. end the unproductive session with the current patient and spend time with the
interrupting patient.
d. tell the interrupting patient, "This session is 5 more minutes; then I will talk
with you."
D
When a specific duration for sessions has been set, the nurse must adhere to the
schedule. Leaving the first patient would be equivalent to abandonment and would
destroy any trust the patient had in the nurse. Adhering to the contract demonstrates
,that the nurse can be trusted and that the patient and the sessions are important. The
incorrect responses preserve the nurse-patient relationship with the silent patient but
may seem abrupt to the interrupting patient, abandon the silent patient, or fail to
observe the contract with the silent patient.
Termination of a therapeutic nurse-patient relationship has been successful when
the nurse
a. avoids upsetting the patient by shifting focus to other patients before the
discharge.
b. gives the patient a personal telephone number and permission to call after
discharge.
c. discusses with the patient changes that happened during the relationship and
evaluates outcomes.
d. offers to meet the patient for coffee and conversation three times a week after
discharge.
C
Summarizing and evaluating progress help validate the experience for the patient and
the nurse and facilitate closure. Termination must be discussed; avoiding discussion by
spending little time with the patient promotes feelings of abandonment. Successful
termination requires that the relationship be brought to closure without the possibility of
dependency-producing ongoing contact.
What is the desirable outcome for the orientation stage of a nurse-patient
relationship? The patient will demonstrate behaviors that indicate
a. self-responsibility and autonomy.
b. a greater sense of independence.
c. rapport and trust with the nurse.
d. resolved transference.
C
Development of rapport and trust is necessary before the relationship can progress to
the working phase. Behaviors indicating a greater sense of independence, self-
responsibility, and resolved transference occur in the working phase.
During which phase of the nurse-patient relationship can the nurse anticipate that
identified patient issues will be explored and resolved?
a. Preorientation
b. Orientation
c. Working
d. Termination
C
During the working phase, the nurse strives to assist the patient in making connections
, among dysfunctional behaviors, thinking, and emotions and offers support while
alternative coping behaviors are tried.
At what point in the nurse-patient relationship should a nurse plan to first
address termination?
a. During the orientation phase
b. At the end of the working phase
c. Near the beginning of the termination phase
d. When the patient initially brings up the topic
A
The patient has a right to know the conditions of the nurse-patient relationship. If the
relationship is to be time-limited, the patient should be informed of the number of
sessions. If it is open-ended, the termination date will not be known at the outset, and
the patient should know that the issue will be negotiated at a later date. The nurse is
responsible for bringing up the topic of termination early in the relationship, usually
during the orientation phase.
A nurse introduces the matter of a contract during the first session with a new
patient because contracts
a. specify what the nurse will do for the patient.
b. spell out the participation and responsibilities of each party.
c. indicate the feeling tone established between the participants.
d. are binding and prevent either party from prematurely ending the relationship.
B
A contract emphasizes that the nurse works with the patient rather than doing
something for the patient. "Working with" is a process that suggests each party is
expected to participate and share responsibility for outcomes. Contracts do not,
however, stipulate roles or feeling tone, and premature termination is forbidden.
As a nurse escorts a patient being discharged after treatment for major
depression, the patient gives the nurse a necklace with a heart pendant and says,
"Thank you for helping mend my broken heart." Which is the nurse's best
response?
a. "Accepting gifts violates the policies and procedures of the facility."
b. "I'm glad you feel so much better now. Thank you for the beautiful necklace."
c. "I'm glad I could help you, but I can't accept the gift. My reward is seeing you
with a renewed sense of hope."
d. "Helping people is what nursing is all about. It's rewarding to me when patients
recognize how hard we work."
C
Accepting a gift creates a social rather than therapeutic relationship with the patient and
blurs the boundaries of the relationship. A caring nurse will acknowledge the patient's
Chapters: 1-9 Questions With 100%
Pass
A nurse assesses a confused older adult. The nurse experiences sadness and
reflects, "This patient is like one of my grandparents ... so helpless."
Which response is the nurse demonstrating?
a. Transference
b. Countertransference
c. Catastrophic reaction
d. Defensive coping reaction
B
Countertransference is the nurse's transference or response to a patient that is based
on the nurse's unconscious needs, conflicts, problems, or view of the world. See
relationship to audience response question.
Which statement shows a nurse has empathy for a patient who made a suicide
attempt?
a. "You must have been very upset when you tried to hurt yourself."
b. "It makes me sad to see you going through such a difficult experience."
c. "If you tell me what is troubling you, I can help you solve your problems."
d. "Suicide is a drastic solution to a problem that may not be such a serious
matter."
A
Empathy permits the nurse to see an event from the patient's perspective, understand
the patient's feelings, and communicate this to the patient. The incorrect responses are
nurse-centered (focusing on the nurse's feelings rather than the patient's), belittling, and
sympathetic.
After several therapeutic encounters with a patient who recently attempted
suicide, which occurrence should cause the nurse to consider the possibility of
countertransference?
a. The patient's reactions toward the nurse seem realistic and appropriate.
b. The patient states, "Talking to you feels like talking to my parents."
c. The nurse feels unusually happy when the patient's mood begins to lift.
d. The nurse develops a trusting relationship with the patient.
,C
Strong positive or negative reactions toward a patient or over-identification with the
patient indicate possible countertransference. Nurses must carefully monitor their own
feelings and reactions to detect countertransference and then seek supervision.
Realistic and appropriate reactions from a patient toward a nurse are desirable. One
incorrect response suggests transference. A trusting relationship with the patient is
desirable. See relationship to audience response question.
A patient says, "Please don't share information about me with the other people."
How should the nurse respond?
a. "I will not share information with your family or friends without your
permission, but I will share information about you with other staff."
b. "A therapeutic relationship is just between the nurse and the patient. It is up to
you to tell others what you want them to know."
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 others."
d. "I cannot tell anyone about you. It will be as though I am talking about my own
problems, and we can help each other by keeping it between us."
A
A patient has the right to know with whom the nurse will share information and that
confidentiality will be protected. Although the relationship is primarily between the nurse
and patient, other staff needs to know pertinent data. The other incorrect responses
promote incomplete disclosure on the part of the patient, require daily renegotiation of
an issue that should be resolved as the nurse-patient contract is established, and
suggest mutual problem solving. The relationship must be patient centered. See
relationship to audience response question.
A nurse is talking with a patient, and 5 minutes remain in the session. The patient
has been silent most of the session. Another patient comes to the door of the
room, interrupts, and says to the nurse, "I really need to talk to you." The nurse
should
a. invite the interrupting patient to join in the session with the current patient.
b. say to the interrupting patient, "I am not available to talk with you at the
present time."
c. end the unproductive session with the current patient and spend time with the
interrupting patient.
d. tell the interrupting patient, "This session is 5 more minutes; then I will talk
with you."
D
When a specific duration for sessions has been set, the nurse must adhere to the
schedule. Leaving the first patient would be equivalent to abandonment and would
destroy any trust the patient had in the nurse. Adhering to the contract demonstrates
,that the nurse can be trusted and that the patient and the sessions are important. The
incorrect responses preserve the nurse-patient relationship with the silent patient but
may seem abrupt to the interrupting patient, abandon the silent patient, or fail to
observe the contract with the silent patient.
Termination of a therapeutic nurse-patient relationship has been successful when
the nurse
a. avoids upsetting the patient by shifting focus to other patients before the
discharge.
b. gives the patient a personal telephone number and permission to call after
discharge.
c. discusses with the patient changes that happened during the relationship and
evaluates outcomes.
d. offers to meet the patient for coffee and conversation three times a week after
discharge.
C
Summarizing and evaluating progress help validate the experience for the patient and
the nurse and facilitate closure. Termination must be discussed; avoiding discussion by
spending little time with the patient promotes feelings of abandonment. Successful
termination requires that the relationship be brought to closure without the possibility of
dependency-producing ongoing contact.
What is the desirable outcome for the orientation stage of a nurse-patient
relationship? The patient will demonstrate behaviors that indicate
a. self-responsibility and autonomy.
b. a greater sense of independence.
c. rapport and trust with the nurse.
d. resolved transference.
C
Development of rapport and trust is necessary before the relationship can progress to
the working phase. Behaviors indicating a greater sense of independence, self-
responsibility, and resolved transference occur in the working phase.
During which phase of the nurse-patient relationship can the nurse anticipate that
identified patient issues will be explored and resolved?
a. Preorientation
b. Orientation
c. Working
d. Termination
C
During the working phase, the nurse strives to assist the patient in making connections
, among dysfunctional behaviors, thinking, and emotions and offers support while
alternative coping behaviors are tried.
At what point in the nurse-patient relationship should a nurse plan to first
address termination?
a. During the orientation phase
b. At the end of the working phase
c. Near the beginning of the termination phase
d. When the patient initially brings up the topic
A
The patient has a right to know the conditions of the nurse-patient relationship. If the
relationship is to be time-limited, the patient should be informed of the number of
sessions. If it is open-ended, the termination date will not be known at the outset, and
the patient should know that the issue will be negotiated at a later date. The nurse is
responsible for bringing up the topic of termination early in the relationship, usually
during the orientation phase.
A nurse introduces the matter of a contract during the first session with a new
patient because contracts
a. specify what the nurse will do for the patient.
b. spell out the participation and responsibilities of each party.
c. indicate the feeling tone established between the participants.
d. are binding and prevent either party from prematurely ending the relationship.
B
A contract emphasizes that the nurse works with the patient rather than doing
something for the patient. "Working with" is a process that suggests each party is
expected to participate and share responsibility for outcomes. Contracts do not,
however, stipulate roles or feeling tone, and premature termination is forbidden.
As a nurse escorts a patient being discharged after treatment for major
depression, the patient gives the nurse a necklace with a heart pendant and says,
"Thank you for helping mend my broken heart." Which is the nurse's best
response?
a. "Accepting gifts violates the policies and procedures of the facility."
b. "I'm glad you feel so much better now. Thank you for the beautiful necklace."
c. "I'm glad I could help you, but I can't accept the gift. My reward is seeing you
with a renewed sense of hope."
d. "Helping people is what nursing is all about. It's rewarding to me when patients
recognize how hard we work."
C
Accepting a gift creates a social rather than therapeutic relationship with the patient and
blurs the boundaries of the relationship. A caring nurse will acknowledge the patient's
