Ch. 5: Relationship Development &
Therapeutic Communication test bank
1) What is the most essential task for a nurse to accomplish prior to forming a
therapeutic relationship with a client?
1. Clarify personal attitudes, values, and beliefs.
2. Obtain thorough assessment data.
3. Determine the clients length of stay.
4. Establish personal goals for the interaction. - ANS ANS: 1
Rationale: The most essential task for a nurse to accomplish prior to forming a therapeutic
relationship with a client is to clarify personal attitudes, values, and beliefs. Understanding ones
own attitudes, values, and beliefs is called self-awareness.
2) If a client demonstrates transference toward a nurse, how should the nurse respond?
1. Promote safety and immediately terminate the relationship with the client.
2. Encourage the client to ignore these thoughts and feelings.
3. Immediately reassign the client to another staff member.
4. Help the client to clarify the meaning of the relationship, based on the present
situation. - ANS ANS: 4
Rationale: The nurse should respond to a clients transference by clarifying the meaning of the
nurse-client relationship based on the present situation. Transference occurs when the client
unconsciously displaces feelings about a person from the past toward the nurse. The nurse
should assist the client in separating the past from the present.
3) What should be the priority nursing action during the orientation (introductory)
phase of the nurse-client relationship?
1. Acknowledge the clients actions and generate alternative behaviors.
2. Establish rapport and develop treatment goals.
3. Attempt to find alternative placement.
4. Explore how thoughts and feelings about this client may adversely impact nursing care. -
ANS ANS: 2
Rationale: The priority nursing action during the orientation phase of the nurse-client
relationship should be to establish rapport and develop treatment goals. Rapport implies
feelings on the part of both the nurse and the client, based on respect, acceptance, a sense of
trust, and a nonjudgmental attitude. It is the essential foundation of the nurse-client relationship.
4) Which client action should a nurse expect during the working phase of the nurse-
client relationship?
1. The client gains insight and incorporates alternative behaviors.
2. The client establishes rapport with the nurse and mutually develops treatment goals.
3. The client explores feelings related to reentering the community.
, 4. The client explores personal strengths and weaknesses that impact behavioral choices. -
ANS ANS: 1
Rationale: The nurse should expect that that the client will gain insight and incorporate
alternative behaviors during the working phase of the nurse-client relationship. The client may
also overcome resistance, problem-solve, and continually evaluate progress toward goals.
5) Which client statement should a nurse identify as a typical response to stress
most often experienced in the working phase of the nurse-client relationship?
1. I cant bear the thought of leaving here and failing.
2. I might have a hard time working with you, because you remind me of my mother.
3. I really dont want to talk any more about my childhood abuse.
4. Im not sure that I can count on you to protect my confidentiality. - ANS ANS: 3
Rationale: The nurse should identify that the client statement, I really dont want to talk any more
about my childhood abuse, reflects that the client is in the working phase of the nurse-client
relationship. The working phase includes overcoming resistance behaviors on the part of the
client as the level of anxiety rises in response to discussion of painful issues.
6) A mother who is notified that her child was killed in a tragic car accident states, I cant bear
togo on with my life. Which nursing statement conveys empathy?
1. This situation is very sad, but time is a great healer.
2. You are sad, but you must be strong for your other children.
3. Once you cry it all out, things will seem so much better.
4. It must be horrible to lose a child, and Ill stay with you until your husband arrives. - ANS
ANS: 4
Rationale: The nurses response, It must be horrible to lose a child, and Ill stay with you until
your husband arrives, conveys empathy to the client. Empathy is the ability to see the situation
from the clients point of view. Empathy is considered to be one of the most important
characteristics of the therapeutic relationship.
7) When an individual is two-faced, which characteristic essential to the development of a
therapeutic relationship should a nurse identify as missing?
1. Respect
2. Genuineness
3. Sympathy
4. Rapport - ANS ANS: 2
Rationale: When an individual is two-faced, which means double-dealing or deceitful, the nurse
should identify that genuineness is missing in the relationship. Genuineness refers to the nurses
ability to be open and honest and maintain congruence between what is felt and what is
communicated. When a nurse fails to bring genuineness to the relationship, trust cannot be
established.
8) On which task should a nurse place priority during the working phase of relationship
development?
1. Establishing a contract for intervention
Therapeutic Communication test bank
1) What is the most essential task for a nurse to accomplish prior to forming a
therapeutic relationship with a client?
1. Clarify personal attitudes, values, and beliefs.
2. Obtain thorough assessment data.
3. Determine the clients length of stay.
4. Establish personal goals for the interaction. - ANS ANS: 1
Rationale: The most essential task for a nurse to accomplish prior to forming a therapeutic
relationship with a client is to clarify personal attitudes, values, and beliefs. Understanding ones
own attitudes, values, and beliefs is called self-awareness.
2) If a client demonstrates transference toward a nurse, how should the nurse respond?
1. Promote safety and immediately terminate the relationship with the client.
2. Encourage the client to ignore these thoughts and feelings.
3. Immediately reassign the client to another staff member.
4. Help the client to clarify the meaning of the relationship, based on the present
situation. - ANS ANS: 4
Rationale: The nurse should respond to a clients transference by clarifying the meaning of the
nurse-client relationship based on the present situation. Transference occurs when the client
unconsciously displaces feelings about a person from the past toward the nurse. The nurse
should assist the client in separating the past from the present.
3) What should be the priority nursing action during the orientation (introductory)
phase of the nurse-client relationship?
1. Acknowledge the clients actions and generate alternative behaviors.
2. Establish rapport and develop treatment goals.
3. Attempt to find alternative placement.
4. Explore how thoughts and feelings about this client may adversely impact nursing care. -
ANS ANS: 2
Rationale: The priority nursing action during the orientation phase of the nurse-client
relationship should be to establish rapport and develop treatment goals. Rapport implies
feelings on the part of both the nurse and the client, based on respect, acceptance, a sense of
trust, and a nonjudgmental attitude. It is the essential foundation of the nurse-client relationship.
4) Which client action should a nurse expect during the working phase of the nurse-
client relationship?
1. The client gains insight and incorporates alternative behaviors.
2. The client establishes rapport with the nurse and mutually develops treatment goals.
3. The client explores feelings related to reentering the community.
, 4. The client explores personal strengths and weaknesses that impact behavioral choices. -
ANS ANS: 1
Rationale: The nurse should expect that that the client will gain insight and incorporate
alternative behaviors during the working phase of the nurse-client relationship. The client may
also overcome resistance, problem-solve, and continually evaluate progress toward goals.
5) Which client statement should a nurse identify as a typical response to stress
most often experienced in the working phase of the nurse-client relationship?
1. I cant bear the thought of leaving here and failing.
2. I might have a hard time working with you, because you remind me of my mother.
3. I really dont want to talk any more about my childhood abuse.
4. Im not sure that I can count on you to protect my confidentiality. - ANS ANS: 3
Rationale: The nurse should identify that the client statement, I really dont want to talk any more
about my childhood abuse, reflects that the client is in the working phase of the nurse-client
relationship. The working phase includes overcoming resistance behaviors on the part of the
client as the level of anxiety rises in response to discussion of painful issues.
6) A mother who is notified that her child was killed in a tragic car accident states, I cant bear
togo on with my life. Which nursing statement conveys empathy?
1. This situation is very sad, but time is a great healer.
2. You are sad, but you must be strong for your other children.
3. Once you cry it all out, things will seem so much better.
4. It must be horrible to lose a child, and Ill stay with you until your husband arrives. - ANS
ANS: 4
Rationale: The nurses response, It must be horrible to lose a child, and Ill stay with you until
your husband arrives, conveys empathy to the client. Empathy is the ability to see the situation
from the clients point of view. Empathy is considered to be one of the most important
characteristics of the therapeutic relationship.
7) When an individual is two-faced, which characteristic essential to the development of a
therapeutic relationship should a nurse identify as missing?
1. Respect
2. Genuineness
3. Sympathy
4. Rapport - ANS ANS: 2
Rationale: When an individual is two-faced, which means double-dealing or deceitful, the nurse
should identify that genuineness is missing in the relationship. Genuineness refers to the nurses
ability to be open and honest and maintain congruence between what is felt and what is
communicated. When a nurse fails to bring genuineness to the relationship, trust cannot be
established.
8) On which task should a nurse place priority during the working phase of relationship
development?
1. Establishing a contract for intervention
