Nurse-Client Relationships Flashcards

A community health nurse has provided care to a client for several months. The client's health goals have been met, and services are being discontinued. According to the CNO's Therapeutic Nurse-Client Relationship standard, which action is essential during the termination phase of the relationship?

Answer: Reviewing the client's progress and summarizing the goals achieved together.

The termination phase is a planned and professional conclusion to the nurse-client relationship. It involves summarizing the client's progress, evaluating the achievement of goals, and ensuring a smooth transition to other services or to self-care. This provides closure and reinforces the client's accomplishments.

A nurse is caring for a client newly diagnosed with a chronic illness who expresses feeling overwhelmed and alone. The nurse also has the same chronic illness. When considering the use of self-disclosure, what is the nurse's primary consideration?

Answer: Whether the disclosure will serve a therapeutic purpose for the client.

The CNO standards emphasize that self-disclosure should be used cautiously and only when it serves the client's therapeutic needs. The primary goal is to benefit the client by, for example, instilling hope or normalizing their experience, not to meet the nurse's own needs for connection or validation.

A client is hesitant to ask questions about their diagnosis, stating, "You're the expert, I don't want to bother you." How should the nurse best respond to address the inherent power imbalance in this therapeutic relationship?

Answer: Acknowledge the client's feelings and create a safe, collaborative environment for them to ask questions.

The nurse-client relationship has an unequal power dynamic. The nurse's role is to empower the client and promote a partnership. Acknowledging the client's feelings validates their concern, while explicitly inviting questions creates a safe space for collaboration and shared decision-making, thereby reducing the power imbalance.

Which of the following is the best example of appropriate professional intimacy within a nurse-client relationship?

Answer: Gently holding a distressed client's hand while providing emotional support.

Professional intimacy involves the psychological, spiritual, and physical aspects of care that create closeness but remain within professional boundaries. Holding a hand for comfort is a therapeutic action that serves the client's emotional needs, whereas the other options cross into a personal or social relationship.

The CNO standards identify empathy as a key component of the therapeutic nurse-client relationship. How is empathy best described in this context?

Answer: Understanding the client's perspective and communicating that understanding back to them.

Empathy is the ability to understand what the client is experiencing from their point of view and to reflect that understanding back to them. This validates the client's feelings without the nurse taking on those feelings, which would be sympathy.

A client in a long-term care facility asks a nurse for their personal social media profile to connect online. What is the nurse's most appropriate initial action to maintain professional boundaries?

Answer: Gently explain that their relationship is professional, not personal, and therefore decline the request.

Maintaining professional boundaries is the nurse's responsibility. This response is direct, respectful, and clearly reinforces the professional nature of the relationship without being punitive. It educates the client on the boundaries of the therapeutic relationship while protecting the nurse's privacy and professional integrity.