D)

1.The client says to the nurse, I feel really close to you. You are the only true friend I
have. The most therapeutic response the nurse can make is,
I am sure there are other people in your life who are your friends; besides, we just
met.
It makes me feel good that you trust me so much; it is important for the work we
are doing together.
Since ours is a professional relationship, let's explore other opportunities in your
life for friendship.
We are not friends. This is strictly professional.

A)
B)
C)
D)

2.A client who had been in a substance abuse treatment program asks the nurse for a date
after the client is discharged. The nurse talks to the client about the importance of a
therapeutic relationship and its characteristics. The nurse is using which of the following
techniques?
Defining boundaries
Defining therapy
Letting the client down gently
Reprimanding the client

A)
B)
C)
D)

3.One of the primary differences between social and therapeutic relationships is the
Amount of emotion invested
Degree of satisfaction obtained
Kind of information given
Type of responsibility involved

A)
B)
C)
D)

4.A nurse is assigned to care for a client whose sexual orientation differs from her own. She
would need to seek clinical supervision if she attempted to
Assist the client to change values
Discuss her feelings about the client with a supervisor
Empathize with the client
Identify anxieties regarding the client's values and sexuality

A)
B)
C)
D)

5.The nurse initiating a therapeutic relationship with a client should explain the purpose,
which is to
Alleviate stressors in life
Become stabilized on medications
Establish relationships
Facilitate a positive change

A)
B)

6.Which of the following is the essential component the nurse must bring to the therapeutic
nurseclient relationship?
Confrontation
Empathy

A)
B)
C)

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C)
D)

Humor
Reframing

A)
B)
C)
D)

7.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
Confrontation
Countertransference
Incongruence
Transference

A)
B)
C)
D)

8.Which of the following statements is true about a nurse's self-disclosure?

It is the basis for effective communication.
Self-disclosure should be used with all clients to some degree.
The more the nurse discloses, the more the client will disclose.
Self-disclosure on the nurse's part should benefit the client.

A)
B)
C)
D)

9.During a regular home health visit to an elderly client, the nurse observes that the client
has feelings of hopelessness and despair. The client says, I'm old, and my life has no
purpose anymore. But promise me you won't tell anyone. How should the nurse
respond?
Don't worry, I won't tell anyone else.
I'm sorry, but I can't keep that kind of secret.
Let's talk about something to cheer you up.
What can we do to help you feel better?

A)
B)
C)
D)

10.During the working phase of a therapeutic relationship, which of the following actions by
the nurse would best help the client to explore problems?
Comparing past and present coping strategies
Encouraging the client to clarify feelings and behavior
Identifying possible solutions for the client's problems
Referring the client to a self-help group

A)
B)
C)
D)

11.Which of the following is a standard for establishing a code of conduct for living?
Acceptance
Empathy
Values
Positive regard
12.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

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A)
B)
C)
D)

nurse can best show empathy through which of the following responses?
I feel so bad for what you are going through.
You feel like your world is falling apart right now.
I have been divorced too. I know how hard it is.
It will get better, lets talk about it.

A)
B)
C)
D)

13.The nurse is working with a patient who has quit several jobs and no longer sends
financial support to his two children living with their mother. This behavior is in conflict
with the nurses values concerning responsible parenting. When discussing family roles
with the patient, the nurse shows positive regard through which statement?
How is not working right now affecting you?
How do you expect your kids to be provided for?
You need to somehow find a way to support your children.
Can the childrens mother can get by for a while until you get better?

A)
B)
C)
D)

14.A nurse makes the statement in a treatment team meeting, Its not worth it to try to teach
this patient how to make better choices. He has been here many times before and goes
back home and does the same thing. The nurse is sharing which of the following?
Value
Awareness
Belief
Attitude

A)
B)
C)
D)

15.When preparing for the first clinical experience with patients on a forensic unit at a
psychiatric hospital, the nursing instructor discusses students beliefs and fears
surrounding forensic patients. The primary reason for discussing personal beliefs is to:
practice reflective communication skills in a role play situation.
assign the most compatible patients to the students.
assess the appropriateness of the setting for implementing nursing skills.
become aware of possible barriers to developing therapeutic relationships.

A)
B)
C)
D)

16.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:
Can this person understand me?
Do I understand this patients expectations of me?
What experiences do I have with people with similar backgrounds?
Is this person going to be able to relate to me?
17.The nurse fails to assess personal values surrounding homosexuality before caring for a
patient that is openly gay. The nurse is most at risk for which of the following when
working with this patient?

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A)
B)
C)
D)

Holding a prejudice toward this patient.

Neglecting to include the patients desires in the plan of care.
Being manipulated by this patient.
Expressing shock when assessing the patients history.

A)
B)
C)
D)

18.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?
The nurse conceals personal information about himself
The nurse needs to increase insight into his own characteristics
The nurse is open to others
The patient is sharing more than the nurse in the therapeutic relationship

A)
B)
C)
D)

19.A nurse notices a patient sitting quietly alone, eyes downcast and looking sad. The nurse
says to the patient, You look like something is bothering you. Which pattern of
knowing did the nurse use to respond to the patient?
Empirical knowing
Personal knowing
Ethical knowing
Aesthetic knowing

A)
B)
C)
D)

20.The nurse assesses fine hand tremors in a patient with a history of heavy alcohol use. If
the nurse understands that the tremors are a direct result of alcohol use, the nurse is using
which pattern of knowing, according to Carper?
Aesthetic knowing
Ethical knowing
Personal knowing
Empirical knowing

A)
B)
C)
D)

21.A nurse to openly admits to not being able to relate to a patients experience. According
to Munhall, this will most likely have what influence on the therapeutic relationship?
The nurse will avoid imposing any values on the patient
The patient will not trust the nurses professional abilities
The nurse will more likely be manipulated by the patient
The patient will be less likely to self-disclose to the nurse

22.The nurse and patient are visiting about upcoming sporting events of which they both
share an interest. This form of interaction has the potential to threaten the nurse-patient
relationship by:
A)
influencing whether the patient likes the nurse or not.

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B)
C)
D)

avoiding serious work that can help the patient change.

lets the patient know that the nurse is genuine with diverse interests.
overstepping ethical boundaries that the nurse should maintain

A)
B)
C)
D)
E)

23.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):
offering sound advice to the patient.
establishing boundaries for both the nurse and patient.
maintaining a patient-focus at all times.
sharing personal feelings openly with the patient.
avoiding concern with whether the patient likes the nurse.

A)
B)
C)
D)
E)

24.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)
Exploring perceptions of reality
Promoting a positive self-concept
Explaining the boundaries of the relationship
Working through resistance
Assisting in identifying problems

A)
B)
C)
D)

25.During the orientation phase of the nurse-patient relationship, the nurse directs the patient
to do which of the following?
Identify problems to examine
Express needs and feelings
Develop interpersonal skills
Identify self-care strategies

A)
B)
C)
D)
E)

26.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)
Exploring perceptions of reality
Promoting a positive self-concept
Explaining the boundaries of the relationship
Working through resistance
Assisting in identifying problems
27.A patient being discharged appears angry with the nurse when she attempts to review

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D)

discharge instructions with the patient. The nurse can best assist the patient in this stage
of the relationship with which of the following responses?
We have to go over these instructions before you can go. Please try to listen.
Would you rather not be discharged today?
I can sense you are angry this morning. Tell me how you feel about being
discharged today.
You should be able to regulate your feelings better by now. Why are you angry?

A)
B)
C)
D)

28.Which of the following occurrences is considered a breach of professional boundaries?

Patient asking a nurse for her phone number
Refusing a gift from a patient
Changing the subject in response to a patient complement
Having a lengthy social conversation with a patient

A)
B)
C)
D)

29.A nurse and patient have just completed reviewing the patients take-home medications.
The nurse is exemplifying which role during this intervention?
Advocate
Caregiver
Teacher
Parent Surrogate

A)
B)
C)
D)

30.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:
Advocate
Caregiver
Teacher
Parent Surrogate

A)
B)
C)

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Answer Key
1.C
2.A
3.D
4.A
5.D
6.B
7.D
8.D
9.B
10.B
11.C
12.D
13.A
14.D
15.D
16.C
17.A
18.C
19.B
20.D
21.A
22.B
23.B, C, E
24.A, B, D
25.A
26.A, B, D
27.C
28.D
29.C
30.D

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